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SPORTS MEDICINE :
MEDICAL: CONDITIONS: OBESITY :
PHYSICAL EXERCISE AND FITNESS:
What Role Should Coca-Cola Play In Obesity Research?
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What Role Should Coca-Cola Play In Obesity Research?
Larry Husten
Pharma and Healthcare
4/27/2014 @ 3:13PM
Forbes
http://www.forbes.com/sites/larryhusten/2014/04/27/
what-role-should-coca-cola-play-in-obesity-research/
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A shorter URL for the above link:
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http://tinyurl.com/kmath7p
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What role should Coca-Cola KO +0.42% and other food and beverage companies
play in funding and communicating research about nutrition and obesity?
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The question is prompted by a recent article in the Journal of the
American College of Cardiology. The state-of-the-art paper reviews the
relationship of obesity and cardiovascular disease and presents the case
that a decline in physical activity is the primary cause of the obesity
epidemic. The article downplays the role of calories and diet and does
not include the words sugar, soda, or beverage. Three of the five authors
of the paper report financial relationships with Coca Cola.
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It is important to acknowledge that there is an active scientific
controversy about the relative importance of diet and exercise. But it
also seems clear that the perspective on this controversy as presented in
this paper is remarkably congruent with the interests of Coca Cola.
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Defending Coca-Cola
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I asked the lead author of the paper, Carl Lavie, a Louisiana cardiologist
and obesity expert, to respond to concerns that the authors relationships
to Coke may have affected the content of the paper. Here is Lavies
(lightly edited) response:
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My personal relationship was providing consulting and giving a couple
of lectures on the importance of fitness. My colleagues have also
consulted and received non-restricted educational grants for research
studies. Coca Cola had nothing to do with the details of the study,
analyzing results, or publishing the paper. Therefore, I do not think that
this relationship adversely impacts any of the results of their studies or
my invited state-of-the-art review article, which happens to be on a topic
where I have published more than anyone else in the world during the past
10-15 years.
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snip
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A Less Benign View of Coca-Cola
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Readers can make up their own minds about Lavies position, but I want to
address a few individual points.
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1. Lavie writes that his views are not for sale. I do not want to suggest
anything so stark, but I also think it is fair and studies have
demonstrated that gifts, even very small gifts, can exert strong
unconscious effects. When combined with the flattery and attention of
being designated a key opinion leader an unconscious alignment with a
company can easily occur.
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Moreover, as I wrote last year, in a recent paper in PLOS Medicine
researchers conducted a systematic review of systematic reviews examining
the association between sugar-sweetened beverages and weight gain and
obesity. For the papers in which the authors reported no conflict of
interest, 10 out of the 12 findings supported the association between
sugar-sweetened beverages and weight gain or obesity. In stark contrast, 5
out of the 6 papers with industry support failed to find evidence for any
such association. In other words, systematic reviews with industry support
were 5 times more likely to find no significant association.Our results,
wrote the authors, confirm the hypothesis that authors of systematic
reviews may draw their conclusions in ways consistent with their sponsors
interests.
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2. Lavie defends Cokes funding of research by saying that pharma does this
all the time. This analogy represents a stretch of logic. Although
pharma-funded research is often criticized, and there are many active
battles over the precise role for pharma in research, it is widely agreed
that pharmaceutical companies must play a vital and important role in
medical research. No one would seriously argue that Coca-Cola has
medicinal value. The only active question is exactly how bad an effect
Coke has on public health. A much better analogy, though still imperfect,
is the tobacco industry.
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3. I think it is naive to believe with Lavie that Cokes main interest in
providing financial support to researchers in this field is to provide a
public service. For-profit companies like Coke and Pepsi dont spend
enormous sums of money just to provide a public service. They expect a
significant return on their investment, though this may be difficult to
quantify. In any case, it is more than obvious why Coke would be
interested in supporting scientists who maintain that sugar does not play
an important role in the obesity epidemic.
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As I mentioned earlier, there is a very active controversy about the
relative contributions of diet and activity to the obesity epidemic, but
in my experience the vast majority of experts agree that diet, and sugar
in particular, plays some sort of significant role in the problem.
Regarding this point, another of the JACC authors, Timothy Church, a
Louisiana preventive medicine specialist and exercise expert, sent a
comment to elaborate on LaVies defense of the papers focus on exercise and
its neglect of sugar and diet:
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We could also have mentioned the effects of air conditioning,
bacteria, viruses, cars, lack of sidewalks, antibiotic use, c-sections
etc, etc on obesity. There are outstanding research papers looking at all
of these things and more.
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We were focused on exercise and fitness. There are thousands of diet
and obesity papers that do NOT mention exercise, yet every time we do an
exercise paper we are expected to go into great depth about diet. It is an
interesting double standard.
But this view does not withstand critical scrutiny. Sugar is by no means
equivalent to air conditioning, viruses, or c-sections. Sugar is at or
near the center of nearly all discussions about obesity. Its just silly to
pretend otherwise.
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The complete article may be read at the URL above.
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Sincerely,
David Dillard
Temple University
(215) 204 - 4584
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