193. Diabetes: Academy of Nutrition and Dietetics Must Do Better!

I have just been reading a paper on the Eatright website which is from the USA Academy of Nutrition Dietetics (AND). This states that the causes of Type 2 Diabetes (T2D) are:

“complex and still not fully known. Sometimes diabetes is triggered by genetics, illness, being overweight or simply getting older. Although food doesn’t cause diabetes, it is part of the strategy for managing the disease” (1).

To say that food does not cause T2D is unbelievable. Does the author not live in the real world? Anyone who troubles to do some research on the topic which is relatively easy with access to the internet will quickly discover that it is the composition of the food which is the primary cause of T2D.

Here is what actually happens:

If you consume a diet which has a high content of sugar and other foods which contain carbohydrates, the body will have to cope with excessive levels of glucose in the blood.
This is done by the pancreas which responds by producing insulin which enables the extra glucose to be utilised by the liver and other organs.
However the high concentrations of insulin in the blood cause insulin resistance to develop in the organs including the liver and the pancreas.
This means that the demand for insulin is increased even further.
Ultimately this results in catastrophic failure of the pancreas so that the ability to secrete insulin is impaired.
As a consequence, it is no longer possible to keep the blood glucose under control. Effectively this is full-blown T2D because it is at this point that the blood glucose starts to increase and if the appropriate tests are conducted the disease will be diagnosed.
This only happens if a person persists with a diet which is high in sugar and carbohydrates over a long period.
During this time the insulin resistance which damages the internal organs gradually increases.
This insulin resistance can result in various diseases/conditions including weight gain, hypertension and cardiovascular disease.
The effect of the raised blood glucose levels is to make things even worse.

There is absolutely no question that the high intake of sugar/carbohydrates is what causes T2D. There is comprehensive research to demonstrate that carbohydrate restriction is an effective treatment (2). Furthermore there are numerous case studies which provide very compelling evidence of the effectiveness of this approach. Many can be found on the Diet Doctor’s website (3).

The key issue is that there are very powerful vested interests which do not want this information to become widely available. This includes food companies which produce foods that have a high content of sugar and or carbohydrates. It is self-evident that if consumers understand which foods are direct cause of T2D then sales will be adversely affected.

The AND is the world’s largest organization of food and nutrition professionals. According to the website it is committed to:

“improving the nation’s health and advancing the profession of dietetics through research, education and advocacy” (4).

However it is dependent on sponsorship from some of the major multinational food companies for part of its income. Currently the main sponsors are the US National Dairy Council, Abbott Nutrition, the Coca-Cola Company Beverage Institute for Health & Wellness, PepsiCo and Unilever. Although Coca Cola has announced that it will cease to act as a sponsor from the end of 2015.

In 2013, Michele Simon, a public interest lawyer, produced a report which was highly critical of the AND with the provocative title:

“Are America’s Nutrition Professionals in the Pocket of Big Food?”(5).

This described in detail the close working relationship between the organisation and many of the big agro-food corporations. Representatives are actively involved in CPD programmes and play a major role in the annual conference. Specific findings included:

Companies on AND’s list of approved continuing education providers include Coca-Cola, Kraft Foods, Nestlé, and PepsiCo.
Among the messages taught in Coca-Cola-sponsored continuing education courses are: sugar is not harmful to children; aspartame is completely safe, including for children over one year; and the Institute of Medicine is too restrictive in its school nutrition standards.
The AND Foundation sells “nutrition symposia” sponsorships for $50,000 at the annual meeting. In 2012, Nestlé presented a session on “Optimal Hydration.”
Roughly 23 percent of annual meeting speakers had industry ties, although most of these conflicts were not disclosed in the program session description.
In an independent survey, 80 percent of registered dietitians said sponsorship implies Academy endorsement of that company and its products.

It is unbelievable that the message:

“sugar is not harmful to children”

is being presented as part of a training programme. No doubt the assertion that:

“food does not cause T2D”

is an attempt to provide some kind of justification but it is utterly pathetic.

The President of AND at the time responded the report in a letter which included the following sentence:

“Let me make it clear that the Academy does not tailor our messages or programs in any way due to influence by corporate sponsors and this report does not provide evidence to the contrary” (6).

However none of the above statements were challenged. The fact remains that there is clearly a close working relationship between some of the leading multi-nationals in the food/drink industry and the organization. It is inconceivable that these companies would continue with the relationship if it was not proving to be beneficial.

There is no doubt that if there is a concerted effort to reduce the consumption of sugar and other foods which contain carbohydrates that this will have a detrimental impact on the sales of specific products of some of the AND sponsors. The suspicion is the companies which are likely to be affected will attempt to throw doubts about the validity of the evidence. This is an established strategy which was used to great effect by the tobacco industry. All the indications are that the article on diabetes is very much part of these tactics. If so, this is regrettable because it shows complete disregard for the health of consumers.

This is not an isolated case and is certainly not restricted to the USA. Companies clearly believe that it is to their benefit to work closely with societies and charitable organizations. Food scientists, nutritionists and dietitians are in a position to influence the food purchasing patterns of a wide range of businesses as well as individual consumers. Unfortunately conflicts of interest are all too common with the result that endorsements of products are not always the independent assessments they appear to be.

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