A group of researchers from San Francisco (California) examined some internal documents of Sugar Research Foundation (SRF), historical reports, and statements related to early debates about the Dietary Causes of Coronary Heart Disease (CHD). The historical analysis published online in JAMA Internal Medicine journal on 12 September 2016 explains how the Sugar Industry shifted the blame and focus to Fat as a cause for Coronary Heart Disease.
Backdrop of Sugar and Coronary Heart Disease
The risk of Sugar (sucrose) to coronary heart disease (CHD) emerged in the 1950s when high rates of CHD mortality were seen in American men, because American diet constituted high Sucrose content. Then began the studies to find out the role of dietary factors influencing CHD risk — cholesterol, phytosterols, excessive calories, amino acids, fats, carbohydrates, vitamins and minerals. By 1960s physiologist John Yudkin identified added sugars as the primary agent, and another one Ancel Keys identified total fat, saturated fat and dietary cholesterol. On 11 July 1965, the New York Herald Tribune published a significant article explaining the new research strengthened the case that sugar increased the risk of heart attacks, and stated that it “threatened to tie the whole business (of diet and heart disease) in a knot”.
Just few days after publication of aforementioned Tribune article in 1965 Sugar Research Foundation (SRF) sponsored its first CHD research project called Project 226. It resulted in a 2-part literature review by McGandy, Hegsted, and Stare “Dietary Fats, Carbohydrates and Atherosclerotic Disease,” which was published in the New England Journal of Medicine in 1967. The study singled out Fat and Cholesterol as the dietary causes of coronary heart disease, and more importantly, downplayed the early warning signals that sucrose consumption was also a risk factor. The argument was that the epidemiologic, animal and mechanistic studies linking sucrose to CHD were limited, and so should not be included in assessment of CHD risk factors. The review concluded that to prevent CHD dietary cholesterol should be reduced and polyunsaturated fat should be substituted for saturated fat in the American diet. It’s worth noting that SRF’s funding and role was not disclosed in the review published in New England Journal of Medicine, because at that time, medical journals did not typically require researchers to disclose their funding sources. The current group of researchers from San Francisco examined other more recent documents of sugar industry and suggested it may have a long history of influencing even the federal policy.
Added Sugars Play Significant Role in CHD
Despite the downplay of sugar risk in coronary heart disease, by the 1980s, few scientists believed that added sugars played a significant role. Studies done later linking saturated fats and sugars to CHD concluded that the latter is more of a problem than the former. They suggested shifting focus away from recommendations to reduce saturated fat and towards recommendations to avoid added sugars. As of 2016, sugar control policies are being promoted in USA and around the world. Doctors also recommend consumers should prefer eating more of whole foods than the processed ones.