HSPH Professors Argue for Nuance in Sugar Study Controversy

Recent controversy around a 1960s review of sugar, dietary fat, and cardiovascular health has muddled problematic industry sponsorship with spot-on findings, according to some nutrition professors at Harvard's School of Public Health.

D. Mark Hegsted, the New York Times reported Monday, was one of three nutrition professors who in the 1960s accepted roughly $50,000 from the sugar industry to publish a review downplaying the links between sugar and heart disease. The Times article, as well as subsequent media attention, came after researchers at the University of California, San Francisco uncovered documents that implicate a trade association then-known as the Sugar Research Foundation and the 1960s Harvard researchers, all of whom are deceased.

Several current Harvard nutrition professors said the Sugar Research Foundation’s sponsorship of the scientists—Frederick J. Stare, who founded the School of Public Health’s Nutrition department; Robert B. McGandy ’51; and Hegsted—highlights a dangerous financial dependency on industry.

At the same time, however, Hegsted’s review of polyunsaturated fats largely matches with today’s dietary recommendations, the current professors said.

“Hegsted was a visionary; he was ahead of his time. He got a lot of stuff right,” professor of Epidemiology and Nutrition Meir Stampfer said. “It’s really unfortunate he took this money from the sugar industry without disclosure.”

When Hegsted compiled his review, most scientific research indicated the harm of consuming saturated fat and the benefit of consuming polyunsaturated fat, professor of cardiovascular disease prevention Frank M. Sacks said. “And Hegsted—he did a lot of that research himself….Going with that research, I think, is very reasonable on the scientific merits.”

The research around sugar’s deleterious effects on cardiovascular health is also fairly recent. Such debates, popularized about 10 years ago, would not have taken place when Hegsted and the other Harvard affiliates were writing, Nutrition Department Chair Walter C. Willett said.

“Back at that time, like in the 1950s and ’60s, not much was known about sugar and carbohydrate in relation to heart disease,” Sacks said.

Although some low-level debate did reference sugar’s negative impact on the body—conversations prompted by British researcher John Yudkin—not much changed at that time, he said. “[Yudkin] was well regarded, but didn’t have enough data to influence the field.”

In the 1960s, Hegsted’s findings were often misinterpreted, Sacks said. According to Sacks, because the harmful saturated fat comprised much of the American diet at the time, dietary guidelines wrongly articulated a total fat reduction—even of the good, polyunsaturated kind of fat.

“They said, ‘reduce fat, and replace it with carbohydrate,’ Sacks said. “As it turned out, the carbohydrate that was available wasn’t whole grains, nuts, [and] beans. The carbohydrate was junk food.”

Forty years later, while sitting on the U.S. dietary guidelines committee, Stampfer said he tried to persuade his colleagues that sugar, the carbohydrate in those junk foods, was the culprit in cardiovascular disease.

“They didn’t buy it,” Stampfer said, adding, “The only harm in it is ‘empty calories,’ that was how it was called back then…[some said] it was fine to have up to 25 percent of calories from sugar.”

Only recently has sugar reentered the debate as problematic for consumption.

In 2013, Willett, who specializes in epidemiology and nutrition, and a colleague published an editorial in the BMJ, a peer-reviewed medical journal, in which he articulated his rationale for limiting sugar intake. That same year, Willett co-authored a review that summarized the adverse effect that sugar-sweetened beverages had on weight gain in children and adults.

Sacks further noted the difference between the problematic industry-funding of the 1960s review and the spot-on findings regarding polyunsaturated fat.

“To me it’s a fairly simple situation… that’s maybe a cautionary note,” Sacks said. “If Hegsted was doing his work now, he would have absolutely disclosed that. If he didn’t disclose it now he would take a lot of flack and maybe disciplinary action—I mean, who knows?”

—Staff writer Melissa C. Rodman can be reached at melissa.rodman@thecrimson.com. Follow her on Twitter @melissa_rodman.