Yoni Freedhoff was scrolling through his Twitter feed last winter when he noticed something that struck him as odd. Coca-Cola’s chief scientific officer had shared a tweet that mentioned the Global Energy Balance Network, an organization of scientists and researchers arguing that the best way to maintain a healthy weight is to exercise more often and consume more calories.
“For me it raised a red flag,” says Dr. Freedhoff, who is a clinician and an assistant professor of family medicine at the University of Ottawa. “‘Energy balance’ is a darling catchphrase for the food industry because the concept, simply put, suggests that you can eat all the crap you want as long as you balance it with exercise.”
So Dr. Freedhoff did something he often does: He searched the organization’s website for its funding sources. Finding none listed, he contacted the group. His suspicions were warranted: The Coca-Cola Company was giving money to researchers who promoted a message that appeared to help the company’s business.
Dr. Freedhoff runs a popular blog, Weighty Matters (the subtitle: “Musings of an Obesity Medicine Doc and Certifiably Cynical Realist”), on which he regularly posts about conflicts of interest among researchers and the food industry. But he thought his Coca-Cola finding deserved a bigger audience than most of his own posts draw, so he went to The New York Times instead. The Times published an article about the funding connection, turning Dr. Freedhoff’s Twitter observation into a national story.
The Times’s coverage also shined a light once again on a confusing and contradictory aspect of health and nutrition research: Studies are widely circulated, but an essential question — who’s funding what? — is often difficult to answer.
There aren’t many people, like Dr. Freedhoff, who sift through the tsunami of available research on health and nutrition, researchers and clinicians say. Those most apt to do it — doctors and scientists — simply lack the time, says Kathleen M. Fairfield, a clinical scientist at the Maine Medical Center, in Portland.
But those who do have started to form their own ecosystem of watchdogs. Marion Nestle, a professor of nutrition, food studies, and public health at New York University, runs a blog called Food Politics, on which she regularly posts about studies funded by the food industry. Ben Goldacre, a researcher at the University of Oxford, uses his blog, Bad Science, to touch on faulty research methods in medicine and health. (Dr. Goldacre has written a similarly themed column for The Guardian.)
Health News Review, a website whose contributors include dozens of scientists, journalists, and clinicians, reviews articles and news reports about health science for accuracy, credibility, and bias.
And then there’s Dr. Freedhoff, a self-described “grunt in the trenches” who produces little research himself. But he reads a lot, scans dozens of reports a day, and gets a read on when research seems a little fishy. Then he blogs about it.
A Blogger and ‘Documenter’
Why are the fields of health and nutrition seemingly plagued by conflicts of interest and contradictory research? For one thing, they’re difficult to study, says Dr. Nestle. Human beings make terrible lab rats: Experiments require long periods of time, and individual health depends on so many factors beyond diet and exercise. David B. Resnik, a bioethicist at the National Institute of Environmental Health Sciences, adds another reason: The field of nutrition is still fairly young and thus subject to uncertainty.
Concerns about conflicts only deepen that uncertainty. Scholars and reporters alike should be “better trained to evaluate evidence” and understand how bias can affect studies, says Kevin Lomangino, managing editor of Health News Review, but it is trained clinicians and academics like Dr. Freedhoff who often make the most effective watchdogs.
Dr. Freedhoff’s watchdog work is not his profession. It’s something he does between seeing patients, and early in the morning before going to his office. Nevertheless, he finds time to blog six days a week and to nurture a Twitter feed that has more than 25,000 followers.
Frequent topics on his blog include nutrition for children (a recent post questions why a Ronald McDonald character regularly visits a children’s hospital in Quebec) and “junk-food fund raising,” a topic he has written about for U.S. News & World Report. His audience is diverse — a mix of science experts, interested amateurs, journalists, and food bloggers. He says the blog is a labor of love and a reflection of his responsibility to “effect change outside my office’s walls.”
Dr. Freedhoff was an English major before switching into science, and he says that the reading and writing his major required helped him become a more effective communicator. He says his “pathological addiction” to social media has helped him develop an eye for red flags in research.
When Mr. Lomangino was a health journalist, he used to contact Dr. Freedhoff for comment as an obesity expert. What drew Mr. Lomangino to the clinician was his “evidence-based perspective on nutrition literature” and his keen eye for discrepancies. (Dr. Freedhoff is now a reviewer for Health News Review.) Dr. Nestle calls him a “documenter” who notices things on the web that she often doesn’t.
Conflicts of Interest
The Coca-Cola connection may now stand as Dr. Freedhoff’s most influential case. Scientific journals and organizations did not always require researchers to disclose the sources of their funding or acknowledge conflicts of interest. For the most part, journals began requiring some sort of disclosure only in the early 2000s, says Dr. Nestle. But even disclosure requirements cannot completely prevent scientists from hiding their conflicts, at least for a while.
Dr. Freedhoff says that when he visited the Global Energy Balance Network’s website, he saw no indication of funding sources or sponsors. (The group added that information to its website after he contacted it.) According to information the Times obtained through open-records requests, Coca-Cola donated $1.5 million last year to start the network.
Leaders of the network told the newspaper that Coca-Cola’s financial support did not influence their research. But Dr. Nestle and others say research bankrolled by the food industry all too often produces results favorable to its sponsors. In fact, since March, she has compiled a list of more than 35 such studies on her blog.
For that reason, many people in the field of health and nutrition were not surprised over the network’s ties to industry, though Dr. Fairfield, from the Maine Medical Center, says the news was still “distressing.” Some, including Dr. Freedhoff, say the ties between the food industry and campus health researchers are reminiscent of those between tobacco companies and scientists in the 1980s and ’90s.
As was the case in many of the tobacco conflict-of-interest cases, researchers in the Global Energy Balance Network are “very reputable scientists,” says Dr. Freedhoff, and include senior faculty members at public universities across the United States. “It’s different because now it’s not Coca-Cola pushing this message,” he says. “It’s some of the world’s foremost exercise researchers pushing this message, and that carries a lot more weight.”
Scientists in the network told the Times that Coca-Cola did not control either their work or their message. They also said their transparency about the company’s support removed it as a problem.
Mr. Resnik, the bioethicist, says many financial conflicts of interest would not have been revealed without the work of individual scientists or watchdog groups. He points to the Center for Science in the Public Interest, a nonprofit organization dedicated to keeping the food industry accountable, and Naomi Oreskes, a history-of-science professor at Harvard who co-wrote a book about scientists with political connections.
Anthony C. Hackney, a professor of exercise physiology and nutrition at the University of North Carolina at Chapel Hill, says he’s seen an increase in the activity of watchdogs since the 1980s, when he got his start as a scientist. But, he says, “we need more.”
Dr. Nestle agrees. She jokes that more people should read Dr. Freedhoff’s blog and hers instead of waiting for large news outlets to write about their findings. “It would save a lot of people a lot of trouble,” she says.
