Industry interference in nutrition science reaches into low and middle income countries

Medical journals, including The BMJ, are bringing greater attention to how funding from the food and beverage industry biases the evidence base in nutrition science. [1] Recent discussions of industry funding bias have largely focused on scientists in prestigious, mostly Western, academic institutions. However, the global footprint of food industry interference is far broader. In addition to exporting ultra-processed foods and beverages to low- and middle-income countries (LMICs), transnational food corporations are exporting Western strategies for funding science that undermines public health. Previously secret internal industry documents unearthed in the Food Industry Documents Library illustrate how this dynamic is unfolding in Colombia. 

In Colombia, where sugar-sweetened beverages are often cheaper than water, rates of sugar-sweetened beverage consumption are 79.2% in adults and 88.5% in minors. [2] In 2016, the health minister, Alejandro Gaviria Uribe, proposed a soda tax in response to rising obesity. Postobón, Colombia’s largest maker of sugar-sweetened beverages and distributor for PepsiCo, is part of a Colombian conglomerate that includes the nation’s largest media company. It successfully filed a consumer complaint prohibiting all media coverage of sugar and obesity and soda tax advocates were threatened into silence.4 Producers of sugar-sweetened beverages controlled media messaging on the soda tax by arguing that the country’s obesity epidemic was driven by physical inactivity, not hyper-processed foods and beverages. [3] The proposed soda tax failed.

Leading up to this, Colombian scientists had been quietly recruited by Coca-Cola. Internal industry documents reveal that by means of a subcontract agreement between Louisiana State University (LSU) Pennington Biomedical Research Center and the University of Los Andes, Bogotá (ULA), Coca-Cola paid ULA $199,500 USD over five years for Olga L. Sarmiento, professor in the Faculty of Medicine, to be the principal investigator along with LSU professor Peter Katzmarzyk, on the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), a study focused on how “lifestyle characteristics” in Colombian children, such as physical inactivity, impact obesity and weight gain. [4,5] Sarmiento and John Duperly, another professor at ULA, also feature on a list of academics who were invited by Coca-Cola to present research at a regional scientific conference in Rio de Janeiro, Brazil in April 2014,  and to raise awareness of the research in the media. [6-9]

Coca-Cola used scientists based in the US to recruit the Colombian scientists. Steven Blair (University of Pennsylvania) and John Peters (University of Colorado) were members of the Global Energy Balance Network (GEBN) which was exposed in 2015 by the New York Times as a scientific front group for Coca-Cola. [10] During the autumn of 2014, Blair and Peters helped Coca-Cola expand the GEBN’s reach into Colombia, using flyers through emails as “recruiting tools”. [11,12] Coca-Cola wanted a credible “honest broker” who “can be a reliable and trusted source for a balance[d] science based view” on physical inactivity as a driver of obesity. [13] The GEBN would “give everyone – academia, public health, private industry, government, and other interested stakeholders – a seat at the table” [emphasis added]. [13] They targeted Duperly noting that “diversity is imp[ortant]—beyond gender”. [11] By 2016, Duperly was publishing opinion pieces in leading Colombian newspapers that argued against the Health Minister’s soda tax proposal on the grounds of energy balance research. [14]

Coca-Cola’s ability to quickly recruit and mobilize Colombian scientists illustrates a particularly concerning dynamic for nutrition science and public health that deserves greater attention. These efforts can prevent the spread of evidence-based policies, such as taxation, that reduce NCDs regionally and globally. [15,16]  Colombia is not alone among LMICs in its history of industry lobbying, a practice that makes it relatively easy to subdue public health advocacy. [17] Universities and scientists in LMICs are vulnerable to industry funding solicitations due to their limited access to public research dollars. Yet local scientists bring unique credibility and cultural relevance when they act as home-grown spokespeople for transnational food and beverage corporations seeking to influence the health policy debates of their nations. 

The Colombian experience underscores the need for major universities in LMICs to adopt strict standards of scientific integrity, freedom and autonomy. Public health entities in these countries should promote dialogue about corporate interference in nutrition science. There is also a need for global unity behind efforts to obtain protections similar to those afforded under the WHO Framework Convention on Tobacco Control (FCTC) for LMICs seeking to regulate ultra-processed foods and beverages in the interests of public health.

Eric Crosbie, Assistant Professor, School of Community Health Sciences, University of Nevada, and Ozmen Institute for Global Studies, University of Nevada.

Melissa Mialon, Honorary Research Fellow, School of Public Health, University of São Paulo, Brazil, São Paulo, and School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia.

Cristin Kearns, Assistant Professor, School of Dentistry, University of California San Francisco, San Francisco and Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA.

Laura Schmidt, Professor, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco and Department of Anthropology, History and Social Medicine, University of California San Francisco, San Francisco, CA.

Competing interests: None declared

Spanish translation of this article

Acknowledgement: This paper was supported by Bloomberg Philanthropies. The funder had no role in the design and conduct of the study, collection management, analysis, and interpretation of the data, preparation, review, approval or decision to submit the manuscript for publication.

Disclaimer regarding translation: This material has been translated into Spanish by Eric Crosbie. BMJ Publishing Group take no responsibility for the accuracy of the translation from the published English language original and are not liable for any errors that may occur. This material has been independently translated into Spanish by Eric Crosbie from the published English language original.


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