Date Published: January 9, 2007
Publisher: Public Library of Science
Author(s): Lenard I Lesser, Cara B Ebbeling, Merrill Goozner, David Wypij, David S Ludwig, Martijn Katan
Abstract: BackgroundIndustrial support of biomedical research may bias scientific conclusions, as demonstrated by recent analyses of pharmaceutical studies. However, this issue has not been systematically examined in the area of nutrition research. The purpose of this study is to characterize financial sponsorship of scientific articles addressing the health effects of three commonly consumed beverages, and to determine how sponsorship affects published conclusions.Methods and FindingsMedline searches of worldwide literature were used to identify three article types (interventional studies, observational studies, and scientific reviews) about soft drinks, juice, and milk published between 1 January, 1999 and 31 December, 2003. Financial sponsorship and article conclusions were classified by independent groups of coinvestigators. The relationship between sponsorship and conclusions was explored by exact tests and regression analyses, controlling for covariates. 206 articles were included in the study, of which 111 declared financial sponsorship. Of these, 22% had all industry funding, 47% had no industry funding, and 32% had mixed funding. Funding source was significantly related to conclusions when considering all article types (p = 0.037). For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding (p = 0.009). The odds ratio of a favorable versus unfavorable conclusion was 7.61 (95% confidence interval 1.27 to 45.73), comparing articles with all industry funding to no industry funding.ConclusionsIndustry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors’ products, with potentially significant implications for public health.
Partial Text: The extent of industrial funding for pharmaceutical research, and its implications for public health, have been extensively considered in recent years. Moses et al. reported that pharmaceutical firms provided 30% of the almost $100 billion spent on biomedical research in the United States in 2004 . These expenditures raise concerns about the integrity of pharmaceutical research . A meta-analysis by Bekelman et al. of 37 original quantitative studies of bias in pharmaceutical research found significant association between industry sponsorship and pro-industry conclusions (odds ratio [OR] 3.6; 95% confidence interval [CI], 2.63 to 4.91) .
Figure 1 depicts the flow diagram for inclusion of articles in the study. A total of 538 articles were retrieved in the searches, of which 332 were excluded. Descriptive data for the remaining 206 articles are presented in Table 1. Financial sponsorship was declared in 111 articles (54%). As shown in Figure 2, the proportion of articles disclosing sponsorship increased significantly from 1999 to 2003 (p for trend = 0.004). Considering all years together, 62% of interventional articles, 67% of observational articles, and 19% of scientific reviews indicated a funding source. Of those that reported sponsorship, 22% had all industry support, 47% had no industry support, and 32% had mixed funding.
The main finding of this study is that scientific articles about commonly consumed beverages funded entirely by industry were approximately four to eight times more likely to be favorable to the financial interests of the sponsors than articles without industry-related funding. Of particular interest, none of the interventional studies with all industry support had an unfavorable conclusion. Our study also documented industry sponsorship was very common during the study period, indicating considerable potential for introduction of bias into the biomedical literature. In view of the high consumption rates of these beverages, especially among children, the public health implications of this bias could be substantial.