Saving the culprit, shifting the blame.

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Heroes can save the world, but villains can change it.

- J. M. Frey

As an end consumer, or a reader, we believe what the authorities tell us. Their words have the power to drive the course of public health. And when someone is at such a high a position, a high degree of trust in them is expected. It's called the stage effect. Giving someone the authority to influence millions automatically increases trust in them, irrespective of them making sense.

So, when they come up with dietary guidelines for the entire country, people believed in them. Little did they know that the basis of these guidelines were research studies designed to satisfy the ego of scientists who were, many times, paid by lobbies who had direct interest in the results of the study and the power to drive it and come up with results favorable for them. One such manipulation happened in case sugar and Coronary Heart Disease. In this article, I make an attempt to outline the events that took place as the Sugar Research Foundation tried to drive the course of public health by manipulating facts and influencing scientists. Let's look at it -

The Timeline:

1954:

World war had ended a decade ago, and authorities noticed a rise in red meat consumption. Americans had started increasing their protein intake again. Coincidentally, there was a rise in diagnoses in Coronary Heart Disease (CHD) for the past 3 decades due to a few laws being updated (which I explained in detail in my blog Fat Phobia). While the research community was divided in two parts, one half blaming cholesterol and red meat for CHD, whereas the other half had data which shifted the concern to a rise in sugar consumption. That's when the Sugar Research Foundation (SRF) stepped in with an attempt to promote a low fat diet and increase profits for the sugar lobby. Henry Hass, the SRF president looked at this as an opportunity to promote sugar, by stating that if Americans were to reduce their saturated fat (ghee, cheese, butter, tallow, lard) by half, and fill those calories by carbohydrates, they can lower their cholesterol by keeping their sugar intake the same. They also ended up spending USD 6,00,000/- to teach people the importance of sugar (they made sure to say sugar and not glucose which is actually necessary for survival)

(ref. 1)

1962:

While the SRF was trying to prove that it's product was safe for consumption, evidence that sugar increases cholesterol and triglycerides (TGs) was surfacing. An American Medical Association council on Food and Nutrition Report found that the type of carbohydrates in a low carbohydrate diet can influence cholesterol. SRF’s vice-president and director of research, John Hickson, started monitoring this field closely .

1957-1964:

One of the pioneers of this research was John Yudkin. He had been constantly challenging studies which considered saturated fat as the only cause of CHD. Around this time, Ancel Key's seven country study was going on, and cholesterol had been blamed for CHD. John Yudkin noticed that it's not fat and cholesterol, but elevated blood glucose is better at predicting heart disease and sugar is a major cause of that.

1964:

John Hickson suggested that the SRF should start a program to counter any/all studies which show even the slightest of effect of sugar on incidence of CHD. He recommended SRF to fund CHD research - "There seems to be a question as to whether the [atherogenic] effects are due to the carbohydrate or to other nutrient imbalance. We should carefully review the reports, probably with a committee of nutrition specialists; see what weak points there are in the experimentation, and replicate the studies with appropriate corrections. Then we can publish the data and refute our detractors." (ref 2)

1965:

Fredric Stare, the chair of the Harvard University School of Public Health Nutrition Department joins SRF's scientific advisory board. Stare was an expert in dietary causes of CHD and agencies like the National Heart Institute and American Heart Association consulted him. This would have been considered suspicious as he had the power to set the nutritional goals of America but was getting paid by an industry which itself carried blame as the cause of CHD. His financial ties were not questioned until 1970s. With so much power on SRFs side, they had the ability to change the course of nutrition science, and they very well tried. However, there were some scientists who noticed the ill effects of sugar, and published some very strong evidence of sugar's effects on health.

July 1965:

A few articles linking sucrose (sugar) to CHD were published in Annals of Internal Medicine in June1965. Two articles showed that blood glucose levels are a better predictor of CHD, and not serum cholesterol. Other article demonstrated that sucrose aggravated hypertriglyceridemia, a state of elevated triglyceride levels, and it was a better predictor of CHD. It also emphasized that fructose component of sugar was mainly responsible. (ref. 3,4,5,6)

July 11, 1965:

Another editorial argued that these findings supported John Yudkin's research (the researcher who has been pointing this out since 1957), and that if elevated triglycerides were a predictor of CHD, sugar was the cause. New research strengthened the case against sugar.

July 13, 1965:

SRF funded a study named Project 226 and payed USD 6,500/- to Hegsted and Robert McGandy to review studies which show a connection between sugar/fructose and CHD. Most of the studies strengthened the connection between sugar and CHD, however there were occasions when Hickson emphasized that they were interested in studies relating sugar to CHD. You would think that the SRF wanted to find out about those studies to help solve the problem, however that wasn't the case as you'll understand in a while.

1967:

Project 226 was published on NEJM. Now, every time a new study is published, the authors are supposed to disclose who funded the study. In this case, they did, but, they did not disclose the funding received from the SRF. The study showed that sucrose increases serum cholesterol, and fructose component of sugar particularly increases TGs. It also compared the effects of complex carbohydrates, fat and starch on serum cholesterol and TGs when substituted for sugar. In summary, substituting sugar by fat and starch caused TGs to fall (most drop with fat, followed by starch) and complex carbs when substituted for sugar lowered cholesterol. They also found that substituting saturated fat with unsaturated fat lowered cholesterol. Now, there were arguments that high serum TGs indicated high chances of CHD. Cholesterol was a poor indicator. And substituting sugar out caused TGs to drop. This was bad news for SRF, so, as one of the funders of the study, they drove the researchers to not consider the studies which show any relation between sugar, TGs and CHD and deemed them irrelevant or infeasible. They only considered studies which measured cholesterol and CHD and ignored everything about TGs. Only 1 study showed that substituting unsaturated fat (vegetable oils) for saturated fat (like butter) dropped cholesterol and thus managed to keep the myth of 'serum cholesterol causes CHD' going on.

The SRF not only drove the review to prove their point, they only considered studies which showed that saturated fat increases cholesterol. Since cholesterol was blamed for heart disease, it was easy to keep it in the lime light. Triglycerides are raised by sugar, and are also a better predictors of CHD. This concept, being poorly supported by the researchers, couldn't get the air it deserved. SRF managed to hide the real indicator (TGs) and cause (sugar) and shifted the entire blame on saturated fat and it's increased consumption when meat consumption was just normalizing and the rise in CHD wasn't as significant as the numbers made it look.

This manipulation of scientific literature has cost us 70 years of ill health. Millions of people have lost their lives because some egoistic men wanted to be right and rich. This flawed science is believed even today. I have seen dietitians and health care professionals blabber how sugar and carbohydrates are necessary. The "have it in moderation" phrase is vague and unscientific which stems from trusting the studies with the best marketing, which are usually funded by such lobbies, and are influenced by people with vested interests. However, the good part is that there are some researchers who follow science instead of their gut. And more and more evidence is popping up exposing how certain lobbies have been manipulating studies. Whatever they tried to hide couldn't stay hidden because the consequences on public health were enormous. Questions were asked, answers were sought and conspiracies were unearthed.

I want to dedicate this post to public health, whistle blower scientists who follow actual science and You. Yes, you, who has the power to strengthen this force of attaining health. Do not blindly believe the authorities when it comes to nutrition. For if they were right, majority of us would not have been suffering from metabolic diseases. And a bigger majority wouldn't be overweight. So take the charge. It's about time we start taking responsibility of our own health. And if you need help, contact me. Until then -

Eat Good, Stay Strong, Live Free

Cheers,

Sushil Dhokne

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References:

1. Hass HB. What's new in sugar research. [Accessed October 10, 2015];Proceedings of the American Society of Sugar Beet Technologists. 1954 http://digitalcollections.qut.edu.au/1407/5/American_Society_of_Sugar_Beet_Technologists_1954_Part_1.pdf.

2. Sugar Industry and Coronary Heart Disease Research, A Historical Analysis of Internal Industry Documents. Cristin E. Kearns, DDS, MBA, Laura A. Schmidt, PhD, MSW, MPH, and Stanton A. Glantz, PhD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5099084/

3. Ostrander LD, Jr, Francis T, Jr, Hayner NS, Kjelsberg MO, Epstein FH. The relationship of cardiovascular disease to hyperglycemia. Ann Intern Med. 1965;62(6):1188–1198. https://pubmed.ncbi.nlm.nih.gov/14295501/

4. Epstein FH, Ostrander LD, Jr, Johnson BC, et al. Epidemiological studies of cardiovascular disease in a total community—Tecumseh, Michigan. Ann Intern Med. 1965;62(6):1170–1187. https://pubmed.ncbi.nlm.nih.gov/14295500/

5. Kuo PT, Bassett DR. Dietary sugar in the production of hyperglyceridemia. Ann Intern Med. 1965;62(6):1199–1212. https://pubmed.ncbi.nlm.nih.gov/14295502/

6. Albrink MJ. Carbohydrate metabolism in cardiovascular disease. Ann Intern Med. 1965;62(6):1330–1333. https://pubmed.ncbi.nlm.nih.gov/14295516/