alt Hacker NewsWhen this news first came out it was mind blowing, but at the same time I don't entirely get it.
So the money quote seems to be:
> The literature review heavily criticized studies linking sucrose to heart disease, while ignoring limitations of studies investigating dietary fats.
They paid a total of 2 people $50,000 (edit: in 2016 dollars).
That doesn't seem like enough to entirely shape worldwide discourse around nutrition and sugar. And the research was out there! Does everybody only read this single Harvard literature review? Does nobody read journals, or other meta studies, or anything? Did the researchers from other institutions whose research was criticized not make any fuss?
I guess the thing that I most don't get is it's now been 10 years since then, and I haven't seen any news about the link between sugar and CVD.
> There is now a considerable body of evidence linking added sugars to hypertension and cardiovascular disease
Okay, where is it? What are the conclusions? Is sugar actually contributing more than fat for CVD in most patients? Edit: Or, is the truth that fat really is the most significant, and sugar plays some role but it's strictly less?
Replies
> That doesn't seem like enough to entirely shape worldwide discourse around nutrition and sugar.
People are often surprised when they find out how little people sell out for. The going rate for a member of congress in 2015 was a little less [0] - about $43,000.
[0] https://truthout.org/articles/you-too-can-buy-a-congressman/
It's really good to ask these questions.
I'm not a medial researcher, but my impression is that many fields find it difficult to produce the robust high-level risk comparisons that you ask about. I.e. if you're looking at blood fats, even there you'll find many complicated contextual factors (age, sex, ethnicity, type of lipids i.e. LDL or lp(a) or ...?). The same might be the case for sugar. So it's not really easy/cheap to combine detailed state-of-the-art measurements of different causes into one randomized controlled trial.
As for the effects of sugar, I think there's some evidence that's not too hard to find, e.g. some meta analyses showing something around 10% increase in dose-dependent risk (RR ~ 1.10) [1,2]. A lot of the literature seems to be focused on beverages, e.g. this comparative cross-national study [3].
[1] https://jamanetwork.com/journals/jamainternalmedicine/fullar...
[2] https://www.sciencedirect.com/science/article/abs/pii/S08999...
This is just the time that we caught. Who knows how many more times it happened and wasn't caught?
> I guess the thing that I most don't get is it's now been 10 years since then, and I haven't seen any news about the link between sugar and CVD.
Perhaps this is more evidence that not everybody has been caught?
It's not like this is some isolated thing, like it's a documented fact that the food pyramid was shaped the way it was due to industry pressure.[1]
1 - Marion Nestle, Food Politics
They paid a total of 2 people...
That's not quite what TFA says. Rather:
"The UCSF researchers analyzed more than 340 documents, totaling 1,582 pages of text, between the sugar industry and two individuals...."
That is, this research (into industry influence) focused on the available and reviewed correspondence between the industry group and two specific researchers. There's nothing about this article or the referenced analysis which precludes additional other researchers being similarly influenced.
I don't know why this was re-posted today (kind of suspicious that this floats again after 10 year just by chance) anyway, there is a full citation-heavy book by Gary Taubes about this, and one of his points was that the sugar industry paid 2 million in 1970's dollars to create the nutrition department of Harvard, which was the first nutrition department in the world. (This was to say that nutrition science itself has been corrupt since its birth).
Good comment. Industry influencing research is nothing new (Global Warming, Oxycodone), and the dollar amount is small but it really doesn't take a lot of money to influence anyone. This case was interesting because they diverted attention to another contributor and influenced public policy against savory snacks; I remember the public health campaign against habitual daily consumption chips/crisps, without equally addressing chocolate bars: https://www.thetimes.com/travel/destinations/uk-travel/a-pac... And I'd also comment the ludicrous abstract comparison of drinking oil in a year. I wouldn't want to eat a football field of raw potato either. I do wonder how/why the Savory Snack industry didn't fire back, and why don't we have anything better than: are they both equally bad or is fat or salt worse.
> They paid a total of 2 people $50,000 (edit: in 2016 dollars). That doesn't seem like enough to entirely shape worldwide discourse around nutrition and sugar.
You would be astonished at how little it takes to bribe, I mean donate, to a politician for example. For as little as $10-20k USD you can get a literal seat at a table with a sitting senator or congresscritter for several hours at a "charity" dinner, with results as expected.
PR can be a lot of bang for your buck.
You could buy a house and a 69 Charger for $25K in the 60's with a tidy sum left over.
Or maybe the combination is the problem. I couldn’t consume much sugar on its own nor much cream but put the two together in ice cream and I could eat it all day long.
"Okay, where is it? What are the conclusions? Is sugar actually contributing more than fat for CVD in most patients?"
Depends on the type of fat, I think. From what I have found out myself, it is trans fats > sugars / simple carbohydrates > polyunsaturated fats > complex carbohydrates > monounsaturated fats > saturated fats.
Obesity really exploded when consumption shifted from butter towards margarine and vegetable oils: https://www.researchgate.net/figure/Trends-in-US-fat-consump...
If anything, consumption of monounsaturated and polyunsaturated fats is the issue: https://www.frontiersin.org/journals/nutrition/articles/10.3...
But of course, you also have to consider nature of food. In nature, you would consume either carbohydrates or fats - either plants or meat. But processed foods include a lot of fats and a lot of carbs in a single package. And that is the actual killer. Fats aren't an issue, carbs aren't that much of an issue, isssue is the nature of fats and carbs consumed, and issue is the way we consume them.
> They paid a total of 2 people $50,000.
In this specific case.
> They paid a total of 2 people $50,000 (edit: in 2016 dollars).
> That doesn't seem like enough to entirely shape worldwide discourse around nutrition and sugar.
A contradictory example where this does occur is in propaganda. Technology can be applied to maximize the reach and influence of otherwise inferior arguments at a fraction of the cost. A relatively small sequence of "shows" or "films" can disproportionately affect the world view of billions.
edit: The adoption of cigarettes across the world was affected by a significantly much smaller investment in ad placement compared to its global adoption and affects due to the reach and amplification "of technology".
> And the research was out there! Does everybody only read this single Harvard literature review? Does nobody read journals, or other meta studies, or anything? Did the researchers from other institutions whose research was criticized not make any fuss?
They did. But Ancel Keys, one of the bribed researchers, author of the infamous seven countries study that laid the groundwork against fat made it his life’s mission to discredit anyone who researched sugar. He effectively made the topic academic suicide. His primary target, that served as a warning example for others was his contemporary in the U.K. John Yudkin.
> I guess the thing that I most don't get is it's now been 10 years since then, and I haven't seen any news about the link between sugar and CVD.
Decades - not 10 years. The payment was made in the 1960's.
You're right to be skeptical, but:
> They paid a total of 2 people $50,000.
That's over half a million, in today's dollars.
With inflation, and whatnot, we get numb to what money was, back when.
communication before the internet was very slow.
Hype or getting viral is not necessarily science so its not clear when and how and why one paper suddenly becomes very known.
We know what sugar and others do, people are probably ignorant or not but its not billions are dead directly, people struggle a little bit more, the statistics number goes up. Now talk to anyone who likes to drink and eat that stuff everyday, do you think they care? no they do not.
Then you have the wrong people sponsoring this.
Fraud etc.
This is one of those where you need to be able to discern nuances in your brain as multiple things are happening.
First, identifying cause and effect of CVD is super hard, and there are lots of studies with various level of indications and in reality we're still far from understanding most of it. Even just the effects of fat and sugar on it isn't clear, and our understanding of fat itself, and all its types, and of sugars and all its types, even that's incomplete. And this makes it a perfect battle ground for grift and financial interests, because you can paint various narratives and cleverly build a case for it, since in reality so many possibilities are still on the table.
I think the conclusions that are on the stronger side are those that relate to medication and surgery. Blood pressure pills, statins, antiplatelet, coronary artery bypass, aortic valve replacement, etc.
When it comes to nutrition and other lifestyle changes, things are muddy. So instead you have "school of thoughts" and belief systems forms that often tie up with personal identity.
Second, you have financial interests meddling with research and messaging. A financial interest might want to mingle even if the research supports them, just not to take any chances. And if we found two cases of it, that's just those that were caught and proven, it's likely there's many more mingling then just that. Even if it doesn't end up proving things their way, you can assume all this mingling slows things down and makes figuring out the truth much harder and slower, which maintains the state of uncertainty for longer and that state is good for financial interests.
Lastly, it's not that we know nothing at all, and everything is just beliefs. There are a few things that have strong evidence repeatedly. We know that smoking, high blood pressure, plaque buildup, high lifetime LDL, clots, and diabetes/insulin resistance are all bad and lead to increase risks of CVD. And avoiding or lowering those, no matter how, helps reduce that risk. But it's not enough for most people that want to feel in control and believe they're living in a way that CVD won't happen to them. Which makes them vulnerable to grifters and various influencers.
Correction: they paid at least 2 people, at least $50,000.
Assuming this is true, it's a lower bound. What else has been tried?
I am only surprised this came out of UCSF and Robert Lustig's name is not on it, since it's often a topic in his books.
Maybe nutrition-health connection is more complex than can be shown by these early studies, and the big lobbying money only needs one study to get congressional support some putative scientific backing, the entire anti science funding arm of Congress uses one factoid about a shrimp treadmill for decades and the entire antivax movement is built on that widely discredited Wakefield paper. https://www.reuters.com/fact-check/shrimp-treadmill-study-co...
Anyways here's a recent study showing fat/sugar intake and nanoplastic correlation. https://www.inrae.fr/en/news/nanoplastics-have-diet-dependen...
> That doesn't seem like enough to entirely shape worldwide discourse around nutrition and sugar.
IDK, see the "BLOTS ON A FIELD?" by Science ("A neuroscience image sleuth finds signs of fabrication in scores of Alzheimer’s articles, threatening a reigning theory of the disease") or "The 60-Year-Old Scientific Screwup That Helped COVID Kill" by Wired (regarding the anti-scientific refusal to acknowledge it as airborne) for a couple of recent examples. Once underlying assumptions stop getting questioned, I think anything is at least possible.
> That doesn't seem like enough to entirely shape worldwide discourse around nutrition and sugar.
Check out the story of Andrew Wakefield. One financially motivated lie can spark wildfire.
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You’re exactly right: This one incident did not shape the entire body of scientific research.
There is a common trick used in contrarian argumentation where a single flaw is used to “debunk” an entire side of the debate. The next step, often implied rather than explicit, is to push the reader into assuming that the opposite position must therefore be the correct one. They don’t want you to apply the same level of rigor and introspection to the opposite side, though.
In the sugar versus saturated fat debate, this incident is used as the lure to get people to blame sugar as the root cause. There is a push to make saturated fat viewed as not only neutral, but healthy and good for you. Yet if you apply the same standards of rigor and inspection of the evidence, excess sugar and excess saturated fat are both not good for you.
There is another fallacy in play where people pushing these debates want you to think that there is only one single cause of CVD or health issues: Either sugar, carbs, fat, or something else. The game they play is to point the finger at one thing and imply that it gets the other thing off the hook. Don’t fall for this game.