Dr. Kelsey also became a scientist and a medical doctor (she earned both a Ph.D. in pharmacology and an M.D. from the University of Chicago) at a time when few women entered STEM professions. Her legacy, in ways not often fully appreciated, also speaks to science and social justice—and to why diverse perspectives matter in science as in society.

Not without evidence

As a newly hired medical officer at the U.S. Food and Drug Administration (FDA) in 1960, Dr. Kelsey was responsible for reviewing drug manufacturer Richardson-Merrell’s application for thalidomide approval in the U.S. Thalidomide was to be sold as a sedative specifically recommended for pregnant women to ease morning sickness. Although doctors had already begun prescribing it in Canada, Europe, and Africa, Dr. Kelsey had questions that she believed the company had not adequately answered, and she refused to approve it without stronger evidence for its efficacy and safety.

At the time, drug companies had to submit applications for approval of new drugs to the FDA, but if the agency didn’t act within 60 days to deny the application, approval was automatic. Under constant pressure from the drug manufacturer, Dr. Kelsey remained steadfast—even as company executives complained to her supervisors. Every 60 days, she returned the company’s application with a request for more evidence, which the company failed to provide. As reports began emerging of babies born without arms or legs—or with flipper-like appendages and deformed internal organs—linked to thalidomide in countries where the drug was legal, the company abruptly withdrew its FDA application in 1961.

Dr. Frances Kelsey refused to approve the drug thalidomide for use in the United States, likely preventing thousands of cases of birth defects. Photo: Flickr User Duckwailk

A year later, following a story in the Washington Post hailing Dr. Kelsey as a “heroine,” Congress unanimously passed the Kefauver Harris Amendment, a law which updated and greatly strengthened the 1938 Federal Food, Drug, and Cosmetic Act. Among other improvements, the Kefauver Harris Amendment required new drugs to pass more rigorous trials and gave the FDA full authority to approve or deny new drug applications. President John F. Kennedy awarded Dr. Kelsey the Medal for Distinguished Federal Civilian Service for her role in improving drug safety.

Difficult decisions, disproportionate impacts

Of the estimated 10,000 “thalidomide babies” born outside the U.S., only around 40 percent survived. In the U.S., some physicians had received supplies of thalidomide with its approval still pending; fortunately, only 17 births were affected. Now in their fifties, thalidomide survivors have struggled with life altering disabilities, as well as major health problems now being exacerbated by age.

Once the dangers of thalidomide became public, pregnant women who had taken the drug faced the difficult decision of whether knowingly to bring children into the world that would face a lifetime of suffering. The burden of deciding what to do and then living with the consequences of their decisions disproportionately fell to women. While ethical considerations were complex—and painful and private and deeply personal for any woman—a complicating factor in the U.S. was that abortion was still illegal in 1961.

What that meant is that women who wanted to end affected pregnancies faced extraordinary obstacles. In a well-publicized case, Sherri Chessen (a.k.a. Sherri Finkbine)—a mother of four in Phoenix, Arizona, pregnant with her fifth child—took thalidomide her husband had obtained during a trip to England. An abortion was quietly arranged by her doctor at a local hospital. Hoping to alert other women who might have unknowingly taken the drug, Sherri—the Phoenix area host of the popular children’s TV show Romper Room—told her story to the press before the procedure was performed. Fearing negative publicity and potential litigation, the hospital withdrew its permission, a judge denied an appeal, and Sherri ended up travelling to Sweden to have the abortion. The aborted fetus was missing both arms and both legs.

Had thalidomide been more widely distributed in this country, other white, financially secure women like Sherri Chessen likely would have made similar trips. As painful as their decisions would have been, it is difficult to speculate on the even greater consequences for poor women—especially poor women of color—who were already disproportionately affected by anti-abortion laws.

Diversity in science and why it matters

By preventing approval of thalidomide in the U.S., Frances Oldham Kelsey not only spared countless children from birth defects or death, she also spared their mothers.

Although Dr. Kelsey rarely spoke about how gender had affected her own career, she did offer a few clues in her “Autobiographical Reflections.”   Of her decision to get an M.D. after already earning a Ph.D., she said, “[As] a woman, I needed the extra credentials. Let us face it, I needed all the help I could get.”

When Dr. Kelsey was offered a job as a research assistant at the University of Chicago—a job that paved the way for her to attend graduate and medical school there—the offer letter was addressed to “Mr. Oldham.” Instead of correcting the mistake and informing her would-be employer she was a woman, she simply signed the letter and showed up. Of that experience in 1936, she said, “to this day, I do not know if my name had been Elizabeth or Mary Jane, whether I would have gotten that first big step up. My professor at Chicago to his dying day would never admit one way or the other.”

Nor will we ever know how much her life experiences as a woman influenced her decisions around thalidomide, but she did reflect, “I was very cautious about using drugs during my own pregnancies.”

Dr. Kelsey receiving the Medal for Distinguished Federal Civilian Service from President Kennedy. Photo: FDA.

Dr. Kelsey’s legacy teaches us that this must change. The point of diversity in science, as elsewhere in our society, is not only to create opportunities for underrepresented groups but also to expand our collective understanding by including and embracing a multitude of experiences and perspectives. Only in doing so can we ever hope to progress toward the democratic ideals of equality, freedom, and justice for all.

But how does anyone really “choose” Coke? While the company removed cocaine from the product more than 100 years ago, the amount of sugar remains staggering. A 20 oz. bottle—just one serving according to its Nutrition Facts label—contains 65 grams of sugar. That’s about 16 teaspoons and far exceeds what the American Heart Association, the World Health Organization, and the U.S. Dietary Guidelines Advisory Committee all recommend that people consume in an entire day. Moreover, recent brain research has shown that sugar “can not only substitute to addictive drugs, like cocaine, but can even be more rewarding and attractive.”

All that science on sugar is important because it contradicts the message the company would like us to hear—that is, that we should “choose” to drink more of their product. Coca-Cola spends hundreds of millions of dollars on annual advertising to persuade us that its choice of what we should be drinking is “our” choice. But the company’s tactics to control consumer “choice” don’t stop with catchy ad slogans. Coca-Cola, like other sugar interests, also pours money into misinformation campaigns aimed at casting doubt on the growing body of scientific evidence showing that excessive sugar consumption is harmful to our health.

When we wrote about this phenomenon in our 2014 report Added Sugar, Subtracted Science, we noted that many companies have their own research institutes and initiatives and pay scientific experts to conduct seemingly independent studies to promote their sugary products. We found that “Coca-Cola’s Beverage Institute for Health and Wellness features misleading content on its website. The site confuses the science around sugar consumption and ill-health by focusing on the role of sugar-sweetened beverages in ‘hydration’ and ‘energy balance’ while ignoring the negative impacts of sugar-sweetened beverages, including their role in obesity and metabolic diseases.”

Just recently, the company established a new “research” institute called the Global Energy Balance Network. Its purpose is to persuade people that they’re focusing too much on calories and portion size and not enough on exercise. The Network claims to provide “a forum for scientists around the globe to come together and generate the knowledge and evidence-based pathways needed to end obesity.”  But it doesn’t take much scratching under the surface to see that the scientists contributing to this forum can hardly claim to be independent of food industry conflicts of interest. At the top of their list of scientists is James O. Hill. A quick search of the Integrity in Science database, maintained by the Center for Science in the Public Interest, shows that Dr. Hill has ties to PepsiCo, McDonald’s, and the Sugar Association. He has also previously received consulting fees from Coca-Cola and other food companies.

Sure, “You can’t beat the feeling” of a Coke, as a 1987 ad put it. Why? It’s the sugar, of course! And, given what we now know is the toxic truth, Coca-Cola and other food companies have a lot at stake in persuading us to “choose” their sugary products over the science that tells us otherwise.

Journalists play a key role in communicating to the public the scientific information generated and used by the government. Earlier this year, UCS partnered with the Society of Professional Journalists to conduct a survey of science, health, and environment reporters. We wanted to know about their experiences trying to obtain information and speak with scientific experts at government agencies.

In a new report released today, we highlight survey findings and contextualize them through in-depth interviews with journalists and agency public information officers (PIOs) that we conducted following the survey.  In our report, we discuss four key barriers journalists identified in their efforts to interview agency scientists:

• Preapproval for interviews is required
• Interviews are closely monitored
• Interviews are denied
• Tough questions are avoided

Journalists’ perspective

Journalists expressed particular frustration with interview preapproval and monitoring. These practices, unlike denying interviews or avoiding tough questions, are explicitly written into policies at many agencies, and journalists rightfully worry that agencies can misuse monitoring and preapproval requirements to chill speech, spin the science, and hide wrongdoing. When PIOs utilize preapproval and monitoring to curtail what journalists can ask and how interviewees can answer, they exert a form of control over how reporters understand an issue and what they write—and hence the information the public receives.

Following the 2014 chemical spill in West Virigina’s Elk River, conflicting information and lack of access made it difficult for the media to assess the safety of the local water. Photo: National Guard

Journalists say they need agency scientists to be able to speak candidly, especially when the data or experts’ interpretation of the data differ from official reports. Such discrepancies can signal inappropriate political or corporate influence or interference and indicate the need for further inquiry. Journalists strongly support whistleblower protections as a vital mechanism for shielding agency experts from retribution when they publicly expose wrongdoing. However, they worry that agency employees may only be willing to risk alienating their employers by taking advantage of whistleblower provisions under the most egregious circumstances, as the act of whistleblowing can significantly damage or end a career.

The degree of control PIOs can exercise over journalists’ interactions with agency employees through preapproval and monitoring—even when that control is exercised responsibly—is a cause of concern within the journalism community.

Agencies’ perspective

We spoke to PIOs at NASA, NIH, EPA, and FWS and asked them what they thought of the barriers journalists had identified. All of the PIOs said that they strive to facilitate, and not inhibit, conversations between scientists and reporters. At some agencies, it’s easier to do that than at others. At NASA, for example, the 1958 Space Act mandates the dissemination of the agency’s scientific findings to the widest possible public. Correspondingly, survey respondents and journalists we interviewed spoke generally favorably about NASA’s openness. A survey respondent noted that “scientists at NASA are the easiest to interview” and that this agency, in contrast to others, has improved in recent years: “Nowadays, I can directly contact scientists at NASA and ask them questions. About a decade ago, this was not the case.”

However, in contrast to the barriers identified by reporters, PIOs at all four agencies cited three issues that they wished reporters were more cognizant of: staff capacity, bureaucracy, and litigation. The latter was emphasized as a particular concern at agencies that perform both research and regulatory functions, like the EPA and the FWS. PIOs have the added challenge of designating clear boundaries between communicating science and communicating policy. Those boundaries can be complex, and lines are not always easy to draw. In responding to a reporter’s inquiries, a PIO must make decisions about separating and clarifying where the responsibilities of scientists end and those of policy makers begin.

The bottom line

Ultimately, when PIOs, scientists, and journalists work together, everyone benefits. Journalists have their questions answered; write accurate, fact-based stories; and meet their deadlines. Scientists get to share their knowledge with the public. Agencies and policy makers gain credibility and trust. And the public obtains information about issues that affect their lives and communities. That’s why journalists, scientists, agencies, policy makers, and the public all have a stake in overcoming the above barriers to communicating government science.

Read our report to learn about the concrete steps agencies, journalists, and scientists can take to achieve that goal.

Following recommendations in the Scientific Report of the U.S. Dietary Guidelines Advisory Committee (DGAC), which UCS supported, the FDA’s decision to update its proposed labeling rule to reflect the scientific evidence on added sugar is a positive and welcome next step. Here are three reasons why.

1) Relying on science to inform policy

Experts are finding increasing evidence that excessive sugar consumption—whether from sugar cane, sugar beets, or corn—has been implicated in a myriad of health problems. Sugar, in the amounts and frequency Americans are consuming it, causes tooth decay. It is also associated with weight gain and with the rise in the incidence of diabetes, cardiovascular disease, high triglycerides, and hypertension. The association between sugar and these chronic metabolic diseases is separate from sugar’s effect on total caloric intake and exclusive of its effect on obesity.

Sugar can also activate the brain’s reward and craving centers, and high sugar consumption can stimulate addiction-like behaviors. In addition, added sugar, particularly from sugar-sweetened beverages, is a source of empty calories—harmful because they displace calories in more nutritious foods.

Like experts at the World Health Organization and the American Heart Association, the DGAC recommended in its Scientific Report that people consume no more than 10 percent of their daily calories from added sugar. In order to follow that science-based recommendation, people need to see the %DV for added sugar on packaged foods and beverages, as the FDA is proposing.

2) Fighting food industry misinformation

It’s hardly a secret that the food industry will oppose the FDA’s new proposal. Food and beverage manufacturers and their trade associations overwhelmingly opposed the original proposed rule to simply include a separate line for added sugar.

In our 2014 sugar reports, we documented the different ways the food industry works to misinform the public on added sugar. This graphic summarizes their tactics.

As UCS documented in two 2014 reports—Added Sugar, Subtracted Science and Sugar-coating Science—the food industry has gone out of its way to persuade the public to eat more sugar.  They’ve attacked the science, lobbied policy makers, and spent billions on advertising and high-powered PR firms. Along the way, they’ve to make sugar-laden products appear healthy and have even pushed sugar on diabetics and children under the guise of social responsibility.  We only celebrate Halloween once a year, but thanks to Big Sugar too many Americans are overdosing every day on the added sugar equivalent of a Halloween haul.

The FDA’s proposed changes to the Nutrition Facts label won’t magically stop food industry misinformation campaigns but will provide one more tool to empower the public.

3) Supporting the public’s right to know

Simply put, we have the right to know what’s in our food, and the current Nutrition Facts label doesn’t provide enough information about added sugar. Most people aren’t familiar with the 61 names for sugar and therefore cannot recognize them in the ingredients list. And without a %DV for added sugar, a separate line for the amount, whether it lists grams or the more familiar teaspoons, doesn’t tell people how much is too much.

Ultimately, the ubiquity of added sugar in our food and beverages means eating healthy foods is not just a matter of consumer choice, as the food industry would like us to believe. It’s hard to avoid added sugar even when we want to, and we need all the information we can get just to understand the scope of the problem.

The FDA’s updated proposed rule to the Nutrition Facts label to include %DV for added sugar is a welcome step in the right direction and would be a victory for science-informed policy if and when the rule is finalized. Tell the FDA you support their proposed changes by submitting a comment on the proposed rule. And tweet your opposition to food industry misinformation and efforts to block science informed policy on added sugar at the hashtag #bullsugar.

While not entirely surprising on its own (we’ve written about it here — and here and here and here and here and here), food industry denial of the science on added sugar stands out starkly in comments to the FDA from major companies and their trade groups. The Grocery Manufacturers Association said, for example, “there is scant evidence to support the idea that added sugar contributes to ill health” and therefore “providing this information in a nutrition label will not help aid consumers in maintaining a healthy diet.”

What is an ordinary person to do when both the food industry disagrees with independent scientists and public health experts so much yet both claim to have the facts on their side? The key is understanding motivations.

The First Line of Food Industry Defense

Perhaps the food industry believes that if they deny the science on added sugars often enough, loud enough, and to the right people—policymakers with the power to change labels and make dietary recommendations to the public—it will just go away.

The same trend we found in comments to the FDA appeared in food industry comments to the Dietary Guidelines Advisory Committee as these experts reviewed the evidence—and in comments on the DGAC’s final report to the U.S. Departments of Agriculture and Health and Human Services, in which the committee found moderate to strong evidence of a link between excessive added sugar consumption and a host of health problems, from type 2 diabetes to heart disease.

Laugh as we may, this tactic has worked in the past for Big Tobacco and for the Merchants of Doubt hawking climate change skepticism for fossil fuel interests. Following the close of the public comment period on the DGAC report on May 8 (Submit your comments today!), the USDA and HHS will develop the 2015 Dietary Guidelines for Americans, a document that will inform what Americans eat for the next five years.

Marion Nestle, a professor of nutrition, food studies, and public health at New York University and author of Food Politics, whom we spoke with about corporate interference in food policy, said, “Attacking the science is the first line of industry defense against recommendations that suggest eating less of their products. Food companies are following the lead of cigarette companies in that regard.”

Calling Something a Fact Doesn’t Make It One

The flip side of denying facts is claiming things to be facts that are not facts. This seems to be the latest trick the food industry is playing. In the website snippet below, the American Beverage Association, a trade group that represents companies like Coca Cola and PepsiCo, says on a page claiming to provide “the facts on added sugars labeling” that “sugar is sugar, regardless of its source.”

The science says otherwise.

Other trade groups, like the International Food Information Council tout their own “research” that finds, of course, that labeling added sugar is misleading and confusing because the public doesn’t know how to read food labels. Yet along with the independent experts serving on the 2015 Dietary Guidelines Advisory Committee, preeminent public health organizations, such as the American Heart Association, support limiting and labeling added sugar. How does the average person make sense of this disagreement over evidence and policy?

Dr. Robert Lustig, a pediatric endocrinologist, expert on the science of sugar, and author of the bestselling book Fat Chance, explained it to us succinctly when we spoke with him by phone. “The only ones opposed to limiting and labeling added sugar,” he said, “are the ones putting it in our food.”

Even at agencies that received high scores for their polices, anecdotal reports and earlier research indicate that, in practice, obstacles to clear communications between agency scientists and the media still exist. For example, a 2011 survey conducted by the Columbia Journalism Review and ProPublica found that the free flow of information between agency scientists and the press was not what journalists had hoped for, given the Obama administration’s promises of transparency.

That’s why—in an effort to shed further light on the issue of policy versus practice—UCS partnered with the Society of Professional Journalists to conduct a new survey of science, health, and environment reporters. We wanted to know about their more recent experiences trying to obtain information and speak with experts at government agencies at all levels.

What did we find? Things haven’t changed all that much since 2011:

• Public information offices routinely require reporters to get their approval before interviewing employees.
• Sometimes, when reporters ask to interview a specific subject matter expert, their request for an interview is routed to a different agency employee by the public information office.
• It’s not unusual for reporters to have to make multiple requests for information and interviews when they go through the public information office to get access to a subject matter expert.
• Despite reporters’ positive working relationships with public information officers, a majority feel that the public is not getting all the information it needs because of the barriers that agencies are imposing on journalists’ reporting practices

Ultimately, suppressing information challenges our democracy. Suppressing information and ideas in the ways this survey indicates harms the public understanding necessary to solve problems our nation’s most pressing problems. It allows for manipulation of the public for political or other reasons that may not be in the public interest. And it permits problems and malfeasance to go on unchecked.

Scientists and journalists have a shared stake in addressing these problems. At a release event at the National Press Club today, Carolyn Carlson, a former SPJ president, and UCS’s Michael Halpern are discussing the survey findings. Stay tuned for updates on this event and an expanded report on the survey’s findings, supplemented with interviews and recommendations, to be released in June.

_______________________________________________________________________________________________
“Thank you for this opportunity to speak. My name is Deborah Bailin, and I am an analyst in the Center for Science and Democracy at the Union of Concerned Scientists. I join my colleagues Lindsey Haynes-Maslow and Doug Boucher who are also speaking today, respectively, on healthy food systems and sustainability. I will be speaking on added sugars.

The Center for Science and Democracy works to expose misinformation campaigns, protect scientists from harassment, defend our nation’s science-based public health and environmental laws, and ensure public access to independent scientific information.

We strongly support the DGAC’s recommendation that Americans should limit added sugar consumption to a maximum of 10% of their daily calories. We also support the Nutrition Facts panel listing added sugars on a separate line from total sugars in both grams and teaspoons.

Myself and Lindsey Haynes-Maslow live-tweeting the hearing.

Studies increasingly point to sugar overconsumption as a major contributing factor in rising risks for metabolic syndrome, including type-2 diabetes and cardiovascular disease. These risks are disproportionately affecting our youth and low income and minority communities, and our nation is bearing the burden of the increasing healthcare costs associated with treating these diet-related chronic diseases.

Broad support exists in the public health community and among concerned citizens for limiting and labeling added sugar. This spring, the Center generated more than 26,600 signatures on a petition which we will deliver as a public comment to the agencies. These signatures represent the public’s approval of the DGAC’s recommendations on sugar. Additionally, we prompted more than 760 public comments from health professionals and food and nutrition scientists, representing support for the DGAC’s scientific-process and urging HHS and USDA to uphold the same standards.

Two reports the Center released in 2014—“Added Sugar, Subtracted Science” and “Sugar-coating Science”—document how food companies and trade associations attempt to influence food policy and to manipulate consumer choice. We found that sugar interests within the food industry have a consistent record of attempting to cast doubt on the body of scientific evidence linking sugar overconsumption to health problems. We also found that sugar interests often prioritize profits over public health in their efforts to influence consumer choice by marketing sugar-laden products as healthy—including products like bread, cereal, and yogurt that often contain surprisingly large amounts of added sugar.

In this regard, voluntary labeling efforts are insufficient. Such efforts are not uniformly implemented, have been shown to confuse consumers, and do not list added sugars. They highlight what food companies want us to know, not necessarily what we need to know.

I urge you to utilize the science on sugar’s health impacts and include strong language in the 2015 Dietary Guidelines encouraging Americans to limit sugar in their diets by restricting their daily intake of added sugars to a maximum of 10% of daily calories. To follow such advice, the public also needs an added sugars declaration on the Nutrition Facts panel. Such guidance would be consistent with the science on sugar and health, allow the public to make more informed choices, and help to promote health for all Americans. Thank you.”

While companies like General Mills and PepsiCo—responsible for the ubiquity of products with excessive added sugar in our grocery stores—may hide behind the veneer of socially responsible messaging, their trade associations are aggressively pushing contrarian views.

In comments to the Dietary Guidelines Advisory Committee (DGAC), the independent scientific body tasked with making recommendations to the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) as these agencies develop the 2015 Dietary Guidelines for Americans, the Grocery Manufacturers Association (GMA), the American Beverage Association (ABA), and  the Sugar Association have taken a page from Big Tobacco’s playbook. These and other food industry trade groups are striving to influence agency rulemaking by casting doubt on the mounting scientific evidence linking added sugar to obesity, diabetes, heart disease, and, yes, even tooth decay.

1) Attacks on the science

Members of the DGAC are distinguished scientists and have done their work with a very systematic, comprehensive and evidence-based approach. Their conclusions represent the scientific consensus. However, by creating the illusion of uncertainty, food industry comments to the DGAC attempt to discredit the committee’s scientific authority in order to undermine its recommendation to label and limit added sugar.

DGAC scientists in the Added Sugars Working Group.

The ABA, for example, asserts that the DGAC is acting improperly by “making recommendations that are more appropriately the responsibility of other authoritative bodies” and “providing recommendations on topics that clearly fall outside of their purview and that fail to reflect the relevant body of scientific evidence.” The GMA disputes the DGAC’s thoroughness, insinuating that the committee’s recommendations are not “based on the totality of available scientific evidence” because they do not align with member companies’ views.  A 14-page letter from the Sugar Association expresses “concerns” with the rigor of the DGAC’s research. In the letter, the trade group accuses the DGAC of following flawed methodology, claiming falsely that the findings in meta-analyses the committee relied on “contradict the positions and advice of U.S. professional organizations.”

2) Spreading misinformation

“Doublethink” is the term George Orwell coined in his novel 1984 for “tell[ing] deliberate lies while genuinely believing in them.”

The DGAC’s draft statement on added sugar, released during their November 2014 meeting, clearly acknowledges the support within the public health community, including the American Heart Association, for limiting added sugar.

In just one of many displays, the Sugar Association contends in its letter that the American Heart Association is one of the professional organizations disagreeing with the DGAC, citing an irrelevant paper on stroke prevention. To the contrary, the American Heart Association has expressly and publicly endorsed exactly what the DGAC is recommending—namely, limiting added sugar to 10 percent of daily calories. The letter says the same thing about the American Diabetes Association and the American Dental Association—and links to papers that similarly contradict the sugar group’s assertions.

In its own letter, the GMA, like the Sugar Association and the ABA, tries to downplay what every gum-smacking eight-year-old learns after visiting the dentist. In the letter, the trade group writes, “the frequency of sugar consumption, the stickiness of the food, and the length of time between sugar intake and tooth brushing plays a bigger role in the development of tooth decay than the quantity of sugar.” That statement is then referenced with a study that finds exactly the reverse: “The evidence that dietary sugars are the main cause of dental caries is extensive …. Without sugar, caries would be negligible.”

3) Deploying industry scientists and influencing academia

Another common tactic of sugar interests—when the only studies they can find unambiguously refute their own assertions—is to deploy their own scientists to dispute mainstream science and repeat industry talking points. In another letter to the DGAC, the GMA chides the committee for an incomplete review of the available science and proffers a list of scientists with whom the committee should consult.

The DGAC found compelling evidence of a link between sugar consumption and obesity, but you’d never know it if you asked industry-funded scientists.

All five scientists named have food industry conflicts of interest on sugar [links to form page; enter scientist’s name in the form to see conflicts]. Theresa A. Nicklas received support from the Sugar Association; Joanne L. Slavin was funded by General Mills; and G. Harvey Anderson received support from General Mills, Archer Daniels Midland, and unrestricted funding from the Sugar Association and the Canadian Sugar Institute. In 2014, the other two, John Sievenpiper and Roger Clemens, appeared on an industry “sponsored satellite program” organized at a biology conference by James Rippe, an infamous figure paid $41,000 a month—among other conflicts of interest—by the Corn Refiners Association to produce and publish research that aligns with the trade group’s position on high fructose corn syrup and health.

4) Undermining policy

Ultimately, the goal of all this sophistry is to forestall policies aimed at protecting Americans’ health. And there’s nothing new in the tactics outlined here. As we’ve written, the Sugar Association went so far as to threaten the World Health Organization in 2003 when it released a report recommending  a 10 percent daily limit on calorie intake from sugar. Those familiar with WHO history described sugar industry pressure as “tantamount to blackmail and worse than any pressure exerted by the tobacco lobby.”

Artist Kara Walker’s “A Subtlety, or the Marvelous Sugar Baby” at the old Domino Sugar factory in Brooklyn, New York. The foam structure was coated in 30 tons of sugar. As a work of “ephemeral art,” it was dismantled after only two months, perhaps a comment on the dominance and potential demise of Big Sugar. Photo: Lauren via Flickr.

Doublethink, in Orwell’s dystopia, is about denying objective reality at the same time those in power are taking advantage of it. There is no place for doublethink in our democracy. As the USDA and HHS prepare the new dietary guidelines, they should rely not on doublethink but on the best available science.

The DGAC’s recommendations on added sugar recognize the growing body of scientific evidence that over-consumption of sugar is a major contributing factor to the increased risk of developing metabolic syndrome, along with the subsequent and significant health care costs of treating it.

By following the DGAC’s recommendation, the USDA and HHS could have a significant impact on turning the tide against the chronic diseases affecting American families and communities across the nation.

But too many children in Baltimore were not so fortunate. This highly contagious and serious disease sickened around 500 area residents, mostly children, and caused a third of them to wind up in the hospital. Across the nation, thousands of people were afflicted during that outbreak and 41 died.

A majority of victims in Baltimore were poor and African American or Hispanic. Vulnerable to barriers like cost and healthcare access, they were unvaccinated—or under-vaccinated—not by choice but by circumstances.

Overcoming social privilege through science-based policies

Today, as the Disneyland measles outbreak continues to unfold, the demographics have changed somewhat. Many white, educated, affluent parents are choosing not to vaccinate their children. However, individuals under-vaccinated by circumstances still tend to be poor and black, placed at greater risk of preventable illness by the decisions of others.

The choice not to vaccinate, often framed in terms of individual liberties, is not just a personal one. It’s infused with privilege and has consequences for those who have less freedom to choose—not only those who have difficulty accessing healthcare but children who are too young to be vaccinated and people with compromised immune systems.

In the wake of the Baltimore outbreak during my college years, both the city and the State of Maryland made important policy changes that improved access to immunizations and empowered residents to protect themselves and their communities through science-driven interventions. Clinics added extra hours; walk-in appointments were permitted; a pre-vaccination physical exam was no longer required; and vaccines were offered free of charge.

But will these measures be enough to keep Baltimore measles free?

Baltimore statement on childhood vaccination

Along with public engagement efforts, Baltimore’s policies have paid off over time. As the current Baltimore City health commissioner, Dr. Leana S. Wen, put it in a public statement this week, “For the last ten years, our city has seen zero measles infections. Zero hospitalizations. Zero permanent injuries. Zero deaths.”

Dr. Leana Wen, flanked by local doctors, scientists, and public health leaders, speaking at the Johns Hopkins School of Public Health on the importance of childhood vaccination. Photo: Deborah Bailin

Dr. Wen made her remarks at a symposium I attended organized by the Johns Hopkins School of Public Health. Sitting in an auditorium at my alma mater hearing Dr. Wen speak made me proud of my school and the city I once called home, but I also keenly appreciated how much my perspective during that outbreak in my college years had been shaped by social privilege as much as by the success of vaccines. I didn’t worry about measles because, unlike the kids in nearby neighborhoods, my parents—and the parents of my friends and the parents of their friends—had easy access to medical care. They had us vaccinated as children and, in doing so, created a level of protection against disease in our communities that was unprecedented in human history.

Yet it is this unprecedented freedom from diseases once a scourge to humanity that has created a different and dangerous kind of privileged perspective—a distortion of risks that rejects science for sickness and places the personal freedom to chance disease above the public will to stay well.

Balancing individual liberties with safeguards to protect the common good has always been a challenge for our democracy, even as science has advanced and policy has worked hard to keep pace. From the audience, I felt the passion—and compassion—in Dr. Wen’s voice as she tried to navigate this complexity. “Baltimore is not an island,” she cautioned, reminding us of the precariousness of her city’s success:

“Despite consensus among doctors and scientists that vaccines are safe and effective, there have been increasing numbers of parents who have chosen not to vaccinate their children. In 2014, there were 644 cases of measles across 27 states.

“The recent outbreak that began at Disneyland is spreading among unvaccinated children. As a result, parents of children who are not able to be vaccinated, such as those under one year of age and those with weakened immune systems, are fearful of illness and complications. The Disneyland outbreak raises the real risk that measles may come roaring back.

“We have come too far to let that happen …. “

Baltimore is not an island

Even as initiatives like Baltimore’s have helped to democratize access to vaccines and reduce racial and ethnic disparities in immunization rates, rising personal belief exemptions across many states mean that we can no longer count on community immunity (the discovery of Arthur Hedrich, another Baltimorean and Johns Hopkins scientist) to safeguard the vulnerable groups Dr. Wen mentioned. To sustain community immunity, localities, states, and the federal government must work together.

Baltimore—its science-based policies and high vaccination rates notwithstanding—cannot maintain its freedom from measles forever, as long as other localities lack stronger safeguards to stop the spread of this preventable disease.

In retrospect, even though I attended college steeped in the culture of Hopkins’ highly regarded achievements in science and medicine, I now recognize that as a student I took my health and my freedom from diseases like measles for granted. Are we not doing the same thing today when we fear vaccines more than the diseases they have prevented so many of us from ever having suffered? Are we not taking both science and democracy for granted if we pretend that privilege equals personal freedom and knowledge carries no responsibility to act on behalf of the public good?

The study examined the salt and sugar content of commercial infant and toddler food in the U.S. Researchers looked at a 2012 dataset of 1074 infant and toddler foods and beverages. Among infant products, they found that 41 of 79 mixed grains and fruits—i.e. healthy seeming items—contained more than one added sugar; in 35 infant items, more than 35 percent of calories came from sugar. Among toddler products, the researchers found that 72 percent of dinners and most cereal bars, breakfast pastries, fruit, snacks, desserts, and juices contained more than one added sugar.

Given the American Heart Association’s recommendations on added sugar, it’s pretty clear from the CDC study that many very young children are getting too much.

How do parents know how much is too much?

The study concludes with advice to pediatricians. Namely, counsel parents to pay attention to labels on the food and drink products they buy for their infants and toddlers and try to limit the added sugar. Unfortunately, this advice—no matter how well parents try to follow it—can only go so far.

An added sugars declaration on the Nutrition Facts label would empower consumers with knowledge of how much sugar has been added to foods. Photo: iStock

Currently, the Nutrition Facts label does not provide parents with enough information to truly make informed decisions. Total sugar is listed in grams—not the more familiar teaspoons—and neither the amount of added sugar nor the percent daily value are provided. So parents, who may be trying diligently to follow their pediatricians’ science-informed advice, cannot know how much sugar has been added to the foods and beverages they are feeding their infants and toddlers—or how much is too much.

As the FDA considers its proposed rule to update the Nutrition Facts label to include added sugar, the U.S. Departments of Agriculture and Health and Human Services are concurrently developing the 2015 Dietary Guidelines for Americans. A forthcoming report from the Dietary Guidelines Advisory Committee—an independent scientific body tasked with providing guidance to the agencies—is expected to contain recommendations on limiting added sugar to a maximum of 10 percent of daily calories and including added sugar and percent daily value on the Nutrition Facts label.

It would be an important, science-based step forward not only for parents of young children but for all Americans if the agencies decide to adopt the DGAC’s recommendations on limiting and labeling added sugar.

It’s not about personal choice

One of the important things that will happen if and when more information about added sugar is made available on food labels is that people will better understand not only the amount of it in any one food product but how omnipresent it is across our food supply.

Cheerios is a brand many consumers trust as “healthy,” but while regular Cheerios only has 1 gram of sugar, Cheerios Protein has a whopping 17 grams per serving (more than 4 teaspoons). That’s more than half what the American Heart Association recommends for women for an entire day. But you’d never know it from the current Nutrition Facts label, which only lists total sugar and no percent daily value.

Predictably, the food industry has responded to the CDC’s study on infant and toddler food with skepticism, doubt-mongering, and the old, tobacco-style “free choice” argument. According to the Grocery Manufacturers Association, a trade group representing major food companies like General Mills, the CDC study “does not accurately reflect the wide range of healthy choices available in today’s marketplace” and “could needlessly alarm and confuse busy parents as they strive to develop suitable meal options that their children will enjoy.”

Indeed! Those busy parents would realize that added sugar is everywhere and almost unavoidable in processed food that is marketed to appear healthier than it really is—not only in infant and toddler food but in cereal, bread, yogurt, pasta sauce, and even salad dressing. These aren’t choices in any real sense of the word. If the food industry really cared about healthy choices, it would accept the science linking sugar to a host of health problems and be honest with their customers. Maybe choices and preferences would change—and maybe the food industry would have to change, too, if it wanted to keep those customers.

And that’s a lot more challenging—but a lot better for public health—than doubt-mongering and science denial.

The Wingspread Conference Center, including the beautiful grounds pictured here, is a very different environment from where I used to teach. All children should be able to learn and grow nurtured by healthy, safe, and comfortable surroundings. Photo: Deborah Bailin

This future for children’s environmental health—and the words I’ve borrowed describing it—is one I had the privilege of envisioning together with an invited group of scientists, advocates, policy experts, and community organizers. Convened by the Children’s Environmental Health Network, we met at Wingspread to articulate the vision and develop a blueprint for what actions would be necessary to achieve it. Although I had previously not devoted extensive thought to child-specific issues, the conversations we engaged in made me reflect in new ways on some of my past, current, and future work—and to see connections and patterns I had not seen before.

Confronting environmental injustice

Although I didn’t know it at the time, my introduction to children’s environmental health came 16 years ago when I began my first real job after college—teaching 11^th and 12^th grade English in a socioeconomically disadvantaged community in Washington, D.C. Growing up going to good schools and having teachers for parents, I knew the value of an education, and I wanted to make the kind of difference in the lives of my students that my teachers had made in mine. I stayed late to plan lessons, took home mountains of papers to grade, and worked tirelessly one-on-one with struggling students through lunch and free periods.

Yet no amount of motivation could have prepared me for the environment where I taught—and no individual effort could compensate for it. Our building was 100 years old. There was lead in the paint. Faulty electrical wiring brought the fire department more than once. My classroom lacked windows, had ancient and malfunctioning heating/air-conditioning vents, and boasted a worn carpet that ate chalk dust better than the vacuum I used to clean it. Many of our textbooks—before they were gradually replaced—were damaged from long storage in drafty, leaky closets where water (and in one case bird droppings) left pages wrinkled and smelling of mildew and mold.

Since leaving in 2002, I occasionally run into former students. Just a few months ago, one of my 11^th graders, now approaching 30, tapped me on the shoulder on the subway. “Hey, Ms. B.,” he said, smiling ear to ear, “Do you remember me?” I couldn’t have been happier to learn that the kid who used to get in trouble for drawing on his desk now has a career as a graphic designer. I find his resilience remarkable, but no child should have to contend with the kind of environment he did just to get an education.

The need for science-based policies that protect children

Harmful environmental exposures and policies that permit them, of course, are not just a problem for children in disadvantaged communities, although children from communities of color, low-income, and tribal communities are some of the most vulnerable. In the case of the school where I taught, there was no shortage of scientific and other evidence documenting the problems and how to solve them, but lack of resources and political will made doing so difficult. In the intervening years, the school raised money and, thankfully, has undergone major renovations that have improved the environment for today’s students, but not all children are as fortunate.

Most of our meetings took place inside the room with the windows on the left here. It was a beautiful view that inspired us to envision the future of children’s environmental health.

Moreover, many federal, state, and local policies have the potential to affect the health of children even when these policies do not pertain specifically to children’s issues. For example, the patchwork of laws governing the recent expansion of unconventional oil and gas development (known as “fracking”) lacks adequate transparency provisions for chemical disclosure and monitoring. This leaves citizens without information they need to make evidence-based decisions about what’s best for their communities—particularly the children.

As my colleague Gretchen Goldman wrote, a new study on air pollution near fracking sites found unsafe levels of formaldehyde, benzene, 1,3-butadiene, and hydrogen sulfide. Exposure to these chemicals poses risks to everyone, but children are uniquely vulnerable. Hydrogen sulfide is heavier than air, and children are thought to be at risk of higher exposure levels because they are shorter than adults. Experts also speculate that the respiratory irritation and asthma-like symptoms caused by exposure to formaldehyde could occur in children from lower concentrations, but we simply don’t know because it hasn’t been studied.

Similarly, it is not known if children are more susceptible to benzene poisoning than adults, but what we do know from animal studies is that benzene is linked to low birth weights, delayed bone formation, and bone marrow damage when pregnant animals breathe it. Prenatal exposure to benzene thus has potential negative and life-altering consequences for children. And so does prenatal exposure to 1,3 Butadiene, which has such widely recognized human reproductive and developmental impacts that the CDC recommends special counseling for pregnant women who have been acutely exposed.

Chemical disclosure and monitoring of air quality around unconventional oil and gas sites is essential if citizens are to have the information necessary to make the right decisions for their communities, but so is information pertaining to children’s health. Policies that protect adults from harmful exposures may not adequately protect children.

Our responsibility as citizens

To achieve the future for children that we envision, it isn’t necessary for all of us to become children’s health experts, but many of us—including myself—can do more to pay attention and advocate by elevating relevant issues.

At Wingspread, a house designed by Frank Lloyd Wright, a narrow ladder spirals alongside the central fireplace to a glass tower at the top. Its purpose was to give children in the family a spectacular panoramic view of the surrounding landscape—their surrounding world. All children deserve to grow up in environments that nurture their imaginations and their ability to see the world, not just survive in it. Photo: Deborah Bailin

For example, for all the research I put into our reports Sugar-coating Science and Added Sugar, Subtracted Science, I was surprised to learn from another Wingspread participant that even baby formula—distributed to new parents at hospitals in food industry sponsored gift bags—contains hidden and excessive added sugar. What a powerful statement about sugar interests’ intrusion into the lives of children! Yet I hadn’t noticed because I hadn’t even been looking.

As we round the corner on another Halloween, we all can take a stand for children’s environmental health by telling our members of Congress to stop the attack on healthy school lunch standards.

Small steps count.

In our democracy, children are a unique group. They cannot vote and cannot otherwise fully participate in decision making that directly influences their health and quality of life. They depend on adults to take evidence about their needs into consideration, especially when our decisions have lasting consequences for their lives. If we care about the future of our nation, we should do so. Even if we have no children of our own, their future is our future—and it is the only future.

The film’s producers are currently organizing a back-to-school challenge—a national campaign to break free from added sugar with a particular focus on kids and schools. They are asking kids, schools, parents and communities to give up added sugar for 10 days. Several of my colleagues and I took the added sugar challenge over the summer, and as we can all attest, it’s easier said than done. Eliminating added sugar from our daily diets requires changing how we think about our food—not just in terms of our personal choices but also our public policies.

The classic peanut butter and jelly sandwich is often loaded with more sugar than dessert. Photo Ibán/Flickr.

1) Added sugar is everywhere

Nothing says school lunch or after school snack like the classic peanut butter and jelly sandwich. Fluffy white bread. Rich, creamy peanut butter. And sweet, gooey grape jelly. Mmmmm!

But how much added sugar is in that PB&J lunch or snack? It may surprise you to know that your kid’s healthy seeming sandwich—it’s just bread, peanuts, and fruit, right?—could well contain more added sugar than dessert.

To put this “healthy” sandwich in perspective, a serving of Oreos (3 cookies) has 14 grams or 3.5 teaspoons of sugar. This sandwich has almost double. And it exceeds the American Heart Association’s recommendation for maximum daily sugar consumption of sugar for women and more than half the recommendation for men.

2) Eliminating added sugar

Although I am hoping you will never look at a PB&J sandwich the same way again, there are alternatives to the high-in-added-sugar version above. Substitute artisan or other bread with no added sugar for the go-to garden variety white bread. Replace the jelly or jam with real fruit. And use only peanut butter with no added sugar.

The sandwich pictured below, which I ate for lunch today, is made from sprouted seven grain bread, banana slices, and peanut butter with only one ingredient: organic roasted peanuts. Finding bread and peanut butter with no added sugar can be challenging, but it is possible. I used 2 slices of Food for Life’s 7 Sprouted Grains bread and 2 tablespoons of MaraNatha’s organic creamy peanut butter.

This peanut butter and banana sandwich I had for lunch contains no added sugar. Photo: Deborah Bailin.

3) Labeling added sugar

The food industry would like us to think that the ubiquity of added sugar in our food is the result exclusively of our personal choices as consumers. We want sugar, says the food industry (and those who represent them), and so they give it to us. Everywhere. In everything from salad dressing to soup to yogurt.

As the Fed Up sugar challenge illustrates, however, it’s hard to avoid added sugar, even when you’re trying to. Contrary to the personal choice argument, the food industry is going out of its way to mislead us about the science on sugar, “bury the data,” and interfere with science-based policies. Given recent research showing that sugar has addictive qualities, it is hardly surprising that food manufacturers are offering us more and more of it—they know we will buy it. And that doesn’t give much credence to the personal choice argument.

Currently, the FDA is considering changes to the nutrition facts label that would include labeling added sugar. Labeling added sugar would give us more control over our food choices by providing us with better information. Since the current label does not distinguish between naturally occurring and added sugar, making good choices can be confusing.

My peanut butter and banana sandwich is a perfect example. The bread and the peanut butter each contain one gram per serving of sugar, but to know whether that is added sugar or naturally occurring sugar, I had to look beyond the nutrition facts label, which only lists total sugar, to the ingredients—and then, for the bread, I had to go online and consult Dr. Robert Lustig’s Shopper’s Guide to the 56 names for sugar to be sure.

It simply shouldn’t be that hard to figure out the sugar in our food!

It’s not just peanut butter sandwiches loaded with hidden added sugar. Many seemingly healthy foods are high in added sugar, too. Read our report Sugar-coating Science: How the Food Industry Misleads Consumers on Sugar to learn about tactics sugar interests use to hide the truth.

Join the Fed Up movement

What can you do? Bring the movie “the food industry doesn’t want you to see” to your community. Join the Fed Up National House Party Day! Invite your friends and family over to watch the movie at a viewing party. You can even get a screening host guide that will help you generate an impactful post-screening discussion.

And get your friends and family–especially the kids–to take the Fed Up Back-to-School Challenge. As I can attest, lifelong good habits start early!

That last one is for real. Indeed, you, too, could join Domino Sugar in “baking an impact” to raise funds to increase participation in school breakfast programs.

As I wrote back in May, however, social responsibility initiatives by food companies should be scrutinized carefully. It can be worth applauding when corporations fund good causes, but the same companies supporting these causes in the name of their popular brands also continue to obscure the science linking sugar to health problems like obesity, diabetes, cardiovascular disease, high triglycerides, and hypertension — together known as “chronic metabolic diseases.” A key element of obscuring the science is undermining policy efforts aimed at limiting added sugar.

Peddling sugar to children and diabetics

Spreading misinformation about sugar among diabetes educators is something we might condemn but expect from the Sugar Association. Trade groups provide many benefits to their member companies, and one of the most important is leverage for influencing policy and public opinion.

Sometimes, member companies hide behind trade associations to protect themselves from negative publicity surrounding an unpopular or controversial position—for example, energy companies calling for action on climate change in the public spotlight while quietly lobbying for fossil fuels through their trade associations.

Artist Kara Walker’s “A Subtlety, or the Marvelous Sugar Baby” at the old Domino Sugar factory in Brooklyn, New York. The foam structure was coated in 30 tons of sugar. As a work of “ephemeral art,” it was dismantled after only two months, perhaps a comment on the dominance and potential demise of Big Sugar. Photo: Lauren via Flickr.

In the case of sugar, apparently it is easier to hide in plain sight. Like its trade group the Sugar Association, Domino Sugar is out on the front lines cultivating the good graces of diabetics and their advocates, most recently as an official sponsor of the “Kids Zone” at the upcoming Step Out: Walk to Stop Diabetes.

The irony—like an extra slice of chocolate cake masquerading as melon—is decadent: Most Americans consume far more sugar than experts recommend. Mounting evidence shows a causative relationship between sugar overconsumption and chronic metabolic diseases. Recent research links sugar overconsumption specifically to diabetes. And some experts even argue sugar is toxic enough that it should be controlled like alcohol and tobacco.

A sugar company promoting sugar to kids under the guise of preventing diabetes is about as disingenuous a gesture as a liquor company sponsoring a campus tequila tasting to fight underage drinking.

Undermining science-based policy

But what does pushing sugar to diabetics, as despicable as that may be, have to do with the “baking an impact” campaign?  If eating breakfast improves school performance and the occasional cookie is okay even for diabetics, why call out the Domino “baking an impact” campaign? The answer takes us back to trade associations and their efforts behind the scenes to influence policy.

Federal policy determines school menus, and it is no accident that breakfast at schools Domino holds up as model beneficiaries of “baking an impact” includes many options high in added sugar. Along with bagels, Rice Chex cereal, and Corn Flakes, children can choose Cinnamon Toast Crunch cereal (10 grams of sugar per serving), Frudel (11 grams), Nutri-Grain bars (12 grams), and BeneFit bars (13 grams). A kid could easily surpass six teaspoons of sugar with just two of these items, without even touching the juice or baked goods. That amount exceeds the American Heart Association’s recommendations that a pre-teen consuming 1600-1800 calories daily ingest a maximum of just 3-5 teaspoons of sugar per day.

Why do kids have access to so many sugary items at school? As our report documents, sugar interests—including the Sugar Association—were instrumental in shaping the USDA’s recent rule implementing the Healthy Hunger Free Kids Act.

The agency considered regulating sugar in foods sold in schools as 35 percent of total calories and as 35 percent of total weight. Put in context, a Nutri-Grain bar has 120 calories and weighs 37 grams. With 40 percent of its calories from sugar, it would exceed the proposed caloric limit. But with only 32 percent of its weight in sugar, schools could include it on their menus.

Public health experts including the American Cancer Society, American Heart Association, and Institute of Medicine agreed that the caloric limit was a more appropriate policy based on scientific evidence and was consistent with the USDA’s Official Dietary Guidelines. They provided 70 comments in support of a caloric limit during the public comment period preceding finalization of the rule.

By contrast, the sugar-by-weight option, which was adopted in the interim final rule, received support from 1,165 commenters—including trade associations and food manufacturers—arguing it was consistent with current measurement methods, would be easier to implement, and would allow for the sale of more products.

The Sugar Association weighed in with explicit misinformation, writing, “reports continue to conclude that sugar intake is not a causative factor in any disease, including obesity.”

Holding sugar interests accountable

Ah, the wholesome glories of the bake sale! Photo: Sara Mohazzebi/Flickr.

Don’t get me wrong—I don’t object to bake sales or sugar per se. My inner eight-year-old may not recollect what charitable cause she was supporting, but she does fondly remember (with three-days’ lunch money in her pocket) the gymnasium one day transforming into a glorious emporium of cookies and cakes and pies—oh my!

But if Domino expects the public to take its gestures of goodwill seriously, the company should distance itself from allies that spread misinformation, not mimic or endorse them. And it should openly own up to the science on sugar, not just its seductive sweetness.

According to the Sugar Association, this was, apparently, the sentiment expressed by a majority of the attendees that stopped by the trade group’s booth earlier this summer at the American Association of Diabetes Educators (AADE) Annual Meeting.

If I were attending the annual meeting of the American Association for Cancer Education, the last exhibitor I’d expect to see would be the Tobacco Merchants Association! If I happened upon such a presence, I’d be a bit dumbstruck at the audacity of promoting tobacco use to cancer educators under, perhaps, the guise of harm reduction. My reaction would probably be to nod and smile politely, while backing away slowly: “Yes, indeed! Certainly, tobacco does get a bad rap.”

Sadly, the Sugar Association patting itself on the back for taunting diabetics with desserts is just the latest example of sugar interests distorting or dismissing the science on sugar’s negative health outcomes in efforts to sway public opinion and influence policy—and underwhelming at best. At worst, distributing so-called fact sheets to conference goers that claim, “The scientific evidence is clear, dietary sugars per-se pose no direct negative health impact,” citing cherry-picked reports from 25 years ago, is appallingly misleading.

But then, it’s hardly surprising to find sugar interests peddling misinformation.  They’re experts at it with decades of experience.

Sugar Information Inc. was the precursor to the Sugar Association. This ad appeared in 1960. Although it contains some factual information (e.g. humans have an innate attraction to sweet tastes), It also contains misinformation (e.g. no other food satisfies your appetite so fast). The statement, “published in the interest of better nutrition,” misleads consumers about the motivation of the organization and suggests that added sugar is good for our health.

Scientific evidence supports a causal relationship between sugar and chronic metabolic diseases

As documented in our recent report Added Sugar, Subtracted Science: How Industry Obscures Science and Undermines Public Health Policy on Sugar, evidence continues to mount implicating excessive sugar consumption—whether from sugar cane, sugar beets, or corn—in numerous health problems. Sugar, in the quantities Americans are consuming it, has been associated not only with type 2 diabetes but also with cardiovascular disease, high triglycerides, and hypertension. The association of sugar with these chronic metabolic diseases is found separate from sugar’s effect on total caloric intake and exclusive of its effect on obesity.

On the basis of the latest and best available scientific information, scientific and governmental bodies, including the World Health Organization (WHO), the American Heart Association (AHA), the U.S. Department of Health and Human Services (HHS), and the U.S. Department of Agriculture (USDA) have recommended sugar intake standards far below the typical American consumption levels.

Despite the adverse health effects of sugar and the recommendations of public health experts to reduce consumption, most Americans consume much more added sugar than they should. Why is this so?

A playbook replete with tobacco-style tactics

As the Sugar Association’s appearance at last month’s diabetes conferences illustrates, sugar interests continue to obscure the science on the health effects of added sugar. As we discuss in both our report cited above and its companion Sugar-Coating Science: How the Food Industry Misleads Consumers on Sugar, sugar interests have, in fact, intentionally and actively worked for more than 40 years to suppress the scientific evidence linking sugar consumption to negative health consequences.

Sugar interests have attempted to discredit or downplay scientific evidence and have intentionally spread misinformation. They have hired their own scientists and have paid seemingly independent scientists to speak on behalf of the industry and its products. They have launched sophisticated public relations campaigns to influence public opinion.

And, yes, they have worked to influence the academic community including at scientific meetings and through the scientific literature.

To implement the tactics cited above, sugar interests spend billions of dollars annually to persuade Americans to eat and drink more sugary foods and beverages through marketing and other measures. Their actions interfere with how the public responds to scientific information about added sugar, distort our understanding of our food choices, and contribute to our continued high consumption of foods with added sugar.

Yes, indeed, sugar does get a bad rap and deservedly so—not only because excessive consumption is bad for us but also because of sugar interests’ efforts to mislead us about this simple fact.

A cynic might say the Sugar Association’s appearance at a diabetes conference is little more than another clever marketing ploy to “bury the data” by sweet-talking health educators and practitioners with deliberate deceits.

As documented in our reports, sugar interests have employed these tactics for years to mislead the public.

Today, however, preventable diseases like measles and whooping cough are on the rise because of unsubstantiated public doubts about vaccine safety. Misinformation in the public sphere, like the thoroughly refuted claim that vaccines cause autism, generates uncertainty and causes people to make decisions about their health and the health of their children based on fear rather than science.

A new and misnamed book co-authored by Robert F. Kennedy Jr., Thimerosal: Let the Science Speak,  is filled with exactly the kinds of misrepresentations of facts and slippery slope distortions of research that sway people—often those who are most earnest about seeking information—away from the science.

A minefield of misinformation

UCS has never been shy about calling out political or corporate interference in developing and implementing science-based public policies. We’ve done so many  times right here and here on this blog—and here and here and here. If there were a story to be told—as the book claims—about the Centers for Disease Control and Prevention colluding with the pharmaceutical industry on a vaccine policy conspiracy, we would be telling it.

But we aren’t because there isn’t.

The argument the book tries to make—that thimerosal in vaccines is harming human health, specifically children’s brains—is an old one that scientists researched thoroughly and subsequently dismissed years ago.  Thimerosal—a preservative containing ethyl mercury—destroys bacteria and has been used to make vaccines safe from contamination since the 1930s. Thimerosal was removed from childhood vaccines in the U.S. in 2001 out of excessive caution by the FDA  in the wake of the EPA’s reevaluation of exposure levels to another type of mercury—methyl mercury. Childhood vaccines administered in other countries still contain thimerosal, as do multi-dose preparations of flu vaccines in the U.S. because studies conclude that exposure to ethyl mercury in the amounts present in vaccines is safe.

Methyl mercury, unlike ethyl mercury, is an industrial pollutant. We are increasingly exposed to it through eating fish and other environmental sources, which is why the EPA reassessed exposure standards in the 1990s. The difference between the two types of mercury resembles the difference between ethyl alcohol (ethanol) and methyl alcohol (methanol). Beer, wine, and liquor contain ethanol; we drink it with dinner. Anti-freeze contains methanol; drinking a few shots would kill you.

A doctor prepares to give a MMR (measles, mumps, and rubella) vaccination in Ethiopia. Childhood vaccines outside the U.S. still contain thimerosal because it has proven safe, effective, and economical. Credit: UK Department for International Development via Flickr.

Although the book acknowledges a difference between ethyl mercury and methyl mercury, the authors extrapolate, against the evidence, that ethyl mercury is just as toxic, if not more toxic, than methyl mercury. Even their sources dispute this claim. Referencing paper after paper after paper on the dangers of mercury, the long list of citations seems impressive, until you follow the links and discover these studies are actually about the effects of methyl mercury, not ethyl mercury.

Studies that conclude ethyl mercury is safe are dismissed as flawed via other studies relying on the Vaccine Adverse Event Reporting System (VAERS) with actual dubious methodology. And via the findings of Mark and David Geier, infamous in scientific circles for advocating chemical castration with Lupron for autistic children. And the assertions of discredited scientists like Boyd Haley, notorious for preying on autistic children and their parents by advocating chelation therapy as a cure for autism.

Findings are also taken out of context. The abstract of this 1975 animal study concludes, “No evidence of toxicity due to thimerosal was seen in any animal. Nevertheless accumulation of mercury from chronic use of thimerosal-preserved medicines is viewed as a potential health hazard for man.” Yet the book only concerns itself with the last part and leaves out or dismisses the significant research published since that continues to show no correlation between thimerosal and neurodevelopmental problems.

And, contrary to what the book would have us believe, children are not being exposed to dangerous levels of ethyl mercury in vaccines. Accessible and transparent information provides details on the mercury content of childhood vaccines. Flu vaccines are the only vaccines containing thimerosal children in the U.S. may still encounter, and even these are available in non-thimerosal formulations.

The danger of spreading misinformation about vaccines

When the first vaccine—for smallpox—was invented over 200 years ago, Thomas Jefferson wrote:

“Every friend of humanity must look with pleasure on this discovery, by which one more evil is withdrawn from the condition of man; and must contemplate the possibility that future improvements and discoveries may still more and more lessen the catalogue of evils.”

Jefferson would have been impressed with the progress science has made against diseases such as smallpox, which was eradicated globally in 1980. To continue to fulfill this vision, though, our democracy demands that we rely on facts and reason, not conspiracy-fueled fictions.

Developing vaccines for some diseases like HIV/AIDS and Ebola continue to elude science. Scientists, policymakers, and the public cannot afford to turn back the clock and re-fight old battles with diseases that are preventable with existing vaccines. When misinformation about vaccines spreads, diseases win. Credit: International AIDS Vaccine Initiative via Flickr.

As RFK Jr. should well know from his work on climate change, generating doubt by misrepresenting the science has negative consequences for the public. Because of his stature and good work on so many other issues, he has a special responsibility to get the science right. But this book falls short.

Simply put, spreading misinformation about vaccines leads to unnecessary sickness and death. Reversing humanity’s progress towards eradicating dangerous infectious diseases—and having to re-fight old battles for community immunity—not only costs lives but distracts attention and resources from diseases we have yet to conquer, like the Ebola virus currently devastating West Africa.

Photo: BBQ Junkie via Flickr http://www.bbqjunkie.com/bbq-competition/moorpark-fall-fest-bbq-cook-off/

Hint: It’s probably more than you think!

Before I get to that, though, I want to underscore the importance of the FDA’s proposed change to label added sugar. Along with more than 275 public health experts, UCS is submitting a joint signed statement to the FDA in support of this important change. With increasing evidence linking the over-consumption of sugar to chronic metabolic diseases like diabetes and cardiovascular disease, labeling added sugar will help the public make more informed decisions about what we put in our bodies.

The sugar adds up

Take a simple menu you might pull together for a family backyard cookout:

The World Health Organization recommends that we consume no more than 10 percent of our daily calories from sugar—that is, 50 grams or about 12 teaspoons. The American Heart Association recommends even less. All of the amounts shown in this table were calculated for single portions from easy recipes on the Food Network website. A teaspoon contains 4.2 grams, and we rounded to the nearest whole number.

This simple meal of summer favorites that does not even include dessert (or bread or cornbread) contains well over a day’s worth of sugar! Even subtracting out the sweet tea, we are left with 71 grams, well above the daily recommended amount. (And vegetarians, we’re not off the hook! Substitute tofu for the ribs in the recipe and it’s still the same BBQ sauce—and the same amount of sugar.)

And the added sugar adds up even more

So … where exactly is all this sugar coming from in a homemade meal? Ketchup is one of those foods that contain a lot of hidden added sugar. No one thinks of it as a particularly sweet food—not like soda or cookies or candy. But one tablespoon—a single serving—of Heinz brand Ketchup contains 4 grams of sugar. This recipe calls for 2 and a half cups of the stuff—on top of which is added a half cup and two tablespoons of brown sugar and some Worcestershire sauce.  That’s for just four servings!

BBQ sauce isn’t the problem

Everyone should be able to enjoy a good family barbeque now and again. The issue isn’t that the BBQ sauce in this recipe has a lot of sugar. If we limited our consumption of excessive sugar to treats and special occasions, we would not be facing the health crisis we are today—with expected life spans for the first time in several generations decreasing rather than increasing.

This cup of Greek Yogurt with sweetened fruit and granola contains 19 grams of sugar. I grabbed it on my way into the office the other day when I’d skipped breakfast at home. I wanted something quick and healthy and my only other choices were pastries with even more sugar. Photo: Deborah Bailin

The real issue is that we are over-consuming sugar at every meal, whether we intend to or not—and that is what is adding up and making us sick.

Why we need added sugars on the Nutrition Facts Label

Every day we are bombarded by food industry disinformation driven by profits. In 2012 alone, the nation’s top 10 food and beverage manufacturers spent more than $6.9 billion to advertise their sugar-heavy brands.

With the exception of the nutrition facts label, food packaging is a landscape of misleading words, numbers, and images aimed at persuading rather than informing. The actual sugar content of an ordinary box of cereal, for example, is often masked by disingenuous claims about fiber and protein cloaked in emotional ploys targeting children and their parents, who want to feel good about what they’re buying.

Voluntary labeling by food and beverage manufacturers, such as the Facts Up Front initiative developed by the Grocery Manufacturers Association, is an insufficient substitute for the FDA’s proposed changes. Food companies generally use voluntary labels inconsistently and surround them with messaging that overemphasizes healthy ingredients, such as protein or fiber, to obscure excessive added sugar.

Moreover, sugar interests’ attempts to “bury the data” linking sugar to chronic metabolic disease and obstruct policies addressing sugar-related health concerns demand action.

Take Cheerios Protein Oats and Honey. Protein is an important part of our diet, but it shouldn’t be exploited to mask added sugar. While allowing General Mills to meet what the food industry views as rising consumer demand for protein-rich products, if you eat the new protein Cheerios, which has a whopping 17 grams of sugar per serving, you might as well be eating Oreo ice cream.

So where is all that sugar hiding? Here are five steps to decode where added sugar lies:

1) Don’t be fooled by Facts Up Front

Facts Up Front appears at the top of the front panel and does include sugar content, but all the rest of the images and words on the front reinforce the message that the product is healthy, distracting consumers from its high sugar content. Photo: Deborah Bailin.

Facts Up Front “is a voluntary labeling initiative” engineered by the Grocery Manufacturers Association. Facts Up Front does not provide new information but rather just repeats in a different format on the front of the box what is already printed in the Nutrition Facts Label on the side or back of the package. It was launched just before the Institute of Medicine released recommendations on front-of-packaging labeling to warn consumers about excessive unhealthy ingredients.

Facts Up Front, by contrast, includes information about both healthy and unhealthy ingredients. This is confusing to consumers because additional front-of-package messaging—everything above and beyond the Facts Up Front label—reinforces only the healthy ingredients like protein and fiber, thus misleading people about sugar and doing exactly the opposite of what the IOM recommends.

2) Beware of health claims

Research has shown that consumers routinely misinterpret health buzzwords on food packaging like “whole grain” and “organic.” Whole grains can be healthy, but the current FDA definition of what counts as “whole grain” for the purpose of food labeling falls far short of what experts consider healthy. Fiber is often processed out of the whole grains to make them taste better and have a longer shelf life—and sugar is added to make higher fiber foods more appetizing.

Cheerios Protein Oats and Honey, for example, is marketed as whole grain and a good source of fiber. One serving does contain 16 percent of the daily recommended amount of fiber, but the 17 grams of sugar per serving—about 4.25 teaspoons—is just two teaspoons short of the entire daily allotment of sugar the American Heart Association recommends for women. Imagine dumping 4 teaspoons of sugar on a bowl of regular Cheerios!

3) Distrust packaging that makes you feel rather than think

The back of the Cheerios Protein Oats and Honey box encourages consumers to feel rather than think. It depicts happy children and claims that the cereal will provide energy for fun activities throughout the day — a claim bizarrely reminiscent of sugar industry advertising 50 years ago, enticing consumers to believe that “No other food provides us with essential energy so fast.” Photo: Deborah Bailin.

The purpose of food packaging is to make consumers buy the food. Except for the Nutrition Facts Panel, which the FDA is in the process of updating, other “information” about the nutritional attributes is there to persuade, not inform. So, when a product says something like “long lasting energy your whole family will love,” ask questions: Where is the energy coming from? Why will my family love it? What is the food company trying to make me feel and how is that feeling influencing my choice of whether to buy it?

4) Read the ingredients

Although it may seem like an obvious step before you buy food “your whole family will love,” food packaging often highlights appealing ingredients on the front of the package intended to reassure consumers about the healthfulness of the food and distract you from bothering with the rest of the ingredients. But it’s the ingredients list that tells the real story.

Cheerios Protein Oats and Honey front-side packaging, for example, says the cereal is made with whole grain oats, granola clusters, and honey. That sounds healthy …. until you read the ingredients list. Whole grain oats and honey are there, but so are sugar, brown sugar, molasses, corn syrup, caramelized sugar syrup, and refiners syrup—a great representative sample of the many names for sugar.

5) Recognize that avoiding added sugar isn’t just about personal choice and responsibility

The brand name Cheerios attracts consumers seeking a healthy cereal. That’s because the original Cheerios has only one gram of sugar per serving (about a quarter of a teaspoon), but its newer, high sugar siblings have as much as 17 times that amount.

It’s no accident that food companies spend billions of dollars annually to advertise high sugar megabrands. Advertising works. And when product messaging informs consumers that Cheerios Protein Oats and Honey tastes “so good” because the cereal contains  11 grams of protein, 27 grams of whole grain, 13 vitamins and minerals, and is a good source of fiber, consumers can hardly be blamed for missing what’s omitted here—especially when the box looks a whole lot like the original, healthy variety of Cheerios. Hidden in plain sight is the REAL reason “they’re so good”—they’re loaded with sugar!

And the policies that have made hidden added sugar omnipresent in our diets? They’re no accident, either.

Life in the past—the importance of tangible evidence

On a recent whale watching excursion at the Stellwagen Bank National Marine Sanctuary off the coast of Massachusetts, I saw whales in their natural habitat for the first time. I was transfixed by their magnificent splashing and spouting. The farthest thing from my mind was how today’s endangered status of whales resulted from demands for better lighting, machine lubricants, and the once commonplace women’s undergarment.

Humpback whales splashing and spouting in Stellwagen Bank National Marine Sanctuary. Photo: Deborah Bailin

”Corsets shaped women’s bodies into various fashionable shapes. Their stays were often made of whale baleen connected with fabric bands—girdles on steroids,” Huyck quipped, “although some historic site interpreters swear they are comfortable.”

Huyck, a public historian who has worked for the National Park Service and the U.S. House Subcommittee on National Parks, connected the dots for me. Resource depletion, she explained, disconnects us from history: “If we don’t have whales, we cannot understand much about corsets made from them.” Disconnected from the tangible resources that literally shaped and limited women’s lives, we lose touch with the cultural and economic forces that brought the whale baleen from under the oceans to the undersides of drawing-room society.

When it comes to women and historic sites, “always assume that women were there,” Huyck emphasized. From the Native American women who ground corn into flour at Mesa Verde to the immigrant women who passed through Ellis Island and made clothes and sold flowers on Manhattan’s Lower East Side, “every historic site is a women’s history site, either directly or indirectly. “

Cliff Palace at Mesa Verde. Photo: NPS

Through the architecture, artifacts, and objects found at historic towns like Charleston, SC, St. Augustine, FL, and Seattle WA, our national historic sites allow us to connect directly with our past. Because American history has often been defined as male political and economic activities and most women had less education and lived primarily in the private worlds of their families, finding written sources from women is often more difficult. Historians have used written sources creatively and collected oral history interviews, but analyzing tangible resources—farming landscapes, soddy homes, quilts, tools, typewriters, ships—is crucial and has offered fascinating insights in recent decades,

Liberty—telling the whole story

At military sites like Fort Monroe National Monument in Virginia, which is on the Chesapeake Bay and vulnerable to sea level rise and coastal flooding, the lives of women who were present are often missing from the stories told about the celebrated men and events such sites represent.

Dusk at Fort Monroe. Photo: NPS.

Traveling by land at the time of the Civil War was difficult and time consuming; waterways often functioned like highways do today. At Fort Monroe, the public can observe the landscape and structures and understand why the fort, an interface between land and water, was built there and became an escape point for slaves during the Civil War.

Although the first two escaped slaves who showed up at Fort Monroe were men, many women escaping slavery found their way there, too. Mary Peake, a free black woman, became famous at Fort Monroe as a teacher to the slaves who had freed themselves. Because Peake was free, literate, and played a public role, we know something about her life, but we have scant information about many other women.

We know, for example, how many Union soldiers died at Fort Monroe, but we do not know how many black women did, because civilian deaths were not counted.  And we do not know how many of them—hungry, tired, desperate and with their children—may have been turned away.

Because slavery was “inherited” through mothers, not fathers, Fort Monroe occupies a vital place in women’s history. “If there were no Fort Monroe gate,” Huyck said, “we couldn’t walk through that gate today and imagine how a slave mother escaping to freedom with her children felt as she hoped freedom was so close for them.”

Pursuit of happiness

Resource depletion and extinction are woven through our history as a nation as much as progress and development are. In the immense fur trade, Native American women taught the European trappers how to live in the American wilderness and also prepared those hides for shipment to Europe, which brought material benefits both to their tribes and to the Europeans.

Without beaver and their ponds, such an international economy becomes hard to “see.” And as plant and animal species in our nation’s forests, like Superior National Forest in Minnesota, change from global warming, it becomes harder to connect with the lives of those who once lived there using forest resources.

Huyck underscored, “It’s hard to understand a forest when it’s gone.”

The iconic Statue of Liberty was closed for eight months for repairs following Hurricane Sandy. Photo: Andrea, Flickr.

As we face more and more extreme weather events and other impacts of climate change, one of the challenges, a subtle one, is that climate change distracts us and impairs our ability to thoughtfully interpret and preserve the whole story—to fully understand who we are and where we’ve come from.

“In the middle of a catastrophe like Hurricane Sandy,” said Huyck, “we don’t feel we have time to talk about why we need historic sites.”

As we reflect on our history as a nation this Independence Day, we must act to preserve our nation’s landmarks and historic sites—so that future generations may know about our past. These places shape our identity as Americans. They tell us about who we are as a people and how our democracy came to be what it is today. And they place women in our tangible past, when written records too often have left them invisible.

Robert Lustig at the recent UCS forum on Science, Democracy, and a Healthy Food Policy.

Lustig was speaking over dinner with UCS staff members following a pre-release screening of the film last Monday in Minneapolis held in conjunction with our forum on Science, Democracy, and a Healthy Food Policy. The film, as my colleague Gretchen Goldman wrote, features the compelling stories of several overweight teens trying to lose weight through diet and exercise. As their stories unfold, it becomes clear they’re up against a great many obstacles out of their control.

Sugar, as we have noted, is at the top of the list of their obstacles as it is for many Americans.

It’s not about personal choices

The kids — who are brave for telling their stories publicly — are also affected by where they live and what kind of food is available at home, at school, and at the grocery store. They are affected by cultural values and attitudes about food and weight in their families and communities. And they are affected by knowledge — and lack thereof — about nutrition and cooking.

Despite exercising, the kids featured in Fed Up are still having difficulty losing weight because it is so difficult to eliminate sugar from their diets. The point the film is making is that, when it comes to sugar, a calorie in is not a calorie out.

As they count their calories and get regular exercise, they’re trying to make good choices and do the things everyone is telling them to do that supposedly will help them lose weight and get healthy. And yet they’re still ending up fighting a losing battle because, ultimately, they are affected by the policies that govern the availability, affordability, and accessibility of food.

Simply put, the current policies framing our food environment favor commodity crops like corn, sugar beets, and soy — and the food and beverage manufacturers that use them — rather than public health. It is no accident that a walk down the cereal aisle is easier on our wallet than a stroll through the produce section, and these kids and their struggles are the casualties of those policies.

Manufacturing doubt

The food industry’s response to the film, while not surprising, has been disturbing. Taking a cue from the tobacco industry’s now well-known strategy of casting doubt on science that supports policies that undercut profits, the Grocery Manufacturers Association has attacked the film for not getting the facts right. In order to convey what it claims are the “correct” facts, the trade group has designed a website mirroring the film’s website with the express purpose of combating what it contends is the film’s mischaracterization of the food industry.

Landing page for the real Fed Up site.

Landing page for the GMA’s “dummy” site.

The website does things that ought to make consumers cringe. For starters, what the GMA considers the “correct” facts are cherry-picked. The first question in a quiz visitors are invited to take asks whether it is true or false that “Food companies have caused the obesity rate to ‘skyrocket.’” Checking the “true” box brings up a grade of “incorrect” followed by the statement that “childhood obesity rates have dropped by as much as 43 percent.” However, the source for this information (which, to the GMA’s credit, it links to) is a New York Times article that actually says something quite different.

While a new federal study has indeed found a 43 percent drop in obesity rates among 2-5 year olds, scientists cited in the NYTimes story — both the authors of the study and others — cautioned against overly optimistic interpretations of the findings. They noted that this demographic makes up only a tiny percentage of the American population, that a third of adults and 17 percent of teenagers are still obese, that obesity rates among women 60 and older have increased, and that even among 2-5 year olds, obesity rates for blacks and Hispanics are much higher than for the rest of this age group.

The study itself concludes, “Obesity prevalence remains high and thus it is important to continue surveillance.” Another study published a few months later also in the Journal of the American Medical Association, concludes that although “the prevalence of obesity may be stabilizing … there is an upward trend of more severe forms of obesity.” As my colleague Michael Halpern pointed out, it is important to interpret both recent studies with caution. Neither supports the optimism towards obesity that the GMA “facts” encourage.

Finessing the evidence

Other questions on the GMA’s quiz receive similar treatment. Support for the Healthy Hunger Free Kids Act, for example, is touted as evidence the food industry is advancing nutrition over fast food, but public comments on the USDA’s proposed rule to implement HHFK show significant food industry influence — influence that has led to a weaker final rule on sugar.

Comments from public health professionals and advocacy organizations argued in favor of limiting sugar in school meals as a percent of total calories. Through 70 comments, they reasoned that this more restrictive option better aligns with recommendations from the American Cancer Society, American Heart Association, and Institute of Medicine, and that it is more consistent with the official Dietary Guidelines for Americans developed by the USDA.

It is not surprising that members of the Grocery Manufacturers Association, such as General Mills, supported weaker policy on sugar. Many of their most familiar and popular brands — marketed as healthy — are loaded with it.

By contrast, limiting sugar by weight — a less restrictive option — received support from many commenters who reasoned that it was consistent with the measurement methods currently relied upon and would be easier to implement, allowing the sale of more products. The Food and Nutrition Service reported that the 1,165 comments in favor of limiting sugar by weight included trade associations and food manufacturers. General Mills, a member of the GMA, went so far as to state, in its comment, that “sugar intake has not been shown to be directly associated with obesity or any chronic disease or health condition except dental caries.”

Guess which sugar option won out in the final rule? Guess which substance is missing from the GMA’s description of how school “chefs” are working to provide healthier meals?

The need for media literacy

Understanding that “a calorie is not a calorie” will not necessarily stop Americans from eating lots of sugar. UCS staff members, it should be noted, are well-informed about the science of sugar and yet are not opposed to enjoying it now and then, as these leftovers from our annual cultural heritage lunch illustrate. However, it is impossible to have a transparent, honest public dialogue about real choices for our food system as long as the prevailing illusion of choice – supported by our current food policies – persists.

Along with the GMA’s mischaracterization of scientists’ efforts to understand trends in the obesity epidemic, the format of the website itself is intended to mislead the public. So-called “dummy” websites are deceptive by their nature and exploit what UCS’s forum working group experts agreed was a major barrier to changing Americans’ food environment: namely, a lack of media literacy.

While a calorie is not a calorie, facts are facts. As a society, we need to get better at separating science from spin. Improving Americans’ media literacy skills from an early age, along with implementing better food policies, is essential to fighting obesity and improving overall public health.

But corporate social responsibility by food companies should be scrutinized carefully.  The same companies donating to good causes in the name of their popular brands are spending orders of magnitude more money to advertise those same brands in ways that obscure the science linking sugar to health problems like obesity, diabetes, cardiovascular disease, high triglycerides, and hypertension — together known as “chronic metabolic diseases.”

Over the past 15 years, General Mills, for example, has donated $50 million through its Yoplait brand to support breast cancer research. The company boasts proudly that it aims “to take a stand for something that impacts the greater good” and connect with consumers through social issues and shared values.

Obviously, funding breast cancer research is a good thing. But, for General Mills, this funding and their promotion of it is also intended to make people who buy Yoplait — and the people who see it in stores — feel like they’re supporting public health when they buy General Mills products.  When we reach for the strawberry flavored tub of Yoplait yogurt — or the “Strawberry Milkshake” flavored Yoplait GoGurt tube for our kids — we’re supposed to think not just about how it feels on our tastebuds but about how General Mills helped our Aunt Bernice beat breast cancer. Every creamy spoonful should taste like both strawberries and the love we feel for the survivors among our family and friends. Every bite should taste sweet with hope. Yoplait yogurts, however, along with many other popular General Mills brands, aren’t just sweet with hope and strawberries. They’re sweet with sugar.

A lot of it.

A single serving of Yoplait strawberry-flavored original yogurt contains 26 grams of sugar — that is, more than six teaspoons, more than half the USDA’s daily intake recommendation for adults, and fully more than what the American Heart Association recommends for women for an entire day.

And it isn’t that we, the consumers, are independently — in a state of perfect freedom — choosing to eat a lot of super sweet yogurt. We make our decisions about food in a carefully constructed marketing framework, and General Mills is spending a lot of money — a lot more than it’s spending on breast cancer research — to shape the context in which we shop. In 2012 alone, General Mills spent over $112 million to advertise Yoplait brand products. Meanwhile, the company is spending an average of little over $4 million over fifteen years — for a total of $50 million — to support breast cancer research. It only sounds like a lot until you compare that sum to what the company spends to advertise this single brand in a single year.

Americans’ food landscape is engineered to make us feel good about buying things that are bad for us. It’s not an accident that loading up our shopping carts with strawberry-flavored yogurt is easier on our wallets than buying real strawberries — or blueberries or blackberries or raspberries. What we need is real, science-informed change in our food policies, so that we’re not subsidizing the commodity crops — corn, soy, sugar beets — that are making us sick. If food companies genuinely wanted to be good corporate citizens, they’d invest in initiatives that did not prioritize profits over public health.

Consumer choice shouldn’t just mean a false choice between added sugar and more added sugar. We should have actual choices when we go to the grocery store that are accessible and affordable to all.

And funding breast cancer research shouldn’t be just another form of advertising.

My mom and dad were unusual in that they were both aware of the science linking sugar to health problems years ago, but they were schoolteachers with a lot of respect for science. My grandparents, on the other hand, unlike my parents, had indulged my mother’s cravings for candy and soda. Her high childhood sugar consumption has caused her lifelong struggles with dental disease, and my parents limited my sugar intake because they didn’t want the same fate for me.

Since my childhood, the evidence has only increased linking sugar not only with tooth decay but obesity, diabetes, cardiovascular disease, high triglycerides, and hypertension (together known as “chronic metabolic diseases”). So why is it that so many Americans continue to consume excessive added sugar not only in obviously sweet products like soda and candy but also in bread, yogurt, salad dressing and many other seemingly healthy foods?

This healthy looking meal contains more than an entire day’s worth of sugar according to USDA recommended guidelines for sugar intake.

The Center for Science and Democracy’s new report Sugar-coating Science: How the Food Industry Misleads Consumers on Sugar provides some answers.

Evading science, engineering opinion

The science supporting a relationship between sugar consumption and chronic metabolic diseases has led several scientific and governmental bodies, including the World Health Organization, the American Heart Association, the U.S. Department of Health and Human Services, and the U.S. Department of Agriculture, to recommend sugar intake far below typical American consumption levels.

But sugar interests understand well that there is no such thing as unframed facts, and they spend billions of dollars annually to shape the context of food purchasing and persuade Americans to eat and drink more sugary foods and beverages—and make us feel good about doing so. U.S. ad spending for the 10 major food and beverage manufacturers in 2012 approached $7 billion.

Major food and beverage manufacturers spent close to $7 billion in 2012 on advertising. Many o their megabrands contain excessive added sugar. Source: Advertising Age

Engaging in false advertising

Given the engineered landscape that most Americans enter when they walk through the grocery store’s doors, choosing foods low in sugar is never as easy as it should be.

Some food and beverage companies have engaged in blatantly false advertising. Coca-Cola marketed its “enhanced” line of flavored waters called Vitaminwater as healthy, but the product has sugar content comparable to soda. Coca-Cola is now facing legal action to stop misrepresenting Vitaminwater. Under pressure of a similar lawsuit, General Mills agreed to stop using the phrase “made with real fruit” on its Fruit Roll-Ups “fruit” snacks because the product is mostly sugar, is not made with whole fruit, and has almost no nutritional value.

Eploying front groups

Sugar interests have also made use of front groups—industry funded organizations with consumer-friendly names that obscure their funders’ financial stakes. Recently released internal documents reveal that in 2009 sugar interests paid the public relations (PR) firm Berman and Company to create deceptive ads promoting sugar consumption.

The ads were aimed at consumers concerned about reducing their sugar intake by reducing their intake of high-fructose corn syrup and ran through a front group called the Center for Consumer Freedom to hide industry sponsorship. By running the ads through the front group, this industry PR campaign was made to appear to the public as an independent statement and intended to convince them that eating sugar was “natural” and therefore OK, against the advice of scientific experts.

Targeting vulnerable demographic groups

Sugar interests use marketing to exploit the unique vulnerabilities of demographic groups with greater potential to increase food industry profits. Children, for example, represent a lifetime of sugar consumption. They are also innately attracted to sweet tastes and lack the capacity to recognize persuasive intent, so they’re an easy target—and they influence billions of dollars in adult spending.

“Advergames” are ads disguised as online games and targeted at children.

As my parents knew, scientific understanding of children’s vulnerability goes back decades, as does regulators’ awareness of them as a target of sugar interests. In 1978, the Federal Trade Commission (FTC) attempted to restrict television advertising of sugary products to children, but lobbying by food and beverage manufacturers derailed those efforts.

Women and minorities are targeted by sugar interests, too. Gender-based strategies are used to connect with women because women are the primary food decision makers in many families. Minorities with growing populations are targeted because they represent a growing consumer base.

Overcoming the odds

While sugar interests have exploited advertising to misinform the public, advertising can also promote the public good. Successful public service announcements (PSAs) have reduced smoking, increased seatbelt use, and prevented drunk driving. A recent New York City anti-sugar PSA campaign has been adopted by the Centers for Disease Control and Prevention (CDC) for a nationwide public health campaign.  New York City’s case may be paving the way for sugar to be the next success story for science-informed public health improvements everywhere.

Additionally, businesses can choose to take a stand for the public good. Last year, Baltimore-based MOM’s Organic Market announced it would stop selling products featuring children’s cartoon characters licensed from TV, books, or films. The chain’s rationale for the move was that marketing to kids—whether for healthy or unhealthy products—at an age when kids are susceptible and unable to decipher marketing from educational material, is wrong.

Ultimately, we need to change our nation’s food policies so that food industry profits don’t come at the expense of public health. The FDA has proposed a new rule to improve food labeling that would require the amount of added sugar to be indicated on the nutrition facts panel of packaged foods. Tell the FDA that we need to label added sugar on our food. Although identifying added sugar won’t immediately change the engineered landscape of food we live in, it is a step in the right direction that our policy makers can and should take.

Science is one piece in the puzzle of democracy. Join our Science & emocracy Dialogues to find out where it fits! This 1990 granite sculpture by W. H. Herrick stands in Burlington, VT. Credit: Adam Fagen

If you missed the first two talks, you can watch the archived videos anytime (links below)—but we do hope you will join us for the live-stream of our third event—a Google+ Hangout with Dan Sarewitz. Professor Sarewitz will speak and answer questions about uncertainty, politics, and technology. Through three concrete examples—earthquake prediction, waste disposal, and regulation of toxic chemicals—he will argue that it is technology that helps us bridge the political divide and solve society’s most pressing problems, not necessarily achieving the public’s consensus about underlying scientific issues.

We don’t expect everyone in the audience for the S&D Dialogues to agree with our featured speakers—no doubt this talk will generate lots of questions for Professor Sarewitz during the Q&A! These provocative talks are intended to shed light on why we started the Center for Science and Democracy—on why there is a need to advance the role of science in our democracy, what various means exist  for doing so, and what challenges we face in the 21^st century. We hope these talks will be enlightening, and we also hope they will inspire you to get involved and take action on the issues you care about most.

“When knowledge isn’t power”

Our first speaker was Naomi Oreskes, Harvard professor in the history of science and acclaimed author of The Merchants of Doubt. Professor Oreskes spoke about how political ideology has driven some Americans to question the science that has driven policy solutions to many problems, including tobacco use, acid rain, ozone depletion, and climate change.

On March 27, 2014, at our first Science & Democracy Dialogue, Naomi Oreskes spoke about how science denial has been used as a powerful political strategy. This cartoon appears in UCS’s 2014 Scientific Integrity Calendar. Credit: James MacLeod

Science, she explained, suggests the need for greater government regulation of the causes of these problems to protect people and the environment from their effects. But implementing science-based solutions has been complicated by cultural values that are as deeply rooted in American democracy as science is itself. The American ideal of “liberty”—or personal freedom—has always been a core value but acquired a new meaning in the political arena following democracy’s victory over communism at the end of the Cold War. Free-market capitalism—business unfettered by government regulations—was seen by some as the best system for bringing about prosperity and the only one that would also protect liberty. According to this worldview, liberty and prosperity became synonymous. Infringements by government on businesses’ pursuit of prosperity were seen as encroachments onto the sacred-to-American-democracy ideal of individuals’ pursuit of liberty.

At the same time, Oreskes argued, science has increasingly pointed to the need for regulatory control of business, and science—and scientists—thus have become political targets. In this political climate, scientific knowledge became a liability rather than the empowering tool it should be.

During the Q&A, participants pointed out that this was all rather demoralizing. After all, what can we do if science has become so politicized that facts no longer matter? Oreskes responded that recognizing the values underlying science denial can help proponents of science-based policies more strategically engage with opponents and proactively shape public conversations and advocacy efforts.

“Polarization Paradox”

Our second speaker, Dietram Scheufele, co-chair of the National Academies’  Roundtable on Public Interfaces of the Life Sciences and John E. Ross Professor in Science Communication at the University of Wisconsin-Madison, took on public perceptions of new scientific discoveries and emerging technologies and how both media environments and people’s values frame these perceptions.

The recent decision by Popular Science to end online reader comments was motivated by the editors’ response to Dietram Scheufele’s research on science communication. To find out what Professor Scheufele thinks of that decision, watch the video of our 2nd Science & Democracy Dialogue. Credit: NASA

“Disagreement,” said Professor Scheufele, “is good.” It makes us seek out more information. It makes us engage more in politics. And, ultimately, it is good for democracy. The catch is that in today’s media environment, disagreement also leads to polarization. Social scientists call this phenomenon the “polarization paradox”—that is, exposure to disagreement is good but we tend not to produce it in our daily lives or online.

What does this mean for public perception of science and policy on issues like stem cell research, vaccines, global warming, and obesity? The bad news is that the public is increasingly taking an “Amazon recommendations approach” to science and politics. We are relying on “algorithms as editors,” and people are getting different information about the important issues of our day, even when it comes from the same sources. Through social media like Facebook and Twitter, people who think like us pass information to us that reinforces like-minded news and views. And we often know what we are supposed to think of a news story—from online reader comments and from social media—before we read it. This “brave new world” of today’s web environment creates more and more public polarization.

The good news is that there are solutions. We need to develop “core competencies” for navigating information on the Internet, Professor Scheufele explained, because “talking across differences matters now perhaps more than ever before but we’ve lost our way in doing this.” We must redeem the skills necessary to extract factual information in a highly fragmented media world. We need to motivate citizens to be accurate in the information they share.

And we need to restore civil debates. The exact same information can mean different things to different people. Moral, religious, and cultural values shape how we receive information, and we’re more likely to believe information if it confirms what we already believe is true—and to disbelieve information if it points the other way. But, Professor Scheufele concluded, “When people are expecting to engage with people who passionately disagree with them, they are more likely to be careful and accurate in their search for and use of information.”

Talking across differences

My takeaway from both of our first two Science & Democracy Dialogues is that we as individual citizens have a role to play in overcoming polarization through our own everyday actions. We need friends who don’t always think exactly the way we do. We need to have more frequent and more civil conversations with people we  passionately disagree with about  things — science and otherwise — that matter to us all.

These aren’t always easy conversations to have, but our democracy is worth it.

President Theodore Roosevelt on a horse in Colorado; Photographer unknown; Around 1905. Credit: National Park Service.

While there may be no scientific way to determine the president who most stood up for science, there is history, and I can’t help but wonder how our two finalists, Roosevelt and Carter, would hold up in another 200 years. Will their impact on the future of science be as great as Lincoln’s was in founding the National Academy of Sciences? What about Jefferson’s role in financing the Lewis and Clark Expedition, contributing to the Library of Congress’s collection, and founding the University of Virginia?

When in doubt about the evidence of history, ask a historian

A few months back when we were planning the contest, I asked eminent presidential historian Richard Norton Smith for his thoughts on the most science-friendly president. At the time, Professor Smith graciously answered my inquiry by naming Teddy Roosevelt as his pick. Since Roosevelt made it to our finals last week, I followed up to see if he would comment further.

Before all those of you who helped Roosevelt win hold your collective breath for Smith’s validation of your choice, I must confess I was pleasantly surprised when he replied instead, upon more reflection, that he had changed his mind. Smith said:

“I’d name John Quincy Adams as the most science friendly president. He’s regarded by many as the legislative father of the Smithsonian. He took great heat politically for proposing a national observatory—a ‘lighthouse of the skies’ in his lovely, hugely disputed phrase—and he was an amateur scientist/botanist himself … a true intellectual who had a broad vision of government’s responsibilities to promote the pursuit of knowledge.”

Although I know many of you diehard Roosevelt and Carter fans may not be persuaded to change your votes, I appreciate Professor Smith’s emphasis on the long view. How do we ensure not only that we take a science-informed approach to today’s most pressing problems but that science informs the solutions to tomorrow’s problems, too?

Our sixth president and a science-based vision for the future

John Quincy Adams, President of the United States, painted by T. Sully; engraved by A.B. Durand. John Q. Adams, full-length portrait, seated in library, circa 1826. Credit: Library of Congress.

John Quincy Adams did not make our shortlist of eight, I believe, because we placed a greater weight on policy achievements linked to issues of pressing, present-day concern. National parks established through the policies of Roosevelt and Carter, for example, are today threatened by climate change, a reminder both of the importance of their conservation policies and the new challenges to conservation that science must now address.

However, the further back in our national past that we look, the harder it may be to see the long-lasting impact of science-friendly leadership because we take for granted so many things that have been achieved.

During his presidency, John Quincy Adams took a science-based approach to the issues of his day. He was not fighting climate change or dealing with an energy crisis, but he did express strong support not only for an observatory but for a national university and a uniform system of weights and measures. And instead of creating national parks, he remarked in his first annual message on how far from the imagination such an endeavor must have been for Americans of his generation:

“The interior of our own territories has yet been very imperfectly explored. our coasts along many degrees of latitude upon the shores of the Pacific Ocean, though much frequented by our spirited commercial navigators, have been barely visited by our public ships … I would suggest the expediency of connecting the equipment of a public ship for the exploration of the whole north-west coast of this continent.”

John Quincy Adams, in other words, viewed science as a matter of national pride and saw the advancement of scientific knowledge as an “improvement” of the human condition. He knew the government had a key role to play in supporting scientific research, too, recognizing that so much “lie[s] beyond the reach of individual acquisition, and particularly to geographical and astronomical science.”

John Quincy Adams and the Smithsonian

Although Adams only served one term as president, he was promptly elected to Congress in 1830 and continued to promote science as a representative from Massachusetts. Coincidentally, just a few months after he left the presidency in 1829, James Smithson, a chemist, mineralogist, and the illegitimate son of an English Duke, died and—pending the subsequent death of his nephew in 1835—willed

“the whole of my property … to the United States of America, to found at Washington, under the name of the Smithsonian Institution, an Establishment for the increase & diffusion of knowledge among men.”

Some in Congress distrusted Smithson’s motives. Others, amidst the brewing North-South divide, disputed the location. Still others thought the money should be used for other things—teacher training, public schools, a national library.

Dinosaur bones, National Museum of Natural History, Washington, D.C. Credit: Library of Congress.

John Quincy Adams championed Smithson’s original idea from the start and pushed tirelessly for years to see it realized. Today, over seven million visitors annually pass through the National Museum of Natural History. How many of them do not leave without a sense of wonder over the age of our planet and the evidence for evolution? Over eight million annual visitors experience the National Air and Space Museum. Who among them, especially the children, does not dream, at least for a moment, about being a rocket scientist?

And these are just two of the Smithsonian’s museums—museums that play a major role in promoting public science literacy. What an amazing legacy for a president and congressman who envisioned the future of our democracy intertwined with science, had the passion to do something about it, and died a decade before Darwin published The Origin of Species and a half century before the Wright brothers first took flight.

UPDATE, Feb. 27, 2014—Acclaimed Teddy Roosevelt scholar Douglas Brinkley weighs in on our winner:

“In the earliest days of the founding of our country there was among some of our Founding Fathers a most happy relationship, a most happy understanding of the ties which bind science and government together.”

JFK speaking at Rice University in 1962 about the rationale for going to the moon: “there is a new knowledge to be gained, and new rights to be won, and they must be won and used for the progress of all people.” Photo: NASA.

Kennedy went on to address the obligations of science to a free society and the role of science and scientists in moving our own country forward by solving complex problems and informing the policies that safeguard the health, safety, and security of all Americans. The National Academy of Sciences is, in Kennedy’s words, “a great natural resource” for our nation’s decision makers.

Of course, JFK was neither the first nor the last U.S. president to recognize and respect the longstanding and indivisible partnership between science and democracy. Some of our presidents, however, have done more than others to respect and protect our nation’s knowledge resources. And that’s why, in honor of Presidents Day, the Center for Science and Democracy is highlighting the science-friendly achievements of eight U.S. presidents.

We believe that, collectively, these eight presidents — Jefferson, Lincoln, Teddy Roosevelt, Eisenhower, Kennedy, Nixon, Carter, and H.W. Bush — have secured a legacy of discoveries, inventions, science agencies, and science-based policies that Americans continue to benefit from today. Until Presidents Day, when the winner will be announced, you can vote for your favorite in our bracket challenge.

Acknowledging the bad with the good

Theodore Roosevelt and John Muir on Glacier Point, Yosemite Valley, California, ca. 1906. Prints and Photographs Division, Library of Congress. Reproduction Number LC-USZ62-107389 DLC.

While determining the president “most” supportive of science  is ultimately a subjective decision, we narrowed our selection based largely on the lasting impact these presidents have had through science-informed decisions made during their administrations.

Such decisions drove America’s progress over time, even if it took future presidents and future generations to fully realize the benefits of what had been set in motion: Jefferson’s commissioning of the Lewis and Clark Expedition, Lincoln’s founding of the National Academy of Sciences, Teddy Roosevelt’s dedication to the national parks, Eisenhower’s establishment of the Defense Advanced Research Projects Agency (DARPA), Kennedy’s advancement of the space program, Nixon’s creation of the Environmental Protection Agency (EPA), Carter’s commitment to addressing the energy crisis, and H.W. Bush’s reauthorization of the Clean Air Act.

Alongside these achievements, it is also important to acknowledge that each of these presidents was a product of the age in which he lived and made other decisions that would not meet today’s standards for being grounded in science.

Jefferson, for example, died before the term “scientist” had even been invented and, more importantly, held antiquated beliefs about race that he and others of his generation incorrectly grounded in science. During the Cold War’s early years, Eisenhower’s scapegoating of Robert Oppenheimer, a result of the McCarthyism scourge, caused many scientists to fear their political beliefs would be used against them and could hurt their scientific careers. And Nixon’s landmark signing of the Clean Air Act stands in stark contrast to his vetoing of the Clean Water Act — for political reasons rather than for a lack of support for its previsions.

How we, as individuals, assess the good and the bad and choose which of these presidents is the “most” driven by science is largely the result of our own values: the cultural groups we grew up in; the communities that forged our understanding of science; our personal experiences with research, policy, and advocacy; and the principles we live by.

Transmitting legacies

Edwin H. Blashfield’s mural in the Library of Congress’s Main Reading Room depicts the world’s great civilizations and their contributions. America represents science, and the figure here is said to be inspired by Lincoln. Photo: LOC.

We invite you to share, in the comments, which president you would nominate and why. And, in the interest of full disclosure, I will share my favorite nominee, too: Lincoln.

As one of the UCS researchers who worked on this project, I spent some time looking at the legacies of all our nominees. I did not have a favorite going in and will celebrate whoever wins our challenge. However, Lincoln stands out to me as the president who most understood the big-picture value of our nation’s knowledge resources.

In an 1858 lecture on discoveries and inventions, Lincoln talks about human ingenuity — our ability as a species to develop empirical knowledge, to innovate, and to improve our condition. But our greatest invention, he says, is not the wheel or the windmill or the steam engine but:

“Writing — the art of communicating thoughts to the mind, through the eye — is the great invention of the world. Great in the astonishing range of analysis and combination which necessarily underlies the most crude and general conception of it — great, very great in enabling us to converse with the dead, the absent, and the unborn, at all distances of time and of space; and great, not only in its direct benefits, but greatest help, to all other inventions.”

Perhaps more than any other president among our nominees, Lincoln left a legacy of his own writings that has helped generations of Americans — including today’s leaders — embrace the full breadth of humanity’s knowledge resources and think through the difficult decisions we have faced in a nation that still is, in some ways, a “house divided.”