Intended for healthcare professionals

Feature Competing Interests

Independence of nutritional information?

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c1438 (Published 22 March 2010) Cite this as: BMJ 2010;340:c1438
  1. Phil Chamberlain, freelance journalist
  1. 1Colerne, Wiltshire
  1. phil-chamberlain{at}uk2.net

    The British Nutrition Foundation promotes itself as a source of impartial information, but as Phil Chamberlain reports, it does not always make its links with industry clear

    Next month the British Nutrition Foundation is hosting a one day conference looking at the science of low calorie sweeteners and aiming to “separate fact from fiction.”

    The event’s promotional web page contains all the key messages that the foundation uses about itself: it is objective and evidence based, is about how to use products appropriately, promotes consumer choice, and appeals to all those engaged in food and public health policy.1

    The web page doesn’t say, though the information is elsewhere on the foundation’s website,2 that the foundation is financially supported by Tate & Lyle, British Sugar, Ajinomoto (which makes Aminosweet), and McNeil Consumer Nutritionals (which makes Splenda sweetener). One of the participants in the panel discussion will be Tom Sanders, head of the nutritional sciences department at King’s College London, which has received millions from sugar company Tate & Lyle .3

    In February the foundation put out a press release saying people could shake off the winter blues by drinking more fluids.4 It didn’t say that funders include Danone (producers of Evian, Volvic, and Badoit bottled water), Coca-Cola, Pepsi, Innocent drinks, Twinings, Nestlé, and various yoghurt drink manufacturers,2 although a footnote at the end does mention the food industry as one of the foundation’s funding sources.

    Funding and independence

    For public health and food policy campaigners this merry go round of donation, publicity, and influence has been a source of concern since the foundation was formed more than 40 years ago. However, in the tightly knit world of nutrition, where people in food companies, non-governmental organisations, academia, and the government know each other and often have to work together, few wish to voice such criticism publicly. The amount of food industry money sloshing around means few researchers haven’t taken funds, and most would say that it has not compromised their scientific independence.

    Joe Harvey, from the Health Education Trust, a charity promoting the development of health education for young people in the UK, offers a contrary view.

    “In my opinion organisations like the British Nutrition Foundation, which want to be seen as offering independent advice and materials, should avoid donations from the food industry or be much more up front about them so the public are aware of the involvement,” he says. “At best it is naive to take industry money and believe there is no quid pro quo. At the very least food companies are able to use such donations to clean up their public image and give themselves enhanced credibility.”

    The British Nutrition Foundation says it “promotes the wellbeing of society through the impartial interpretation and effective dissemination of scientifically based knowledge and advice on the relationship between diet, physical activity and health.”5 This perception of independence and scientific rigour is crucial because it allows the foundation to weave strong links with the government and present itself as a disinterested commentator to the media.

    The fact is that the organisation’s membership is a roll call of food industry stalwarts. The 39 members include producers such as Cadbury’s, Kellogg’s and Northern Foods, restaurants such as McDonalds and PizzaExpress, all the main supermarket chains apart from Tesco, and industry bodies such as the Potato Council.2

    The foundation emphasises that its funding comes from many different sources,6 though it is clear that industry support is vital. Paul Hebblethwaite, the chairman of the board of trustees, said in the 2008-9 annual report: “Their donations are of great importance to the foundation, and in particular support our charitable work with schools, consumers and health professionals.”6

    Sara Stanner, the foundation’s science programme manager, says, “The donations we receive from food and drink companies are used at ‘arms length’ and in a generic sense to supplement the funding we secure from the other sources.” She adds that,Our ability to protect our independence is strengthened by this diversity in funding and centres on our strong governance . . .  Strange as it may seem we are not pressurised, commercially or politically, to be selective in the repertoire of nutrition topics we address.”

    Many of the foundation’s staff move between the organisation and the food industry.7 Mr Hebblethwaite has had “a distinguished career in the food industry working for a number of major companies including Cadbury-Schweppes and Chivers-Hartley.”8 He is also chairman of the Biscuit, Cake, Chocolate and Confectionery Trade Association.8 The organisation’s board of trustees and oversight committees contain many current employees of the food industry as well as academics from various institutions.6 Former foundation staff include Gill Fine, the Food Standard Agency’s director of consumer choice and dietary health, who previously worked for Sainsbury’s.9

    Ms Stanner says, “Our view is that we are fortunate in attracting scientific staff of a very high calibre from all walks of human nutrition, which enriches the work we do and ensures we are able to provide a mature and balanced view on nutrition issues . . . . To ensure diversity in the expertise available among our Trustees, our Articles of Association state that not more than two of our Trustees (out of a total of 12) can be Industrial Governors (ie, from the food industry).”

    Educational role

    Members are served though regular briefings and invitation-only conferences as well as being able to draw on the foundation as a resource for literature, advice, and third party endorsement.

    For instance, the foundation contributed to arms length industry initiatives such as PhunkyFoods, a programme to promote healthy eating and physical activity among under 11s.10 PhunkyFoods is a wholly owned subsidiary of the private nutrition consultancy Purely Nutrition, and the programme is funded by Nestlé, Northern Foods, and Cargill. According to Northern Foods, the foundation contributed to the campaign’s teaching materials for schools.11

    The foundation’s website is also used by food companies who need to direct readers to what they can say is an independent source of information. Kraft has a healthy living website with a section on nutrition and useful links.12 The foundation is the top link, but nowhere is it mentioned that Kraft has been a financial supporter since at least 2004.13

    The government has contracted the foundation to produce educational materials. These include the Licence To Cook website for the Department for Children, Schools, and Families (www.licencetocook.org.uk), a recipe book for year 7 (11-12 year old) pupils,14 educating teachers about food technology,15 and a contract from the Food Standards Agency to help young people “engage with the core food competences.”6 Companies have been happy to fund these government projects run through the foundation.6

    Tim Lobstein, director of policy and programmes at the International Association for the Study of Obesity-International Obesity Task Force, said the organisation had produced several educational resources in the past that seemed to support industry messages. The foundation “did a big piece of work for the Food Standards Agency reviewing ‘influences on consumer food choices’ which conveniently left out any review of the influence of marketing and advertising techniques,” he said.16

    Oliver Tickell, from the Campaign Against Trans Fats in Food, looked at the documents the foundation had produced on his area of interest and came to a similar conclusion.

    “The first is a briefing sheet and is very balanced,17” he said. “The other is a submission to the Scottish parliament on a bill to limit trans fats, and essentially it says to do nothing.”18 Tickell says that this view coincides with that of the food industry, which doesn’t want to see regulation.

    Influence

    Its presence in Whitehall brings influence, and the foundation is overt about this saying: “Through active engagement with government, schools, industry, health professionals and journalists, we also aim to provide advice to help shape and support policy and to facilitate improvement in the diet and physical activity patterns of the population.”19

    In the foundation’s annual report, Ms Stanner, adds: “Some of our work has a direct effect on policy. For example, the Science Group carried out a systematic review of the effects of early life exposure to peanuts on risk of allergy, for the Food Standards Agency, the findings of which are feeding through to policy.”6

    However, historically, such influence has been far from benign. A World in Action documentary from 1985 quoted previous director general, Derek Shrimpton, saying: “In the period I was there the foundation was solely taken up with defence actions for the industry.” He said that the foundation had been constantly engaged in frustrating government committees aiming to recommend reductions in sugars, salt, and fats.20

    Meanwhile Ms Stanner can also be found on a Sainsbury’s website aimed at the parents of young children, where she is a resident expert on diet and nutrition.21 The website does not mention that Sainsbury’s funds the foundation.

    The foundation sees its communication role as key and aims to provide swift and expert advice to journalists, who often are not medical reporters but cover issues from a consumer point of view.6 In this it has carved a successful niche for itself.

    Several independent listing services aimed at patients and consumers, including Patient UK and netdoctor, repeat the group’s own description without mentioning its industry links.

    Meanwhile when it is quoted in the media it is most commonly without any other description. A LexisNexis search for British Nutrition Foundation references in UK newspapers in the past year returned 128 references. Only two mentioned that the foundation had industry funding.22 23

    Ms Stanner says “If we engage in any piece of project work that involves support from one of our member companies (or any other industry link), we always clearly acknowledge this.  In our experience, most people that we talk to are aware that we get funding from different sources, including industry and government.”

    But typical of the reporting was an article in the Independent when McDonalds said it was going to publish the nutritional content of its meals.24 The newspaper asked the foundation to assess popular takeaway meals, including that of McDonalds, which was given the worst health rating. The article did not mention that McDonalds funds the foundation.13

    Joanne Lunn, then a nutrition scientist at the foundation, was quoted by the paper saying: “These are large portions and it is not recommended that you eat high-fat meals such as these regularly. You should remember the adage, ‘There is no such thing as a bad food, only a bad diet.’”24

    The media seek out the British Nutrition Foundation as a ready source of authoritative comment on matters of nutrition and wider food policy. In return the foundation swiftly delivers succinct analysis in a language that suits its audience and does not offend either its partners in Whitehall or its paymasters in the food industry. It is a relationship that shows every sign of continuing.

    Notes

    Cite this as: BMJ 2010;340:c1438

    Footnotes

    • Competing interests: PC has completed the unified competing interest form at www.icmje.org/coi_disclosure.pdf (available on request from him) and declares (1) no financial support for the submitted work from anyone other than their  employer; (2) no financial relationships with commercial entities that might have an interest in the submitted work; (3) no spouses, partners, or children with relationships with commercial entities that might have an interest in the submitted work; and (4) no non-financial interests that may be relevant to the submitted work.

    References

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