{"id":26832,"date":"2024-11-11T04:15:00","date_gmt":"2024-11-10T20:15:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26832"},"modified":"2024-11-11T05:30:14","modified_gmt":"2024-11-10T21:30:14","slug":"bmj%e5%8f%91%e8%a1%a8%e5%88%86%e6%9e%90%e6%96%87%e7%ab%a0%ef%bc%9a%e8%8b%b1%e5%9b%bd%e6%94%bf%e5%ba%9c%e7%9a%84%e8%90%a5%e5%85%bb%e4%b8%93%e5%ae%b6%e6%8e%a5%e5%8f%97%e5%85%a8%e7%90%83%e6%9c%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26832","title":{"rendered":"[BMJ\u53d1\u8868\u5206\u6790\u6587\u7ae0]\uff1a\u82f1\u56fd\u653f\u5e9c\u7684\u8425\u517b\u4e13\u5bb6\u63a5\u53d7\u5168\u7403\u6700\u5927\u98df\u7269\u516c\u53f8\u7684\u8d44\u52a9"},"content":{"rendered":"\n

Feature<\/strong> BMJ Investigation<\/p>\n\n\n\n

UK government\u2019s nutrition advisers are paid by world\u2019s largest food companies, BMJ analysis reveals<\/h1>\n\n\n\n

Sophie Borland<\/h3>\n\n\n\n

BMJ<\/em>\u00a02024;\u00a0386\u00a0doi:\u00a0https:\/\/doi.org\/10.1136\/bmj.q1909<\/a>\u00a0(Published 11 September 2024)Cite this as:\u00a0BMJ<\/em>\u00a02024;386:q1909<\/h3>\n\n\n\n

Campaigners say these conflicts of interest are detrimental to public health, but defenders say they reflect the lack of funding in nutrition research. Sophie Borland<\/strong> reports<\/p>\n\n\n\n

More than half of the experts on the UK government\u2019s advisory panel on nutrition have links to the food industry, a BMJ analysis has found. At least 11 of the 17 members of the Scientific Advisory Committee on Nutrition (SACN) have conflicts of interest with the likes of Nestl\u00e9, sugar manufacturer Tate and Lyle, and the world\u2019s largest ice cream producer, Unilever.<\/p>\n\n\n\n

SACN is a powerful group of people appointed as independent experts that provides advice to the government\u2014which in turn influences policy. Since its establishment in 2000 it has produced high profile guidelines on daily salt and sugar intake, vitamin D supplements, and feeding babies.<\/p>\n\n\n\n

But there is concern that both SACN and the previous governments reviewing its recommendations have not done enough to curb rising rates of obesity and food related ill health. Currently, 28.3% of women and 26.9% of men in the UK are obese, up from 13.8% and 10.7%, respectively, three decades ago.1<\/a> Deaths from premature heart disease in England are at their highest in 14 years,2<\/a> and diabetes cases in the UK are at record levels.3<\/a><\/p>\n\n\n\n

Campaigners say that these conflicts of interests at the heart of policy making are detrimental to public health. Others say that they reflect the lack of funding for nutrition research and that removing experts with industry links from SACN would \u201cdiminish\u201d its expertise (Video 1<\/a>).<\/p>\n\n\n\n

Money changes minds<\/h2>\n\n\n\n

The BMJ<\/em> looked at the interests declared by members of SACN\u2014in publicly available documents published on the government website\u2014in the past three years.4<\/a><\/p>\n\n\n\n

Among its members is David Mela, a retired senior scientist from Unilever, who has done consultancy work for the firm that earned him over \u00a35000 last year. He also has shares in Unilever worth over \u00a35000. He has done consultancy work for Tate and Lyle, Coca-Cola\u2019s Israel franchise CBC Israel, and Cargill, which produces cocoa and chocolate products among other things.<\/p>\n\n\n\n

Another SACN member, Julie Lovegrove, is the chair of an expert group at the International Life Sciences Institute Europe, based in Brussels. Its member companies include PepsiCo, Cadbury\u2019s US owner Mondelez, and General Mills, the American firm behind Cheerios and Haagen Dazs.<\/p>\n\n\n\n

Member Kevin Whelan has worked for Nestl\u00e9 Health Science (owned by Nestl\u00e9), Danone, Alpro, Yakult, and the Dairy Council. He has received research grants from the International Nut and Dried Fruit Council and the Almond Board of California.<\/p>\n\n\n\n

Gill Fine is a shareholder at Sainsburys, and Paul Haggarty is head of lifelong health at the University of Aberdeen\u2019s Rowett Institute, which receives funding from the red meat and dairy industries. \u201cI have no role in the administration of external funding in this position, and I am not familiar with these particular projects, which may be carried out in themes other than lifelong health at Rowett,\u201d Haggarty told The BMJ<\/em>. \u201cMy own research is not funded by industry as a personal choice, and this is reflected in my declarations.\u201d<\/p>\n\n\n\n

The Department for Health and Social Care responded on behalf of SACN and all members named in this article, saying that SACN members are required to confirm existing potential conflicts of interest annually and to declare new ones at the first appropriate committee meeting, which are included in the minutes and published on the SACN website.5<\/a><\/p>\n\n\n\n

Chris van Tulleken, associate professor at University College London and the author of a bestselling book on ultraprocessed food, told The BMJ<\/em>: \u201cEven small financial conflicts affect behaviour and beliefs in subtle or unconscious ways\u2014we have data from food and pharma research showing this. This means that declaring conflicts doesn\u2019t mitigate them.<\/p>\n\n\n\n

\u201cConflicts in SACN damage the reputation and credibility of the committee. How can someone who claims to have an interest in public health have any links to companies like Coca-Cola or Unilever? We have known for decades about the harm caused by the products that companies like these make. Some companies make slightly less harmful products, but all are controlled and constrained by the same financial incentives, which mean they can\u2019t self-regulate.\u201d<\/p>\n\n\n\n

Undermining public health<\/h2>\n\n\n\n

Six members of SACN are members of the American Society for Nutrition, which is funded by Mars, Mondelez, Nestl\u00e9, PepsiCo, and the Sugar Association, among others. These include Whelan, Mela, and Lovegrove; the other three are Sian Robinson, Susan Fairweather-Tait, and Mairead Kiely. Others have financial links to Danone, the infant formula manufacturer Mead Johnson Nutrition, and General Mills (Lucilla Poston, Ken Ong, and Susan Lanham-New, respectively).<\/p>\n\n\n\n

Rob Percival, head of policy at the Soil Association, a charity aiming to transform the way we eat, farm, and care for the natural world, told The BMJ<\/em>: \u201cWe\u2019re concerned that the committee and its integrity might be undermined by those ties to the food industry. That\u2019s not to say that individual scientists have been corrupted; the challenge is systemic. There\u2019s now really good evidence that conflicts of interest at the interface of science and policy can skew either specific policies or public narratives in favour of the food industry in ways which undermine public health.\u201d<\/p>\n\n\n\n

SACN\u2019s current work includes reviewing the evidence over ultraprocessed foods, artificial sweeteners, and plant based food and drink.6<\/a> Last July the committee issued a statement on ultraprocessed foods that warned that increased consumption was \u201cassociated with increased risks of adverse health outcomes,\u201d adding that there were \u201cuncertainties around the quality of evidence available.\u201d7<\/a><\/p>\n\n\n\n

Experts including van Tulleken and Percival say that SACN did not do enough to present the case for tougher regulation on ultraprocessed foods. The UK is behind countries in Latin America that have introduced warning labels on products high in sugar, salt, and fat.8<\/a>9<\/a><\/p>\n\n\n\n

A spokesperson for the Department of Health and Social Care told The BMJ<\/em>: \u201cNo members of the committee are directly employed by the food and drink industry, and all have a duty to act in the public interest and to be independent and impartial.\u201d<\/p>\n\n\n\n

Lack of research funding<\/h2>\n\n\n\n

Katharine Jenner, director of the Obesity Health Alliance, a coalition of over 50 organisations, told The BMJ<\/em> that SACN members\u2019 ties to the food industry are partly a result of the lack of money in relevant research. \u201cNutrition funding is notoriously underfunded. So many of the studies are industry funded as the people who have got a particular interest are the research and development teams of the companies. It really is a very poorly funded world, and that just invites more industry funding.\u201d<\/p>\n\n\n\n

Alison Tedstone, former chief nutritionist at Public Health England, which was replaced by the Office for Health Improvement and Disparities, adds that several experts on SACN are in receipt of research grants from the food industry and that this practice is \u201cexpected\u201d by a key national funding body. She says that in her experience applications for nutrition research to the Biotechnology and Biological Sciences Research Council (BBSRC) are more likely to be successful if there is partnership funding from food businesses. That can range from supplying products to be used in studies to funding part of the study.<\/p>\n\n\n\n

A BBSRC spokesperson told The BMJ<\/em> that, although \u201ccollaborations with industry and other stakeholders are encouraged, it is not expected.\u201d They point to organisational guidance for researchers, which the spokesperson says includes managing and making explicit any conflicts of interest. They say, \u201cThe BBSRC encourages the researchers it funds to build strategic partnerships with industry and broader stakeholders, such as government and charities, to accelerate the translation of research into public benefit.\u201d<\/p>\n\n\n\n

Excluding conflicted members<\/h2>\n\n\n\n

The BMJ<\/em>\u2019s findings come amid growing awareness over the importance of conflicts of interest in the food industry. Last year researchers from the Centre for Food Policy at City, University of London, and the Science Policy Research Unit, University of Sussex Business School, warned that conflicts of interest in food regulation were putting public health at risk.10<\/a>The BMJ<\/em> has previously reported on conflicts of interest at the Science Media Centre\u2014an organisation that facilitates health and science reporting\u2014which has received money from Nestl\u00e9, Coca-Cola, and Tate and Lyle.11<\/a><\/p>\n\n\n\n

Experts tell The BMJ<\/em> that the composition of SACN needs to be reviewed, in light of members\u2019 ties to the food industry. Percival says that we should \u201clearn from the precedent set internationally\u201d by organisations such as the World Health Organization (WHO), where members with conflicts of interest are excluded from key decisions.<\/p>\n\n\n\n

The Department of Health and Social Care told The BMJ<\/em> that, when members have a direct interest on a specific topic or issue, it is handled under the SACN code of practice12<\/a> and that those members \u201cmay be\u201d excluded from the discussion. SACN membership includes those with technical industry expertise \u201cto ensure a broad range of skills, expertise, and experience are available during discussions,\u201d it adds. \u201cSACN\u2019s conclusions reflect the considerations of the whole of SACN and are not influenced by any individual members of the committee.\u201d<\/p>\n\n\n\n

Van Tulleken says that SACN should ensure that five years from now there are no members with recent industry ties. He says that any \u201cindustry representative\u201d should be removed immediately. \u201cThe first, necessary\u2014but absolutely insufficient\u2014step to getting control of the UK\u2019s epidemic of diet related disease is to deconflict SACN. That is the most important thing that must happen. It will send a clear message that there is an intention to regulate the food industry. This is what happened with tobacco, and it must happen with food.\u201d<\/p>\n\n\n\n

Tedstone, however, who is a member of the WHO Nutrition Guidance Expert Advisory Group subgroup on policy actions\u2014and also advises them on obesity related projects\u2014as well as the Obesity Health Alliance, says that refusing to allow experts with industry ties on SACN would \u201cdiminish\u201d its expertise.<\/p>\n\n\n\n

\u201cWHO has made a decision to take nobody who takes any research money from industry, and that has left them in a position where they have people who are not research active. It\u2019s harder to get people who are thinking about the subject, actively researching about the subject.\u201d<\/p>\n\n\n\n

Tedstone, who was chief nutritionist at Public Health England at the time SACN was making recommendations on daily sugar intake in 2015, adds: \u201cI\u2019ve never seen any conflicts within SACN. One of my big worries about SACN is that somebody\u2026 [might] think they\u2019ve solved the nation\u2019s nutrition problems by deleting SACN and all that did was delay future legislation. It\u2019s important but there are more important conflicts that go on in the food chain and policy.\u201d<\/p>\n\n\n\n

Former health secretary Victoria Atkins is married to former managing director of British Sugar, Paul Kenward; these two posts coincided. The Conservative government was also criticised for failing to release lobbying letters from food and advertising companies ahead of proposed advertising restrictions on unhealthy products.13<\/a> On SACN, Tedstone adds: \u201cThis is tricky, and there are these interests\u2014but where\u2019s the evidence of bias?\u201d<\/p>\n\n\n\n

Van Tulleken insists: \u201cDespite two decades of work from a conflicted SACN there has been an explosion of suffering and death from diet related disease in the UK, so I don\u2019t think it\u2019s credible to claim that the committee has been very effective. There are some excellent independent experts, but they are a minority, and in my view their work has been hampered by conflicts of interest with the industry that has created this health crisis. SACN must become independent of the food industry.\u201d<\/p>\n\n\n\n

Formula milk and baby food links<\/h3>\n\n\n\n

The BMJ<\/em>\u2019s analysis has found that at least six of the 11 members in SACN\u2019s subgroup on maternal and child nutrition have ties to food companies, including baby food manufacturers and formula milk brands.<\/p>\n\n\n\n

Ann Prentice is a council member of the Nestl\u00e9 Foundation, an organisation founded from a donation from Nestl\u00e9 to support research in lower income countries, and Marion Hetherington has undertaken work for Danone and Ella\u2019s Kitchen, the latter on an unpaid basis. The group\u2019s chair, Ken Ong, has received research funding worth over \u00a35000 a year from Mead Johnston Nutrition, which makes formula milk.<\/p>\n\n\n\n

Last July the subgroup produced guidelines on feeding young children aged 1 to 5 years. Some experts think that it held back on recommending the benefits of home cooked food over ready made baby food and on spelling out that \u201cgrowing up\u201d formula milk was entirely unnecessary.<\/p>\n\n\n\n

Nestl\u00e9 and Danone are two of the world\u2019s largest infant milk providers, and Ella\u2019s Kitchen is the most popular baby food brand in the UK.14<\/a> \u201cIt raises the question\u2014if you\u2019re working for and supporting a commercial baby food company, and then you\u2019re also sitting on a committee that\u2019s making public health recommendations\u2014how can you be expected to give an independent view around how babies should be fed?\u201d asks Vicky Sibson, director of First Steps Nutrition Trust, a public health nutrition charity.<\/p>\n\n\n\n

\u201cI also think certain conflicts should be red lined\u2014so we should not have anyone who works with the formula industry sitting on a subcommittee of SACN and making recommendations for how you feed babies,\u201d she says. \u201cThat should be a red line. I think it should be the same for commercial baby foods. This is a very important committee; it\u2019s very influential.\u201d<\/p>\n\n\n\n

The Department of Health and Social Care responded on behalf of SACN and all members named in this article. A spokesperson says: \u201cNo members of the committee are directly employed by the food and drink industry, and all have a duty to act in the public interest and to be independent and impartial.\u201d<\/p>\n\n\n\n

SACN members with declared conflicts of interest<\/h3>\n\n\n\n

David Mela, retired<\/strong><\/p>\n\n\n\n

    \n
  • Consultancy and shares for Unilever (consultancy worth over \u00a35000 a year, shares worth over \u00a35000)<\/li>\n\n\n\n
  • Consultancy for Tate and Lyle (income over \u00a35000 a year)<\/li>\n\n\n\n
  • Consultancy for Cargill (produces chocolate and cocoa products among other products)<\/li>\n\n\n\n
  • Consultancy for Coca-Cola\u2019s Israel franchise CBC Israel<\/li>\n\n\n\n
  • Member of American Society for Nutrition, which is funded by, among others, Mars, Mondelez, Nestl\u00e9, PepsiCo, and Unilever<\/li>\n<\/ul>\n\n\n\n

    Julie Lovegrove, professor of human nutrition, University of Reading<\/strong><\/p>\n\n\n\n

      \n
    • Chair and member of International Life Sciences Institute (member companies include PepsiCo, Mondelez and General Mills) Europe\u2019s qualitative fat intake expert group<\/li>\n\n\n\n
    • Research funding from Dutch Dairy Council and Danish Dairy Foundation (both worth over \u00a35000 a year)<\/li>\n\n\n\n
    • Member of American Society for Nutrition<\/li>\n<\/ul>\n\n\n\n

      Kevin Whelan, professor of dietetics, head of the Department of Nutritional Sciences, King\u2019s College London<\/strong><\/p>\n\n\n\n

        \n
      • Research grant from Danone (worth over \u00a35000 a year)<\/li>\n\n\n\n
      • Research grant from Almond Board of California (worth over \u00a35000 a year)<\/li>\n\n\n\n
      • Lecture and podcast recording with Alpro<\/li>\n\n\n\n
      • Lecture for Nestl\u00e9 Health Sciences<\/li>\n\n\n\n
      • Chaired annual meeting for Dairy Council<\/li>\n\n\n\n
      • Research grant from Almond Board of California (worth over \u00a35000 a year)<\/li>\n\n\n\n
      • Research grant from International Nut and Dried Fruit Council (worth over \u00a35000 a year)<\/li>\n\n\n\n
      • Presentation for Yakult<\/li>\n\n\n\n
      • Member of American Society for Nutrition<\/li>\n<\/ul>\n\n\n\n

        Gill Fine, public health nutritionist<\/strong><\/p>\n\n\n\n

          \n
        • Shareholder of Sainsbury\u2019s<\/li>\n\n\n\n
        • Consultancy work for Musgrave Group (owner of 15 food retail and wholesale brands)<\/li>\n\n\n\n
        • Former scientific governor and trustee of British Nutrition Foundation (whose members include British Sugar, Coca-Cola, Kellogg\u2019s, Mars, and McDonald\u2019s)<\/li>\n<\/ul>\n\n\n\n

          Paul Haggarty, head of lifelong health, Rowett Institute of Nutrition and Health, University of Aberdeen<\/strong><\/p>\n\n\n\n

            \n
          • Rowett Institute\u2019s industry partners include DairyCo, Quality Meat Scotland, and Harbro, which provides animal feed to dairy and livestock farmers<\/li>\n<\/ul>\n\n\n\n

            Sian Robinson, professor of lifecourse and lifestyle, Newcastle University*<\/strong><\/p>\n\n\n\n

              \n
            • Member of American Society for Nutrition<\/li>\n<\/ul>\n\n\n\n

              Susan Fairweather-Tait, professor of human nutrition (mineral metabolism), Norwich Medical School, University of East Anglia<\/strong><\/p>\n\n\n\n

                \n
              • Member and fellow of American Society for Nutrition<\/li>\n<\/ul>\n\n\n\n

                Mairead Kiely, professor in nutrition, School of Food and Nutritional Sciences, University College Cork*<\/strong><\/p>\n\n\n\n

                  \n
                • Member of American Society for Nutrition<\/li>\n\n\n\n
                • Research funding from Meat Technology Ireland (worth over \u00a35000 a year)<\/li>\n<\/ul>\n\n\n\n

                  Susan Lanham-New, professor of human nutrition and head of the Nutritional Sciences Department, University of Surrey<\/strong><\/p>\n\n\n\n

                    \n
                  • Definition related work for General Mills<\/li>\n<\/ul>\n\n\n\n

                    Ken Ong, MRC investigator and professor of paediatric epidemiology, MRC Epidemiology Unit and Department of Paediatrics, University of Cambridge*<\/strong><\/p>\n\n\n\n

                      \n
                    • Research funding from Mead Johnson Nutrition (worth over \u00a35000 a year)<\/li>\n<\/ul>\n\n\n\n

                      Lucilla Poston, professor of maternal and fetal health, King\u2019s College London*<\/strong><\/p>\n\n\n\n

                        \n
                      • Danone\u2019s Nutricia Research organisation sponsored her PhD student<\/li>\n\n\n\n
                      • Research grant from Almond Board of California (worth over \u00a35000 a year)<\/li>\n<\/ul>\n\n\n\n

                        Subgroup on maternal and child nutrition<\/h4>\n\n\n\n

                        Ann Prentice, honorary senior visiting fellow, MRC Epidemiology Unit, University of Cambridge<\/strong><\/p>\n\n\n\n

                          \n
                        • Council member of Nestl\u00e9 Foundation, (honoraria and travel expenses worth over \u00a35000 a year)<\/li>\n<\/ul>\n\n\n\n

                          Marion Hetherington, professor emerita in biopsychology, University of Leeds<\/strong><\/p>\n\n\n\n

                            \n
                          • Provided a research summary for Ella\u2019s Kitchen (unpaid)<\/li>\n\n\n\n
                          • Consultancy work for Danone<\/li>\n\n\n\n
                          • Speaker at conference for Dairy Council Northern Ireland<\/li>\n<\/ul>\n\n\n\n
                              \n
                            • *Also a member of the subgroup on maternal and child nutrition<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

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