‘Almost every middle-income country is being targeted by Big Food and its scientific agents’

I have long been interested in the politics of science, in particular, the corruption of scientific knowledge that often results when corporations have strong interests in certain scientific outcomes. When I began this project in the early 2010s, the history of corporate bias of science by the tobacco and pharmaceutical industries was well known, but little was known about possible interference in the science of obesity by the massive food industry whose products have a huge impact on what we eat. After the emergence of the obesity epidemic (it came to the public’s attention in the mid-1990s), governments and public health authorities began making major investments in scientific research on obesity. By the early 2010s, understandings of the causes and solutions to the obesity epidemic had grown enormously, yet the condition continued to spread. Why was that, I wondered. Could the science be distorted in some way? And which industry is deeply invested in making sure we continue to eat the kinds of high-fat, sugar and salt foods that are making us ill? These questions launched this research.

The exercise-first response argued that it does not matter how much you eat and drink; as long as you exercise off the calories, you would not gain weight. This claim is the centerpiece of a body of knowledge I call “soda science”. Reflecting the corporate sector’s interest in promoting this view, soda science was made backwards, that is, conclusion first. Its main claim emerged from a meeting of major food-industry CEOs [chief executive officers] who were asked to decide how the industry’s chief non-profit, ILSI, should approach the obesity question [ILSI or International Life Sciences Institute is a US-based, industry-funded non-profit, with branches around the world, that sponsors research on nutrition and food safety]. The CEOs rejected a broad programme on food and exercise and agreed only to sponsor a programme encouraging exercise. From there, a handful of university-based scientists began to create the other elements of a science of obesity. They added the main analytic framework and some arguments and then, over time, filled in the data and more hypotheses to support the conclusion with which they started.

I believe the message resonated with the American public when it began to be energetically promoted in the early 2000s because Americans had been primed to accept it for some 30 years. Since the rise of market-dominated, or neoliberal, governance of health in the 1970s, healthcare has been privatised, with the government backing off and responsibility being placed in the hands of individuals. Since the 1970s in the US, health has been seen as a personal accomplishment. Within this movement, fitness regimes—walking, running, cycling, weight-lifting and so on—have received the most attention. Sensing a big market, corporations soon found it useful to promote personal fitness. Food companies promoted active lifestyles to detract from the influence of diet, while the fitness industry encouraged exercise-filled lifestyles to sell its products. Another reason the exercise-first argument has gained so much traction, some believe, is that it is more fun to add exercise to one’s daily routine than to limit one’s diet, especially of high-energy foods that are so tasty.

Corporations have a great many ways to influence scientific organizations, and we can assume they will use all the means at their disposal to shape decisions of organizations that deal with their products. In the case you mention, a former president of a non-profit (ILSI), previously a vice president at Coca-Cola, wielded personal influence on the or-ganisation more than a decade after retiring. That tells us that even after his retirement, his personal authority and personal ties (of friendship, perhaps) with long-timers at the organisation persisted. In this industry-funded scientific organisation, it was clear that actors tied to industry had more clout than actors who were merely scientists. As long as industry funded the organisation, lead industry actors can be expected to wield influence, despite the formalities of retirement and conflict of interest guidelines. On top of that, Coca-Cola continued to generously fund ILSI. The scien-tists at ILSI would have been hard-pressed to ignore Coke as long as Coke was a major funder. Some five years later, Coca-Cola, seeking to finally end the scandal surrounding its influence on obesity science, severed ties with ILSI at every level. That may be the only way to drastically reduce corporate influence.

No, this is not different from conventional understandings of conflicts of interest in science. It is a perfect example of such conflicts. The university-based scientists involved in the Global Energy Balance Network [GEBN was a non-profit, funded by Coca-Cola, that sought to promote research on exercise and obesity] routinely denied that Coke’s funding influenced their research and conclusions. Again and again they insisted there was no conflict of interest. Many in the public health field simply accepted their statements, while others had difficulty accepting them, as the conflict seemed too obvious to deny.

There is no way to measure Coke’s influence on public opinion in the US, but for sure it was (and perhaps may still be) substantial. The transparency list the company released in the mid-2010s shows that it gave millions of dollars to hundreds, if not thousands, of small organisations every year, encouraging them to promote exercise, and sometimes requiring that they sell only Coke products in their vending machines. In China, where fewer people were involved in making the science and policy on obesity, the influence of the corporate sector, and especially Coke, was easier to see. Since Coke entered the China market in 1978, it has partnered with a state-owned enterprise to bottle and sell Coke drinks in the country. One imagines that the profits from that partnership would discourage the Chinese government from making soda taxes part of its policies aimed at preventing chronic diseases.

With the rise of social media and the growing sophistication of online tools for uncovering clandestine influence, it is getting much harder for influence campaigns to succeed. On the other hand, there are many avenues for corporate influence; for example, individual scientists based in universities might have close ties to certain companies, ties they can easily conceal when serving on review boards for global or intergovernmental organisa tions. I would be cautious in assuming corporate influence on these organisations has dramatica lly declined. After all, money talks.

In 2015, the New York Times’ exposé of Coke’s funding of the GEBN created such a massive scandal that Coke felt it had no option but to defund GEBN, letting the organisation die. Since GEBN was the major project of the soda scientists, the loss of virtually all their funding led to the demise of soda science as an “active project”. The “active project” part is crucial. When GEBN was being actively supported by Coke, to the tune of $20 million, there were many group activities, such as sessions at conferences, workshops and collectively-written articles. The GEBN was influential, claiming that its energy balance science was the best approach anywhere. Since the loss of corporate funding, individual researchers have continued to publish findings that aligned with soda science, but those findings have constituted separate threads of thought. Collective action requires funding; when the funding dried up, group action to advance soda science largely came to an end.

In good science, the conclusion should follow from the testing of objectively gathered data. The process used in making soda science distorts the knowledge because it starts with a foregone conclusion, and then gathers data that support it. In this case, the science was doubly distorted: the conclusion was supplied by industry and the data were collected to support an industry-based conclusion.

It is extremely difficult to know if a particular science has been distorted. It takes concerted effort to discover the hidden links. One can look for a coincidence of interests (between companies and a particular science). Or one might track all the articles promoting a certain scientific position and look closely to see who funded the work. In this way one can begin to gather clues that, in time, can add up to a bigger story of corporate corruption of the knowledge.

Absolutely. Research in Latin America and South Africa, among other places, has documented the many ways in which food companies are working to use science to boost sales of their mostly high-sugar, salt and fat products. Almost every middle-income country with a rapidly growing middle class is now being targeted by Big Food and its scientific agents. Today they have set aside the promotion of exercise and are focusing on the fight against government regulation of junk food, pressing the argument that the companies are part of the solution.

Your readers may be interested to know that ILSI has an active branch in India, which acts as a regional hub for South Asia. The board of directors includes corporate officers at Ajinomoto, Herbalife, Mondelez and Abbott Healthcare, all company names familiar from my research. ILSI operates as a global organisation; some of the dynamics I uncovered in the US and China are likely to be unfolding in India as well.

A major danger is that the corporate nature of the science will not be discovered, and that policymakers will build industry-friendly science into policies that work for the benefit not of the public but of the corporations. An even bigger danger is that, even if the corporate nature of science is revealed, local policymakers and scientists will not be concerned about it. In parts of Latin America, major food companies have convinced local policymakers that they are legitimate advisors, that their policy positions are effective, and that industry is a genuine partner and contributor to national health. With no one to challenge the industry bias, it will continue to shape public policy in ways unlikely to improve public welfare.

I am not sanguine about the possibility of creating partnerships that truly protect scientific integrity. But I am an anthropo logist. Some in the public health field believe that the field of nutrition, the one involved here, can do much better than it is now doing. Those involved need to recognise that industry bias is a serious problem, make the disclo- sure of financial ties routine and thorough, and create principles to manage the existing conflicts of interest that ensure companies are not influencing the design, conduct, interpretation, or presentation of the research. This is a challenge. Insiders in the nutrition field report that many in their field simply do not consider corporate influence on their science a serious problem.

Imagine investigating an issue that no one involved wants to talk about. Every day was full of challenges. And there were risks. When I first published the core findings on Coke’s influence on China’s policy (in January 2019), I was deeply fearful of what the company might do to silence me. I had read of Mexican public health researchers who had their mobile phones laced with malware after arguing publicly for soda taxes; some hinted that Coke, a major seller of sugary soda in Mexico, was involved. I was afraid something similar might happen to me. Fortunately, it did not. I was vaguely threatened with a possible lawsuit if I proceeded to publish an article about the inner workings of another organisation in a scholarly publication. That also did not materialise.

India would be a productive site for an in-depth investigation of the influence of big corporations, foreign and Indian, on public health policy. In an appendix, Soda Science spells out a set of concepts and methods that can be used to get to the bottom of things. I hope the book might inspire some brave researchers to take on this project.