Food research and institutional corruption

The cheerful labels call out as I walk through the supermarket: Quaker Oats “can help reduce cholesterol,” Green Giant veggies “may reduce the risk of heart disease,” and Hershey’s chocolate has “antioxidants,” which I’ve heard are good for you. And do you remember Jamie Lee Curtis teaching us that Activia yoghurt is “clinically proven to help regulate your digestive system in two weeks”? Saturday Night Live did a hilarious sketch about Activia, but I suppose those in need might have concluded the yoghurt works even better than promised.

A couple days ago I participated in a fascinating workshop at Penn State on “Industry Sponsorship and Health-Related Food Research,” sponsored by the Rock Ethics Institute at Penn State and the Edmond J. Safra Center for Ethics at Harvard. It was part of a long-term Safra Center project on institutional corruption.

Institutional corruption goes beyond bribery and other individual illegal acts. It involves ongoing practices, often entirely legal, which undermine the purpose, integrity, or public trust of an institution.

The workshop focused on “functional foods,” which the U.S. Institute of Medicine defines as “any food or food ingredient that may provide a health benefit beyond the traditional nutrients it contains.”

Healers of both respectable and dubious qualification have long touted the medicinal properties of various foods, but U.S. regulatory law used to distinguish fairly clearly between food and drugs. The Nutritional Labeling and Education Act of 1990 blurred this distinction by allowing food labels to include FDA-approved health claims, which must be supported by “significant scientific agreement.”

Scientific agreement is often lacking, so food companies often resort to qualified health claims (“some evidence suggests . . . may reduce risk of”), and increasingly they rely on vague “structure-function” claims (“calcium builds strong bones”), or nutrient content claims (“Omega-3 eggs”). These last two kinds of claims avoid depressing talk of disease, and they don’t burden consumers with wordy qualifications. They also don’t require FDA notification or approval. Producers must provide scientific evidence upon request, but so far the FDA has issued only two warning letters about structure-function claims. The European Union, in contrast, requires prior government approval for any health or nutrition claim in food marketing.

University-industry partnerships play a big role in research on functional foods. Press releases simplify the research conclusions, and the media produce sensationalized coverage of the latest wonder food. Evidence suggests that industry-funded studies tend to reach conclusions favorable to industry. That doesn’t mean the conclusions are always wrong, but the research requires more careful public scrutiny.

Moreover, the problem is not only biased evaluation of evidence, but the type of questions that researchers ask in the first place. Most research on functional foods examines only potential benefits, neglecting potential risks. If people substitute a functional food (“antioxidant chocolate”) for other food or behavior (exercise), they may end up worse off than before. Dannon claimed that Activia promotes “regularity,” but the company didn’t mention that the yoghurt does so only if you eat at least three containers per day. (In an unusual move, the Federal Trade Commission charged Dannon with deceptive advertising, and the company agreed to pay $21 million and to stop making such health claims without FDA approval.)

What to do? Improved conflict-of-interest guidelines may help. Food research is increasingly global, and the Singapore Statement on Research Integrity suggests a set of global standards. But such guidelines and standards remain empty gestures if they aren’t supported by institutional changes. Possible institutional measures include research programs on potential negative effects of functional foods, a certification system for independent public-interest food scientists, and improved government regulation of functional food claims.

More broadly, I wonder how to promote research and education on functional foods without succumbing to the common image of food as technology. I once heard a French chef say that after dinner American parents ask their kids if they got enough to eat, whereas French parents ask how the food tasted. Despite their promise, we shouldn’t let functional foods obscure the cultural and aesthetic dimensions of what and how we eat.

Guten Appetit!