1. Snow, Denise JD, RN, CNM, NP

Article Content

Poor nutrition is a risk factor for chronic illness. The role of the clinician is to promote health and to guide patients toward healthy dietary choices from birth through the life span based on recommendations from government resources, professional organizations, and peer-reviewed journals. Unfortunately, conflict of interest of those making the recommendations is sometimes an issue and corporate tactics manipulate some of this information.


Published research can influence recommendations. For example, Rippe et al. (2017) wrote about the upper limit for added sugar consumption and concluded that although it was likely best to minimize excessive calories from sugars, the scientific basis for restrictive guidelines was not yet established. This could cause some to caution restrictive guidelines such as those promulgated by respected scientific organizations; however on close scrutiny, five of the six authors either work for or have consulted for Nestle, Coca-Cola, Pepsi, the Corn Refiners Association, Abbott (Similac), and several other food industries.


Magnuson, Roberts, and Nestmann (2017) reported that recent studies on children with special dietary needs continually show that people of all ages generally take in less sucralose than the acceptable daily intake and that sucralose is safe for its intended use as a no-calorie substitute to sugar. This research was financed by the Calorie Control Council, an organization that supports use of artificial sweeteners. The Calorie Control Council contends that a comprehensive evaluation of evidence supports use and ongoing availability of acesulfame potassium, aspartame, neotame, saccharin, stevia sweeteners, and sucralose. Scientific reviews financed by the Council are being used to justify the support of the products.


Government entities using industry funding has become more common. Last year, a National Institute of Health project was canceled after it was learned that $60 million had been solicited from alcohol companies to support research on the benefits of alcohol consumption (Wadman, 2018). In the United Kingdom, the Medical Research Council (MRC, 2018) announced its alliance with research funders and industrial relationships through the recently created Human Nutrition Research Unit (HNR) and acknowledged that HNR scientists have received financial support from companies including Coca-Cola, Mars, Nestle, Institute for Brewing and Distilling, Weight Watchers, and others. This collaboration results in research funded by MRC such as The Big Breakfast Study (with additional funding from Kellogg and Nestle) with the goal of evaluating mechanistic basis of amplified morning thermogenesis leading to weight loss, which is beneficial to the breakfast cereal industry (Ruddick-Collins, Johnston, Morgan, & Johnstone, 2018).


Clinicians rely on professional organizations to provide information through educational sessions, annual meetings, and their respective clinical journals. However, funding and sponsorship can sometimes be entangled with publications, presentations, and findings. Transparent, detailed information about sponsorship, funding, relationships, and other potential conflicts of interest allows professionals to fully make informed decisions about the validity and quality of dietary advice.


Be skeptical of dietary advice until you find out about potential sources of conflict of interest among the authors and the agency, including relationships and funding from the food industry. Not all funding is fully disclosed. Maintaining a healthy skepticism is essential to practice and for accurately advising women and children.




Magnuson B. A., Roberts A., Nestmann E. R. (2017). Critical review of the current literature on the safety of sucralose. Food and Chemical Toxicology, 106(Pt A), 324-355. doi:10.1016/j.fct.2017.05.047 [Context Link]


Medical Research Council. (2018). Annual report and accounts 2017/2018. Swindon, United Kingdom: Author. Retrieved from[Context Link]


Rippe J. M., Sievenpiper J. L., Le K. A., White J. S., Clemens R., Angelopoulos T. J. (2017). What is the appropriate upper limit for added sugars consumption? Nutrition Reviews, 75(1), 18-36. doi:10.1093/nutrit/nuw046 [Context Link]


Ruddick-Collins L. C., Johnston J. D., Morgan P. J., Johnstone A. M. (2018). The big breakfast study: Chrono-nutrition influence on energy expenditure and bodyweight. Nutrition Bulletin, 43(2), 174-183. doi:10.1111/nbu.12323 [Context Link]


Wadman M. (2018). NIH pulls the plug on controversial alcohol trial. Science. Retrieved from Accessed May 8, 2019. [Context Link]