Time for complete transparency about conflicts of interest in public health nutrition research

Hennessy, Marita; Cullerton, Katherine; Baker, Phil; Brown, Amy; Crawley, Helen; Hayes, Christine; Kearney, Patricia M.; Kelly, Colette; Mialon, Mélissa; Petticrew, Mark; Rundall, Patti; Trickey, Heather; White, Martin; Redsell, Sarah

doi:10.12688/hrbopenres.12894.1

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Comparatively, when studies were funded or supported by the sugar industry, the reverse was found (328) . The bias found in industry-sponsored studies is a well-documented issue in nutrition research, and may potentially undermine the results of the present review (328)(329)(330)(331) . Greater research funding from governments and other funding agencies is needed to avoid a reliance on industry-funded analyses in the case of NNS.…”

Section: Discussionmentioning

confidence: 86%

The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review

et al. 2020

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Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionary, table-top sweeteners, and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though and increase in NNS consumption in the has been observed. Research examining how the increased availability of low-sugar, NNS containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.

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Section: Discussionmentioning

confidence: 86%

The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review

et al. 2020

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“…If sufficient training is not available from impartial sources, then it is possible that many HCP may resort to attending industry-sponsored training to fill these resource gaps, as previously found in a systematic review of the interactions between HCP and industry (45) . Issues pertaining to conflicts of interest and the influence of nutrition industry funding within health research and clinical practice have come under increased scrutiny in recent times (45)(46)(47)(48)(49)(50) . The 2016 WHO Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children specifically prohibits the sponsorship of meetings and the 'provision of information for health workers other than that which is scientific and factual' (51) .…”

Section: Discussionmentioning

confidence: 99%

Exploring healthcare professionals’ views of the acceptability of delivering interventions to promote healthy infant feeding practices within primary care: a qualitative interview study

Toomey

Flannery

Matvienko‐Sikar

et al. 2020

Public Health Nutr.

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Objective: Early-life nutrition plays a key role in establishing healthy lifestyles and preventing chronic disease. This study aimed to (1) explore healthcare professionals’ (HCP) opinions on the acceptability of and factors influencing the delivery of interventions to promote healthy infant feeding behaviours within primary care and (2) identify proposed barriers/enablers to delivering such interventions during vaccination visits, to inform the development of a childhood obesity prevention intervention. Design: A qualitative study design was employed using semi-structured telephone interviews. Data were analysed using qualitative content analysis; findings were also mapped to the Theoretical Framework of Acceptability (TFA). Setting: Primary care in Ireland Participants: Twenty-one primary care-based HCP: five practice nurses, seven general practitioners, three public health nurses, three community dietitians and three community medical officers. Results: The acceptability of delivering interventions to promote healthy infant feeding within primary care is influenced by the availability of resources, HCP’s roles and priorities, and factors relating to communication and relationships between HCP and parents. Proposed barriers and enablers to delivering interventions within vaccination visits include time constraints v. opportunistic access, existing relationships and trust between parents and practice nurses, and potential communication issues. Barriers/enablers mapped to TFA constructs of Affective Attitude, Perceived Effectiveness and Self-Efficacy. Conclusions: This study provides a valuable insight into HCP perspectives of delivering prevention-focused infant feeding interventions within primary care settings. While promising, factors such as coordination and clarity of HCP roles and resource allocation need to be addressed to ensure acceptability of interventions to HCP involved in delivery.

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“…8,9 It is therefore of little surprise that with the advent of multi-stakeholder, public-private partnerships, in addition to the increasing interest in corporate social responsibility and voluntary pledges by commercial actors, the concept of conflict of interest (CoI) has become one of the most contested issues in contemporary health governance. 10,11 In their analysis of responses to a draft World Health Organization (WHO) tool for the prevention and management of conflicts of interest. 12 Ralston and colleagues 13 have identified the 'centrality of competing conceptions of CoI' as a critical challenge to global health governance.…”

Section: Introductionmentioning

confidence: 99%

"Conflicted" Conceptions of Conflict of Interest: How the Commercial Sector Responses to the WHO Tool on Conflict of Interest in Nutrition Policy Are Part of Their Standard Playbook to Undermine Public Health Comment on "Towards Preventing and Managing Conflict of Interest in Nutrition Policy? An Analysis of Submissions to a Consultation on a Draft WHO Tool"

Moodie

2020

Int J Health Policy Manag

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Managing conflict of interest (CoI) among the interested stake-holders in nutrition policy is a vexed and controversial issue. This commentary builds on Ralston and colleagues’ highly informative analysis of the 44 submissions to the World Health Organization (WHO) draft tool on preventing and managing CoI in national nutrition programs. The commentary proposes that the commercial sector actors are, by definition, too conflicted to objectively respond to the draft tool. The responses of the commercial sectors are predictable, as they mimic their positions during the prior negotiation for the development of the Framework for Engagement of Non-State Actors (FENSA). Their overall approach, and specific responses, are typical of the now standard methods of the ultra-processed food and beverage industry’s ‘corporate playbook.’ In addition, Ralston et al’s analysis raises a number of other issues, such as: why these corporations are so keen to be included in the world of multi-stakeholder partnerships, why so few member states responded to the draft tool, and problems with the term ‘private sector.’ The commentary ends with a suggestion for WHO to seek broader involvement from the 160+ member states who have yet to participate in the consultations regarding the draft tool.

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Time for complete transparency about conflicts of interest in public health nutrition research

Cited by 5 publications

References 27 publications

The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review

The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review

Exploring healthcare professionals’ views of the acceptability of delivering interventions to promote healthy infant feeding practices within primary care: a qualitative interview study

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