What’s more harmful to your health — sugar or fat? Is it most important to exercise? The answers can depend on who’s paying for “scientific” research.

Cans of soda and bottled water in New York, 7 May 2018 (AP Photo/Mark Lennihan)

“I love soda.” You can buy mugs, t-shirts, even wallets that carry that bold declaration.

Most people almost certainly know that sodas are not healthful. The sugar and corn syrup used to sweeten soft drinks cause weight gain, obesity, diabetes, heart disease and other ills.

But news coverage about the issue can be confusing. One study will report that sugar definitely causes heart disease and obesity, while the next will assert that exercise is far more important to fight these growing plagues of human society.

And many people argue that fat is more dangerous to health than sugar is.

It’s hard to navigate the headlines about the latest studies. And there is now a growing body of evidence that the sugar industry is taking advantage of that uncertainty by designing and paying for studies that will show that something, anything, other than sugar is driving the obesity epidemic.

It takes money to conduct research.

To understand how this could be, it’s important to know how health, nutrition, medicine and science are generally reported. It’s an area of news different from other types of coverage. While politics, sports and wars are all reported by direct observation, science medicine and health coverage relies heavily on medical and scientific journals.

This is because medical and scientific researchers report their findings this way. Ever hear the term “publish or perish”? To get ahead as a researcher, it’s important to get results published.

Academic centers and agencies that provide the money for research require recipients of their funding to submit their findings to peer-reviewed journals, where other experts in the field ask questions and point out weaknesses. These results are then made public for other labs to try to replicate.

It’s a system that helps cut way back on fraud. But it can also be vulnerable to manipulation. It takes money to conduct research, and sometimes those providing the funds choose how the results are written up, even providing manuscripts for the researchers to sign off on.

“There are all kinds of ways that you can subtly manipulate the outcome of a study, which industry is very well practiced at,” said Stanton Glantz, director of the University of California San Francisco’s Center for Tobacco Research and Education.

That appears to have happened with a batch of research on sugary drinks, and the media reports that followed.

Shaping public opinion

Glantz’s colleague Cristin Kearns found documents in 2016 that showed the sugar industry started influencing diet research back in the 1960s.

The industry paid leading researchers at Harvard to conduct a review that ended up trashing previous research linking sugar to heart disease. Published in the New England Journal of Medicine, a prestigious medical journal, the review found “no doubt” that reducing cholesterol was the only way to lower the risk of heart disease through diet.

“The literature review helped shape not only public opinion on what causes heart problems but also the scientific community’s view of how to evaluate dietary risk factors for heart disease,” said Kearns.

Another 2016 study, this one done by Daniel Aaron and Michael Siegel at Boston University, found that 95 major U.S. health and medical groups — including the American Heart Association, the American Diabetes Association, the Juvenile Diabetes Research Foundation and the Centers for Disease Control and Prevention — got funding or sponsorships from Coca-Cola or PepsiCo between 2011 and 2015.

“During the study period, these two soda companies lobbied against 29 public health bills intended to reduce soda consumption or improve nutrition,” they wrote in the American Journal of Preventive Medicine.

The medical groups deny that the funding influences their policies.

But Siegel directly compared the soda company funding efforts to tactics used by tobacco companies to cast doubt on smoking’s role in causing cancer and heart disease. “Now, most organizations refuse tobacco money. Perhaps soda companies should be treated similarly,” he and Aaron wrote.

‘Coke influenced China’s policies.’

In 2015, Coca-Cola got called out for funding a group called the Global Energy Balance Network, which promoted the idea that exercise was more important than diet in staying healthy. The group was quickly disbanded.

But Coke didn’t stop its efforts there.

In a report last year, Susan Greenhalgh of Harvard University found that Coca-Cola and its surrogate, a non-profit known as the International Life Sciences Institute (ILSI), had successfully managed China’s obesity policies. ILSI was founded in 1978 by Alex Malaspina, who was, at the time, a vice-president of Coca-Cola.

“Through a complex web of institutional, financial, and personal links, Coke has been able to influence China’s health policies,” Greenhalgh wrote in her report.

“There have been decades of work on how Big Pharma and Big Tobacco have tried to influence science and dictate policy, but the research on Big Food and Big Soda is just now emerging,” Greenhalgh said.

“When I reviewed China’s policies, I could see them using the very same language Coke did,” she said. “For example, they talk about energy balance and making physical activity part of medical treatment or balancing eating and moving.”

Targeted advertising

There’s little doubt that makers of soft drinks, energy drinks, sugary teas and other drinks want customers. The advertising is everywhere. But what may be surprising is who is being specifically targeted.

Another report in 2015 found that black and Hispanic kids are disproportionately targeted by ads for sugary sodas, snacks and calorie-laden restaurant foods.

“Sugar-sweetened beverages are marketed extensively to children and adolescents, and large increases in consumption of sugar-sweetened beverages have occurred among black and Mexican-American youth, who are known to be at higher risk for obesity and the development of type 2 diabetes than their white counterparts,” said Dr. Sonia Caprio, a pediatrician at Yale University.

There’s no doubt that people are exercising less and that exercise is extremely important to health. There’s also no doubt that high-fat diets can cause obesity, diabetes, heart disease and cancer. But sugar, especially from sodas, is a major culprit, too. You just wouldn’t know that from reports about studies like this one, linking a rise in heart disease to women doing less housework.

Who paid for that study? Coca-Cola.


  1. How do big industries influence what we know and believe?
  2. How does media coverage reflect industry influence?
  3. Why is it important to look at the funding received by organizations?

Maggie Fox has been reporting on health and science for more than 20 years and is currently a consulting editor to Medscape and WebMD and a consultant on health and science news. She has covered conflict, politics and other international events from London, Hong Kong and Beirut. She has covered the cloning of Dolly the sheep, Ebola epidemics, stem cell technology, vaccine controversies and other stories for Reuters, CNN, National Journal and NBC News. She lives in Washington, DC.

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