Intended for healthcare professionals

Feature Sugar

Sugar: spinning a web of influence

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h231 (Published 11 February 2015) Cite this as: BMJ 2015;350:h231

Re: Sugar: spinning a web of influence

As a group of scientists working within academia, we were concerned by the implications of a commissioned feature suggesting industry should stop funding external research [1]. Universities are one of the best types of institution to carry out nutrition research. Academic researchers are interested in finding out the truth. If all universities refused to work with the food industry and the food industry carried out their own research without any collaboration with Universities, would this be a better situation? We think not. It would lead to more inferior research, greater potential for bias, and the decision to publish resting with the sponsor, potentially increasing publication bias.

Most journals have clear guidelines for declaring potential competing interests [2]. The guidelines specify that the funding body should have no role in the study design, analysis of the data or content of publication. Even freelance journalists commissioned by the BMJ declare their many competing interests. Yet it is this transparency that forms the basis of the criticism contained in the feature.

In addition to singling out individuals for criticism, simply because they follow best practice in declaring competing interests, the BMJ feature targeted the Carbohydrates working group of the government’s Scientific Advisory Committee on Nutrition (SACN). The feature failed to mention that the SACN committee commissioned their own independent research on carbohydrate and cardio-metabolic health, conducted by the University of Leeds, to inform their recommendations. As independent researchers we published our own separate findings and subjected them to further peer review in leading medical journals [3-6]. The SACN committee is comprised of some of the most active and competent researchers in nutrition research, and we query whether there is anyone at this senior level who would not be declaring some form of competing interest.

It is vital that nutritionists are a well regulated and recognised profession. Journalists should not get confused by those who call themselves ‘nutritionists’ following a short, non-accredited training programme, compared to degree level training from accredited courses. The Association for Nutrition [7] protects and benefits the public by defining and advancing standards of evidence-based practice across the field of nutrition. Furthermore, nutritionists can potentially lose their registration if found to have not upheld these professional qualities, offering further protection against bias.

In summary, we strongly believe that it is simply unrealistic to expect government to fund all research used to inform nutrition policy. Therefore, providing there are robust systems in place to ensure that nutritionists declare all potential conflicts of interests and that research and publishing processes are transparent, there should be no barrier to researchers seeking funding from any source.

References
1. Gornall J. Sugar – spinning a web of influence. BMJ 2015;350:h231
2. Good Publication Practice (GPP2, 2009) (http://www.ismpp.org/gpp2)
3. Threapleton DE, Greenwood DC, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 2013;347:f6879.
4. Greenwood DC, Threapleton DE, Evans CEL, Cleghorn CL, Nykjaer C, Woodhead C, et al. Glycemic Index, Glycemic Load, Carbohydrates, and Type 2 Diabetes: Systematic review and doseresponse meta-analysis of prospective studies. Diabetes Care 2013;36:4166-71.
5. Threapleton DE, Greenwood DC, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. Stroke 2013;44:1360-8.
6. Greenwood DC, Threapleton DE, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose-response meta-analysis of prospective studies. British Journal of Nutrition 2014;112:725-34.
7. Cade J, Eccles E, Hartwell H, Radford S, Douglas A, Milliner L. The making of a nutrition professional: the Association for Nutrition register. Public Health Nutrition 2012;1-8.

Competing interests: Competing interests to declare Dr Charlotte E L Evans has worked on government funded projects as well as projects funded by the Medical Research Council, Kelloggs, Warburtons and Kids Company charity. Dr Darren C Greenwood has worked on projects funded by government, Medical Research Council, WCRF, Kelloggs, Meat and Livestock Commission and Danone. Dr Victoria J Burley has worked on projects funded by government, WCRF, Medical Research Council, Kelloggs and Meat and Livestock Commission and the Sugar Bureau. Professor Janet E Cade is Registrar for the Association for Nutrition; and has worked on government funded projects as well as projects funded by the Medical Research Council, WCRF, National Prevention Research Initiative, Kelloggs, Meat and Livestock Commission and the Kids Company charity

17 February 2015
Charlotte EL Evans
Lecturer in nutritional epidemiology
Darren Greenwood, Victoria Burley, Janet Cade
University of Leeds
Woodhouse Lane, Leeds, LS2 9JT