Sleep is good. This is one thing both experts and the person in the street can agree on about that knitter up of the unravelled sleeve of care . Getting decent sleep not only leaves you feeling refreshed, but lack of good quality sleep is associated not just with fatigue and lower life quality, but can also increase the risk of diseases such as Alzheimer’s and type II diabetes.
Sadly, as we age we are less likely to get good sleep, we sleep less deeply than when we were younger, wake more and are more likely to be disturbed in our sleep.
Recently the Global Council on Brain Health (GCBH) published 20 recommendations that would help people over 50 years of age to have better sleep.
Now in reporting this did the newspapers focus on the recommendations to not drink alcohol three hours before bed time, keeping mobile phones and tablet devices out of the bedroom or keeping pets out of the bedroom?
Well, that’s disappointing, I like my afternoon cuppa
Yes, as does my Mum and thousands of Australians rich in years.
The advice is sensible though. After all, caffeine is a stimulant, and who amongst us has not used strong coffee to try and stave off sleep. Ironically enough, moderate coffee consumption is associated with lower risks of Dementia and type II diabetes.
The effects of caffeine can persist some time, taking 400 milligrams of caffeine can cause you to lose up to an hours sleep and have to have more disturbed sleep up to six hours after you have taken it.
But, you are going to say “But …” aren’t you
But, 400 milligrams of caffeine is roughly the equivalent of chugging four espressos at once, and is the maximum recommended daily caffeine intake. And you really shouldn’t consume more than 300 milligrams in one go.
A typical afternoon cuppa will have between 50-100 milligram caffeine, depending on whether it is tea or coffee, instant or brewed. This is 1/8th to ¼ the amount used in the sleep study. Here are some representative levels of a variety of caffeinated beverages per typical serve.
Now, you won’t drink 400 milligrams of caffeine in one hit usually, people typically have between 2-4 cups per day. This makes calculating the amount of caffeine in your body a little tricky, as the amount present in your body accumulates to different levels depending on how often you drink it.
Simulations I have run suggest that the level of caffeine in your body six hours after consuming 400 milligrams of caffeine (the amount that can lose you an hour of sleep) is a bit under the maximum amount of caffeine in your body after consuming 100 milligrams of caffeine .
If you drink you last caffeinated drink with 100 milligrams of caffeine in it at 4 pm, then you need to wait around four hours for the caffeine levels to fall below the levels associated with the loss of one hours sleep, make it six hours to be safe and if you have had a beverage with 100 milligrams of caffeine in it at 4 pm, you should be going to bed at 10 pm (or put it another way, if you want to go to bed at 10pm, you last caffeinated drink with 100 milligrams caffeine should be at 4 pm).
Of course I have calculated these values based on the average amount of time it takes the body to absorb caffeine and break it down.
You are going to say “It’s complicated” now, aren’t you
Well, yes. The amount of time peoples bodies take to break down caffeine is roughly 4 hours on average, but this can vary from as little as 2.5 hours to as much as 9 hours. This can produce huge differences in the amount of caffeine in the body (roughly three fold between the slowest and fastest rate of breakdown.
As well, the pathways in the brain that are responsible for the stimulant effect of caffeine can vary in sensitivity.
So you can have someone like me who can drink espresso late at night with no apparent effect on sleep, and my partner, who cannot drink a cup of tea after 3 pm without having disturbed sleep.
So what about age, which is the whole point of this
As you age, your body’s ability to break down drugs and natural products is reduced.
On the basis of caffeine concentrations alone, the recommendation to avoid caffeine after lunch is being a little over cautious .
On the other hand the brain systems that caffeine interacts with to cause stimulation alter with age, and this may make older people more sensitive to caffeine’s effects.
What is the bottom line then?
Getting good sleep is about more than cutting out tea and coffee after lunch.
The Global Council on Brain Health has suggested several approaches to improving sleep quality, so that you can get about 7- 8 hours of sleep in a 24-hour period.
These include not drinking alcohol three hours before bedtime (this recommendation will disturb my in-laws most), not eating or drinking generally for three hours before bed , getting regular exercise, getting more outdoor light exposure, losing weight if you are overweight, having a regular bedtime routine and not having smart phones and tablet devices in the bedroom at night as the screens light is distracting.
Avoiding (NOT do not drink tea or coffee at all all) caffeine is sensible advice as part of a coordinated approach to better sleep. Slamming back double espressos late at night is guaranteed to disturb your sleep, but an afternoon cuppa is unlikely to bother you (unless of course you are caffeine sensitive).
Be sensible, use a coordinated approach to the recommendations rather than fixating on one thing and hopefully you will sleep better.
 These are simplistic simulations, using the data on caffeine breakdown by young and old men from https://www.ncbi.nlm.nih.gov/pubmed/6886969
Comparative pharmacokinetics of caffeine in young and elderly men and assuming you drink 100 milligrams of caffeine at 10 am, 1 pm and 4 pm.
 The recommendation to avoid caffeine after lunch has been widely misinterpreted as to mean having no caffeinated beverages after lunch.
 As I write this a large part of Australia is in the grip of a massive heat wave, keeping hydrated, especially for older people, is essential in the conditions, so make sure you are getting plenty of fluids even at night.
The study involved a trial in Cambodia led by the South Australian researchers where varying levels of thiamine (vitamin B1) was added to fish sauce products during the manufacturing process.
Breastfeeding mothers and children who ate the fish sauce were then tested to confirm adequate levels of thiamine was present in their blood to prevent the disease.
Beriberi is caused by thiamine deficiency and in infant cases can quickly progress from mild symptoms such as vomiting and diarrhoea to heart failure.
With the findings published in the Journal of Paediatrics, Principal Nutritionist and Affiliate Professor at SAHMRI Tim Green said the next step was to lobby for funds to expand the trial in a bid to convince the Cambodian government of the merits of thiamine fortification.
“We’ve done this relatively large randomised controlled trial, but we provided the fish sauce in this case,” he said.
“Our next step is to scale up – to get Cambodian government or Cambodian industry involved and show that it works with 100,000 or 200,000 people.
“And if we can show that works, we can provide evidence to the government and they can also mandate the addition of thiamine to fish sauce.”
While fish sauce has no nutritional advantage over other foods trialled in the study, it was selected because of its near ubiquitous use in Cambodian culture.
Fish sauce is produced in centralised locations, making it easier for government and industry to control, and is already fortified with iron
Fortification is used in many countries around the world, but to be effective it is important to select a foodstuff already consumed by the majority of the population.
“Fortification is used in a lot of different settings – we do it in Australia, for example fortifying wheat flour with folic acid, or salt with iodine,” Professor Tim said.
“However, the important thing to consider is what you fortify may differ from country to country depending on what the staple is.
“We found that fish sauce in South East Asia is a good vehicle because it’s so popular and so widely consumed.”
While the trial was focused on Cambodia, Professor Green said a similar strategy could be adopted in other South East Asian countries affected by beriberi disease.
“Because beriberi isn’t always recognised and the onset from the initial symptoms – which can be quite mild – to death is so rapid, the best thing to do would be to prevent it in the first place,” Professor Green said.
While the study focused on thiamine fortification, the identification of fish sauce as the food of choice for delivery could also be expanded to cover other nutritional deficiencies.
Professor Green said his team had also considered the possibility of using fish sauce to deliver vitamin B2.
South Australia’s capital Adelaide has three long-standing public universities, Flinders University, University of South Australia and the University of Adelaide, each of which are consistently rated highly in the international higher education rankings.
Countries with such different food cultures as, say, Mexico and Palau are facing the same nutritional risks and following the same obesity trends. Our research aims to understand why, and we have examined the link between various facets of globalisation (trade, for instance, or the spread of technologies, and cultural exchanges) and the worldwide changes in health and dietary patterns.
A recent global study reports that worldwide, the proportion of adults who are overweight or obese increased from 29% in 1980 to 37% in 2013. Developed countries still have more overweight people than developing nations, but the gap is shrinking. In Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa, obesity levels among women exceed 50% in 2013.
The WHO identifies unhealthy nutrition patterns, along with increasing physical inactivity, as the main drivers of rising body weight around the world. Diets rich in sugar, animal products and fats constitute important risk factors for non-communicable diseases, such as cardiovascular diseases, diabetes, and different types of cancer.
In 2012, cardiovascular diseases killed 17.5 million people, making them the number one cause of death globally. Because more than three quarters of those deaths took place in low- and middle-income countries, causing substantial economic costs for their public welfare systems, the WHO classifies food-related chronic diseases as a growing worldwide threat, on par with traditional public health concerns such as under-nutrition and infectious diseases.
The Western world was the first to experience substantial weight gains of their populations, but the 21st century has seen that phenomenon spread to all parts of the globe. In a widely cited 1993 article, University of North Carolina’s Professor Barry Popkin attributes this shift to the “nutrition transition” by which diets became less dominated by starchy staples, fruits, and vegetables and richer in fats (especially from animal products), sugar and processed foods.
The different stages of this transition, Popkin says, are related to social and economic factors, such as industrialisation level, the role of women in the labour force and the availability of food-transforming technologies.
The meat factor
The rise of the percentage of the population that’s overweight, and changes in diet patterns broadly coincide with the globalisation process. Undoubtedly, globalisation has affected people’s lives in various ways, but has it caused a nutrition transition?
In order to answer this question, we have analysed the impact of globalisation on changing dietary patterns and overweight prevalence using data from 70 high- and middle-income countries from 1970 through 2011.
We found that globalisation has led people to consume more meat products. Interestingly, the social dimensions of globalisation (such as the spread of ideas, information, images and people) are responsible for this effect, rather trade or other economic aspects of globalisation.
For instance, if Turkey caught up to the level of social globalisation prevalent in France, meat consumption in Turkey would increase by about 20%. So our analysis takes into account the effect of rising incomes; otherwise, it could be confounded by the connection between higher incomes making both communication technology and meat products more affordable.
But while the study shows that globalisation affects diets, we could not establish a relationship between globalisation and increasing body weight. One explanation for this result could be that we investigated the question from a bird’s-eye perspective, not taking into account specific circumstances of countries.
So while, on average across the world, globalisation does not seem to be the driver of rising obesity, it may nonetheless play a role in specific countries.
The processed-food impact
An alternative interpretation of this unclear result is that other factors are responsible for the rising prevalence of overweight people around the world. For example, increasing consumption of processed foods is often associated with rising weight levels.
A study in the United States showed that Americans derive three quarters of their energy from processed foods, which contain higher levels of saturated fats, sugar, and sodium than fresh foods.
The increasing availability of processed foods is related to the rapid expansion of the retail industry. Modern logistics technology help retailers centralise procurement and inventory, which drives down costs and allows very competitive pricing.
After saturating Western markets, supermarkets began to spread to developing countries, which had greater growth prospects. Latin America, central Europe and South Africa saw their grocery store boom in the 1990s. Retailers later opened in Asia and are now entering markets in African countries.
An interesting, yet little explored, aspect in the discussion of processed foods is the role of multinational companies in offering unhealthy “Western diet”, such as fast food and soft drinks. Multinationals are one of the two market leaders in many emerging countries, including Brazil, India, Mexico, and Russia and they are known for substantial food and beverage advertising.
But it remains unclear whether people gain weight because they adopt a Western diet, or whether they largely preserve their taste for regional cuisines but change the nutritional composition of traditional recipes by adding more meat products, fats, and sugar.
Changing food habits: the role of labour markets
Apart from these supply-side factors, some studies on US data also associate overweight prevalence with changes in the labour market, particularly the increased participation of women.
But on the one hand, working mothers may have less time to prepare meals or to encourage their children to spend active time outside. And on the other, more working hours are likely to boost family income, which can positively influence children’s health through better access to health care, high-quality food, participation in organised sports activities, and higher quality childcare.
Since the decision to work is personal and closely related to individual characters and environment, it is difficult to establish a causal relationship between work status and children’s overweight levels. Some studies report a positive effect, but reliable evidence remains scarce. These studies also focus on the role of working women but not on men when there is no evidence indicating a differential impact of working mothers versus working fathers.
People are also increasingly working rotating night shifts. According to a systematic review carried out by the International Labor Organization, about one in five of all employees in the European Union (25%) work night shifts, and night work often constitutes an integral part of the shift-work system.
Such schedules presumably render it more difficult to establish regular meal habits and may encourage frequent snacking to maintain concentration at work. Finally, because modern technology has greatly reduced physical demands of many workplaces, individuals must eat fewer calories to avoid weight gain.
While many globalisation-related explanations for obesity seem plausible, robust empirical evidence establishing a causal link is scarce. This is partly due to the fact that food and eating habits have multiple and often interrelated determinants, which makes it challenging to test the causal impact of a single factor. And it’s further aggravated by the fact that some of the proposed causes of obesity interact and potentially amplify each other.
Despite initial academic evidence then, the main drivers of the global rise in obesity levels remain, to a large extent, a black box.
Discover Fabrice Etile and his team’s research work on food with the Axa Research Fund.
EPA and DHA omega-3s reduce the risk of coronary heart disease (CHD), according to results of a new, comprehensive meta-analysis published in the Mayo Clinic Proceedings and sponsored by the Global Organization for EPA and DHA Omega-3s (GOED). Among randomized controlled trials (RCTs), there was a statistically significant reduction in CHD risk in higher risk populations, including:
16 percent in those with high triglycerides and 14 percent in those with high LDL cholesterol.
A non-statistically significant 6 percent risk reduction among all populations in RCTs, a finding supported by a statistically significant 18 percent reduced risk of CHD among prospective cohort studies.
“What makes this paper unique is that it looked at the effects of EPA and DHA on coronary heart disease specifically, which is an important nuance considering coronary heart disease accounts for half of all cardiovascular deaths in the U.S.,” said Dr. Dominik Alexander, lead author and Principal Epidemiologist for EpidStat. “The 6 percent reduced risk among RCTs, coupled with an 18 percent risk reduction in prospective cohort studies — which tend to include more real-life dietary scenarios over longer periods — tell a compelling story about the importance of EPA and DHA omega-3s for cardiovascular health.”
Additional study details include:
The study reviewed 18 randomized controlled trials (RCTs) and 16 prospective cohort studies, with 93,000 and 732,000 subjects, respectively.
The study examined outcomes such as myocardial infarction, sudden cardiac death and coronary death.
The study compared the results of RCTs, which explore interventions under strict clinical conditions, to those of prospective cohort studies that are observational, and followed larger populations for longer periods of time.
“There are important public health implications related to reducing the risk of coronary heart disease, and therefore we are encouraged by the results of this comprehensive analysis,” said Dr. Harry Rice, Vice President of Regulatory and Scientific Affairs for GOED. “It’s also important that the observed risk reductions were even stronger in patient populations with elevated triglycerides and LDL cholesterol levels, two risk factors that affect more than one quarter of the American population.”
“The results confirm that increasing omega-3s is a healthy lifestyle intervention that can contribute towards reductions in CHD risk,” added Adam Ismail, Executive Director of GOED. “Remember that increasing omega-3 intakes is basically just improving the quality of one’s diet slightly, like reducing the amount of sodium or increasing your dietary fiber. It is a simple, inexpensive, and achievable change that most consumers need to make to optimize their health.”
An accompanying editorial in Mayo Clinic Proceedings also acknowledges the importance of the study. “The meta-analyses of Alexander and colleagues suggests that omega-3 fatty acid intake may reduce risk of adverse CHD events, especially among people with elevated levels of TGs or LDL-C.…omega-3 fatty acid intake of at least 1 gram of EPA+DHA per day, either from seafood or supplementation (as recommended by the American Heart Association), continues to be a reasonable strategy,” said the authors.
Study authors did point out that further clinical trials looking specifically at CHD outcomes may continue to provide a better understanding of the promising beneficial relationship between EPA/DHA and CHD risk. Current RCTs have varying durations, different baseline CHD status for study participants, and utilize several methods for patient selection and randomization. Future studies should:
Increase patient populations to account for dropout rates in longer trials.
Extensively detail how subjects are diagnosed to create uniform diagnostic criteria.
Be appropriately powered to detect an effect in current clinical conditions.
Measure baseline omega-3 intake or status of study participants to determine the extent to which it confounds results.
The study was supported by a grant from GOED, which played no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
It’s a long, hot summer’s day and you’re looking forward to an ice cream. But within seconds of your first bite, you feel a headache coming on: a brain freeze.
What’s going on?
Your brain isn’t literally freezing, or even sensing cold. It can’t sense cold or pain because it lacks its own internal sensory receptors. In fact, surgeons usually perform brain surgery on conscious, sedated patients with the only pain coming from the scalp, skull and underlying tissues, not from the brain itself.
headache attributed to ingestion or inhalation of a cold stimulus.
Anything cold (solid, liquid or gas) that passes over the roof of the mouth (the hard palate) and/or the back of the throat (posterior pharyngeal wall) can trigger a brain freeze headache.
Pain can be to the front of the head or the temples and while short lasting, can be intense, though not debilitating. People who have these headaches usually do not seek treatment, so there has been very little research into how brain freeze occurs.
People most likely to have brain freeze also tend to suffer from migraines, suggesting a common underlying mechanism for both.
One study compared how common brain freeze was in people with migraine alongside those with tension type headaches. When an ice cube was placed on the hard palate of their mouths for 90 seconds, 74% of migraine sufferers reported pain along their temples versus 32% of those with a history of primary headache disorders (headaches that do not have an underlying or identifiable cause).
Only 12% of volunteers without a history of primary headache disorder experienced brain freeze headache with the same stimulus. These observations are robust and have been replicated.
What causes brain freeze?
An old fashioned idea about the cause of migraine suggested excessive blood flow through the blood vessels that supply blood to the brain caused the pain. However, this vascular hypothesis for migraine, although still popular, is now largely discredited.
Another theory about what causes migraine relates to altered excitability of neuronal pathways that detect and transmit the sensation and pain in the head via the trigeminal system, the major nerve that transmits sensory information from the head to the central nervous system.
Ordinarily the cold sensation is not painful. However, if the trigeminal system is prone to over-excitability in people with migraine, pain kicks in at lower level (a lower threshold). If an over-excitable trigeminal system also applies to people with brain freeze, then the threshold may be low enough to activate pain after only a brief exposure to ice cream.
Researchers are studying what causes hyper-excitability of the trigeminal system. The effects of a specific chemical signalling molecule CGRP (calcitonin gene-related peptide) released by trigeminal neurons are a necessary component of migraine pain.
In genetically inherited migraine, the cellular processes that result in the release of CGRP from trigeminal neurons has been altered. These same mechanisms may explain the hypersensitivity to cold stimulus in ice cream headaches.
It seems likely that all headaches are the result of changes in activity in the trigeminal system, although why we perceive them in the front of the head and at the temples in particular is a mystery.
Is there anything I can do to stop brain freeze?
While we do not know exactly what causes brain freeze, there may be a simple way to reduce your chances of having one this summer.
Research shows how long brain freeze headaches last relates to the surface area of the mouth that comes into contact with the cold stimulus. So, if you want to reduce your chance of a brain freeze, you may want to avoid gulping down your ice cream all at once. Take small nibbles instead.
The hunt is on for fine wines across Australia worthy of raising a glass to, with entries for the prestigious Royal Queensland Wine Show (RQWS) opening today.
Chief Judge David Bicknell will lead a team of expert judges for his second year at the helm, as they sniff, swirl and taste their way through the nation’s top drops, at the first capital city wine show of the season.
This means the RQWS judges will be the first to critically review the 2017 vintage in Australia, setting the benchmark for the industry and letting wine lovers know which bottles to look for.
In keeping up with changes in consumer interest, a new dry red wine class called ‘current drinking light dry red’ has been introduced to the competition for 2017.
Bicknell said the new class is for current release dry red wines that are bottled early for current consumption.
“This should be a fun class where we will see modern ‘bar wines’ that have captured the imagination of the wine savvy public,’’ he said.
“Winemaking technique and variety are irrelevant, enjoyment is paramount and we will hopefully see a few natural and low sulphur wines in the mix as well.”
More than 1,800 wines from 243 wineries were entered into this year’s competition, which saw a sparkling take out Grand Champion Wine of Show for the first time in RQWS history and a pinot noir claim the Stodart Trophy, which is usually won by shiraz.
Entries must be in by April 21, 2017, with judging taking place from June 26 and July 7.
Asahi Beverages, comprising some of Australia and New Zealand’s most successful beverage businesses, including Schweppes Australia, Asahi Premium Beverages, Independent Liquor and The Better Drinks Co., has awarded Dematic a contract to build a high bay warehouse storage facility.
The warehouse in Heathwood, Queensland, will consist of a satellite storage solution containing six aisles of six-deep satellite ColbyRack capable of storing 28,000 pallets.
The automated storage and retrieval system (ASRS) will include six new Dematic RapidStore Storage Retrieval Machines (SRMs) with Dematic’s latest “free roaming” Automover satellite carts. The solution will also feature Skate Auto-loading Truck Docks, a pallet conveyor system, stretch wrapper, automatic barcode labelling, and a full case picking area.
“Dematic was selected by Asahi Beverages as their preferred logistics integration partner following an extensive tender process that assessed experience, comprehensiveness of offering, and local capability,” said David Rubie, Dematic’s Manager of Industry Logistics.
“We look forward to working with Asahi Beverages to deliver a supply chain solution that is a core component of their ongoing success.”
“Our new Queensland high bay warehouse is another major step forward in the transformation of our customer centric logistics network,” said Tracey Wagner, General Manager, Logistics and Customer Operations, Asahi Beverages.
“We are pleased to be working with an experienced integrator such as Dematic on this crucial program.”
Last Friday , over 170 people from the Australian Institute of Packaging (AIP), the Australian Packaging & Processing Machinery Association (APPMA), the Supply Chain & Logistics Association of Australia (SCLAA) and the QLD Supply Chain and Logistics Conference (QSCLC) spent their Christmas Party packing over 1100 hampers for Foodbank to provide to those in need during the holiday season.
The hampers included 800 family hampers, 200 ladies packs and 110 children’s packs. The total value of the hampers was over $120,000 worth of items that were either donated, or the funds raised for, by the industry.
According to the AIP, the hampers would not be possible without the continued support from the industry including Campbells Arnotts, Colgate, Ego Pharmaceuticals, Edex, Tip Top GW Foods, All Purpose Transport, Office Max, BDO, APPMA, Orora, Linde Forklifts, Tip Top Foodservice -GW Foods, Coles and Department of Housing and Public Works.
Over the last five years, the team has packed 5400 hampers to the value of close to $660,000 for people in need and looks forward to even more hampers in 2017.
Bestech Australia has introduced the OX2/231, an oxygen permeability tester to determine oxygen transmission rate of film and package products, including plastic films, composite films, sheeting, plastic bottles, plastic bags and other packages.
This is important to ensure the food product maintains a long shelf life. It comes with 2 test modes for both films and packages for accurate tsts.
The tester can test 3 specimens at once, and then export test results for analysis. An easy-to-use menu interface with LCD display ensures viewing and exporting data is convenient. The OX2/231 is recommended for the following packages:
• Films – Plastic films, aluminium foils, etc
• Sheeting – Engineering plastics, rubber and building materials
Nestlé researchers have found a way to structure sugar in such a way that, even when much less is used in chocolate, the tongue perceives an almost identical sweetness to before.
The discovery will enable Nestlé to significantly decrease the total sugar in its confectionery products, while maintaining a natural taste.
“This truly groundbreaking research is inspired by nature and has the potential to reduce total sugar by up to 40% in our confectionery,” said Stefan Catsicas, Nestlé Chief Technology Officer.
“Our scientists have discovered a completely new way to use a traditional, natural ingredient.”
Nestlé is patenting its findings and will begin to use the faster-dissolving sugar across a range of its confectionery products from 2018 onwards.
The company expects to provide more details about the first roll-out of reduced-sugar confectionery sometime next year.
The research will accelerate Nestlé’s efforts to meet its continued public commitment to reducing sugar in its products.
It is one of a wide range of commitments the company has made on nutrition. This includes improving the nutritional profile of its products by reducing the amount of sugar, salt and saturated fat they contain, while at the same time as increasing healthier nutrients such as vitamins, minerals and whole grain.
HealthShare NSW is reaping the benefits of using the National Product Catalogue (NPC) and Smart Media as a preferred method of managing and exchanging data with trading partners.
The GS1 Australia National Product Catalogue is a single repository of product and pricing data already used widely across healthcare for the purpose of sourcing critical data for procurement, supply chain and clinical use.
GS1 Australia’s Smart Media service is one of the solutions HealthShare NSW use to automatically access authenticated product images and related digital content from their suppliers.
The National Product Catalogue was selected by HealthShare NSW as it met the NSW Health solution criteria for system-to-system access to accurate procurement information directly from data owners.
Smart Media is also referred to as one of the preferred options HealthShare NSW use to manage and share up-to-date digital assets with their trading partners as the integration of this data with the National Product Catalogue avoids duplications.
HealthShare NSW is also implementing the use of the National Product Catalogue for food supplies. It is intended to make NPC compliance mandatory for all food contracts, effective April 2018. This will enable streamlined data validation and synchronisation processes that will result in reduced anomalies in purchasing and accounts payable.
According to Mark Fuller, GS1 Australia’s Chief Operating Officer, implementation of the National Product Catalogue for food supplies will provide our health providers with accurate, trusted data, including nutrition and allergen information, direct from suppliers and brand owners which is essential for patient safety today.
“We are pleased to see HealthShare NSW continuing to be a leader in actively implementing GS1 standards in the Healthcare Sector, providing significant benefits to not only suppliers and purchasers but also patients who will ultimately benefit from the data being provided.”
High fat, low fat, no carb, more carb: when it comes to getting information on eating to manage high blood cholesterol, confusion reigns.
We checked the most recent research from trials that tested the impact of specific foods on blood cholesterol. The verdict? Good news first! Eating more nuts, legumes, plant sterols (molecules found in plants) and olive oil helps lower blood cholesterol.
The bad news? Discretionary foods (aka junk) raise blood cholesterol, especially bad cholesterol (called LDL). Eating less lowers it.
Do you know your blood cholesterol level? If you don’t, ask your GP to check it. Over a third of Australian adults have high cholesterol.
1. Eat legumes
Legumes and pulses, including baked beans, kidney beans, chick peas, lentils and split peas, can help lower cholesterol levels. The most recent Australian Health Survey found fewer than one in five Australians ate them on the day of the survey.
The results of 26 randomised control trials (the gold standard of research trials), which included 1,037 people who had either normal or high cholesterol levels, were added together. The data showed LDL cholesterol was reduced by 5% in response to eating 130 grams of pulses per day. This is equivalent to one small can or about a third of a 400 gram (large) can of baked beans.
Pulses are high in vegetable protein and fibre. They lower blood cholesterol in a number of ways. The soluble and insoluble fibres assist with lowering cholesterol absorption in the gut, while they promote growth of beneficial gut bacteria in the large bowel.
Plant sterols, or phytosterols, are chemically similar to blood cholesterol and are found in some plant foods, including nuts. Plant sterols are concentrated from plant sources and then added to some commonly eaten foods such as margarines, spreads or milk.
Plant sterols compete with two other types of cholesterol
for absorption from the gut: pre-made cholesterol, which is found in some foods like prawns, and cholesterol, which is made in your liver. This “competition” process lowers the total amount of cholesterol that eventually ends up in your blood.
A review concluded that two grams of plant sterols a day leads to an 8-10% reduction in LDL cholesterol.
The type of fat the plant sterols are mixed with is important. A meta-analysis of 32 randomised control trials, involving around 2,100 people, found bigger reductions in total cholesterol (a mix of good and bad types) and LDL cholesterol when plant sterols were added to margarines or spreads derived from canola or rapeseed oil, rather than sunflower or soybean oil.
3. Eat nuts
Nuts are high in protein and fat, but the amounts of polyunsaturated, monounsaturated and saturated fat vary. In a review of 25 intervention trials, eating approximately 67g of nuts a day (about half a cup) led to a 5.1% reduction in total cholesterol and 7.4% for LDL.
It didn’t matter what type of nuts people ate; the more nuts, the bigger the cholesterol reduction. People with higher LDL cholesterol at baseline or who were not overweight had a bigger improvement. One caution is that half a cup of nuts contains about 400 calories (1600kJ), so you need to eat nuts instead of another food, or eat less each day but have them every day.
4. Use olive oil
Olive oil is a major component of the Mediterranean diet and the predominant source of fat. Olive oil contains a high proportion of monounsaturated fat.
More than 80% of olive oil’s healthy compounds (called phenolic compounds) are lost during the refining process, so less refined varieties, such as virgin olive oil, are a better choice.
A review of eight trials that included 350 people consuming high phenolic olive oil found medium effects on lowering blood pressure and small effects on lowering oxidised LDL (a type of LDL), with no significant effects on total or LDL cholesterol.
In contrast, another trial randomly selected over 7,400 men and women at high risk of heart disease to follow three diets: the Mediterranean diet plus extra-virgin olive oil, or Mediterranean diet plus nuts, or a control diet (low fat). After 4.8 years follow-up, those in both the olive oil and nut groups had a 30% lower risk of heart attack, stroke or death from heart disease compared to controls.
In a recent trial, 47 men and women were randomised to substitute 4.5% of their usual food intake of olive oil or butter for five weeks, and then crossed over to the other group for another five weeks. Researchers found total cholesterol and LDL-cholesterol levels were significantly higher after consuming butter compared to olive oil.
The reduction was biggest in those who had high blood cholesterol to start with. Switching to a healthier spread makes sense for those with high cholesterol.
5. Avoid junk food
In our study, we found people were able to make a number of smaller changes across a range of the foods that lower blood cholesterol levels, including increasing nuts, soy foods and plant sterols.
But the biggest change people made was cutting back on energy-dense, nutrient-poor foods (junk foods) and eating a wider variety of healthy foods. The benefits of making these changes? They lowered their cholesterol, lost weight and lowered their blood pressure.
A big study examined changes in diet quality scores and heart disease risk in 29,000 men from the Health Professionals Follow-up Study and 51, 000 women from the Nurses’ Health Study (1986-2010). After four years of follow-up almost 11,000 people had a heart disease “event”.
Those who had the biggest improvement in their diet quality score had a 7-8% lower risk. You can check your diet quality using our Healthy Eating Quiz.
When it comes to heart disease risk factors, get your cholesterol and blood pressure checked next time you see your GP.
In Australia, one in every two people has a chronic disease. These diseases, such as cancer, mental illness and heart disease, reduce quality of life and can lead to premature death. Younger generations are increasingly at risk.
Crucially, one-third of the disease burden could be prevented and chronic diseases often share the same risk factors.
A collaboration of Australia’s leading scientists, clinicians and health organisations has produced health targets for Australia’s population to reach by the year 2025.
These are in line with the World Health Organisation’s agenda for a 25% global reduction in premature deaths from chronic diseases, endorsed by all member states including Australia.
Today the collaboration is announcing its top ten priority policy actions in response to a recent health report card that identifies challenges to meeting the targets. The actions will drive down risk factors and help create a healthier Australia.
1. Drink fewer sugary drinks
One in two adults and three out of four children and young people consume too much sugar. Sugary drinks are the main source of sugar in the Australian diet and while many other factors influence health, these drinks are directly linked to weight gain and the risk of developing diabetes.
Almost 40% of children and young people’s energy comes from junk food. Children are very responsive to marketing and it is no coincidence almost two-thirds of food marketing during popular viewing times are unhealthy products.
Restricting food marketing aimed at children is an effective way to significantly reduce junk food consumption and Australians want action in this area. Government-led regulation is needed to drive this change.
Campaigns that highlight the dangers of smoking reduce the number of young people who start smoking, increase the number of people who attempt to quit and support former smokers to remain tobacco free.
More than 90% of Australian young people are not meeting guidelines for sufficient physical activity – the 2025 target is to reduce this by at least 10%.
Active travel to and from school programs will reach 3.7 million of Australia’s children and young people. This can only occur in conjunction with safe paths and urban environments that are designed in line with the latest evidence to get everyone moving.
6. Tax alcohol responsibly
The Henry Review concluded that health and social harms have not been adequately considered in current alcohol taxation. A 10% increase on the current excise, and the consistent application of volume-based taxation, are the 2017 priority actions.
People with a mental illness are over-represented in national unemployment statistics. The 2025 target is to halve the employment gap.
Unemployment and the associated financial duress exerts a significant toll on the health of people with a mental illness, and costs an estimated A$2.5 billion in lost productivity each year.
Supported vocational programs have 20 years of evidence showing their effectiveness. Scaling up and better integrating these programs is an urgent priority, along with suicide prevention and broader efforts.
8. Cut down on salt
Most Australian adults consume in excess of the recommended maximum salt intake of 5 grams daily. This contributes to a high prevalence of elevated blood pressure among adults (23%), which is a major risk factor for heart diseases.
Around 75% of Australian’s salt intake comes from processed foods. Reducing salt intake by 30% by 2025, via food reformulation, could save 3,500 lives a year through reductions in heart disease, stroke and kidney disease.
9. Promote heart health
Heart disease is Australia’s single largest cause of death, and yet an estimated 970,000 adults at high risk of a cardiovascular event (heart attack or stroke) are not receiving appropriate treatment to reduce risk factors such as combined blood pressure and cholesterol-lowering medications. Under-treatment can be exacerbated by people’s lack of awareness about their own risk factors.
National heart risk assessment programs, along with care planning for high-risk individuals, offer a cost-effective solution.
10. Measure what matters
A comprehensive Australian Health Survey must be a permanent and routine survey every five years, so Australia knows how we are tracking on chronic disease.
All of these policies are effective, affordable and feasible opportunities to prevent, rather than treat, Australia’s biggest killer diseases.
Public health advocates meeting in Parliament House will call for a 20 per cent levy on sugar sweetened beverages as part of a broader list of 10 health priorities for Australia.
Professor Tom Calma AO, Chancellor of the University of Canberra will launch Getting Australia’s Health on Track – a policy report for a healthier Australia.
The event is hosted by the Australian Health Policy Collaboration (AHPC) together with the Public Health Association of Australia (PHAA) and Australian Healthcare and Hospitals Association (AHHA). Also speaking are Ministers Gillespie, King and Senator Di Natale.
Getting Australia’s Health on Track was developed by a national collaboration of 70 leading chronic disease experts and organisations who have also worked together on the related Australia’s Health Tracker. Australia’s Health Tracker, a national chronic disease report card was launched in July this year. Recently, the second phase of this work Australia’s Health Tracker by Area launched, providing localised data and reports on chronic diseases.
Now this work enters its third phase – Getting Australia’s Health on Track – which outlines a suite of policies that will help address the problems revealed in the Tracker data sets.
“Currently, less than 1.5 per cent of spending is dedicated to prevention. One in two Australians are now living with a chronic disease; we must take preventative actions now for a healthier future,” commented Rosemary Calder, Director AHPC.
“These 10 priority policy actions are more than health policies and offer significant social and economic benefits for Australia. Australia’s Health Tracker reveals some of the nation’s greatest health challenges – now here is a list of some of the best solutions.”
Apart from the sugar tax, the priority policy actions are:
HEALTHIER DIETS: Protect children and young people from unhealthy food and beverage TV marketing;
REDUCE SMOKING: Enhance media campaigns to reduce smoking;
REDUCE SMOKING: Reduce health and mortality disparities in disadvantaged populations caused by smoking;
INCREASE PHYSICAL ACTIVITY: Invest in active travel initiatives to and from school to kickstart a national physical activity plan;
REDUCE HARM FROM ALCOHOL: Consistent volumetric tax on alcohol products and increase current tax rate;
IMPROVE MENTAL HEALTH: Scale up supported vocational programs for people with a mental illness;
REDUCE BIOMEDICAL RISK: Reduce salt content in processed foods and meals to decrease the risks of high blood pressure;
REDUCE BIOMEDICAL RISK: Scale up primary care capacity in primary and secondary prevention of cardiovascular risks;
MONITOR HEALTH: Invest in comprehensive national measurement and monitoring of chronic diseases and their risk factors in the population over time.
Deputy Prime Minister Barnaby Joyce has slammed the proposal to introduce a sugar tax and said eating less and exercise are the ways to reduce obesity.
As the SMH reports, Joyce was responding to a report presented to Parliament which claims there should be a tax of 40 cents per 100 grams of sugar on sugary soft drinks.
The report by the Gratton Institute estimates that community or “third party” costs of obesity were about A$5.3 billion in 2014/15; and says a tax would not only reduce obesity levels but also recoup some of these costs.
But Joyce, who is also Agriculture Minister and has warned of the devastating affect a sugar tax would have on the sugar industry of North Queensland, said the National Party would not support it.
“If you want to deal with being overweight, here’s a suggestion: stop eating so much and do a bit of exercise,” he said.
“This is one of these suggestions right from the start we always thought was bonkers mad but now it’s getting more and more momentum so we have to say, ‘We are not going to be supporting a sugar tax’.”
He said the comparison with the tobacco excise does not hold because all cigarettes are bad for you, while the occasional soft drink is not.
“I believe in the freedom of the individual … We the government are not going to moralise about what you take out of the fridge,” he said.
A forensic accountant has alleged that dairy processor Murray Goulburn may have overstated its earnings and even lost money in the last financial year.
It was claimed in early November that its treatment of the milk supplier support program in its accounts was wrong.
This in turn has led to dairy farmers doubting whether they’ll get repaid, according to The Sydney Morning Herald. Not helping the situation is the company’s decision to write off part of the advance.
Forensic accounting company, Morris Forensic, says Murray Goulburn’s pretax profit of more than $57 million should have been a loss of just over $92 million.
Morris Forensic believes that Murray Goulburn treating the advance as an ‘asset’ is not correct because there is no right to recover the advance from farmers. “In my opinion, Murray Goulburn’s financial statements should have been prepared on the basis that the amounts paid or payable to suppliers for milk purchased during the year were inventory purchases,” Morris Forensic argues in its report.
Murray Goulburn has confirmed to the SMH that farmers do not have to repay the advance and that the company has already written off part of the advance.
“In my opinion, the manner in which Murray Goulburn recognised the MSSP assets of $183.334 million in its 2016 financial report resulted in Murray Goulburn increasing its reported profit before income tax by approximately $150 million,” Morris Forensic said in its report.
Murray Goulburn is the subject of a class action and of ASIC inquiries due to allegations that it misrepresented certain aspects in its prospectus when it raised capital from investors last year.
It’s no wonder people are confused about whether it’s good to eat cheese, when even food experts are divided. Some argue that we’re not eating enough of this important source of protein and calcium, while others say the high levels of salt and saturated fat mean we should be eating less.
Whatever your position, it’s becoming increasingly hard to avoid cheese. Whether its grilled halloumi with poached eggs for breakfast, pumpkin and feta salad for lunch, or pepperoni pizza for dinner, cheese is a key ingredient in many regular meals. It’s a popular snack food, with many health professionals promoting crackers and cheese as a high-protein snack. A cheese platter is also the favourite way to kick off afternoon drinks or a barbeque.
So just how much cheese are Australians eating, and is it good for us?
The Australian Dietary Guidelines recommend that adults eat about 2.5 serves of dairy (including milk, yoghurt and cheese) a day. They also say this should preferably be low-fat to ensure that nutrient needs are met without exceeding energy requirements.
Available sales data for cheese suggest that Australians are eating 13.6kg of cheese per person per year, which works out at 37g per person per day, or just less than one Australian portion (Australian portion sizes are 25% bigger than European Union ones, at 40g compared with 30g).
It seems that the advice to limit full-fat cheeses to two or three serves per week is being ignored. Low-fat products only made up 29% of dairy products consumed in the last dietary survey while cheese accounted for 99% of the high-fat dairy products consumed.
This is 11% and 40%, respectively, of the amount used as the reference guide for daily intake labelling. So even though actual recommendations depend on individual energy requirements, it is still clear that we need to limit our consumption of full-fat cheese to avoid excessive amounts of saturated fat.
The levels of sodium in cheese are also something to watch out for as too much salt increases blood pressure, which increases the risk of heart disease and stroke.
Interestingly, processed cheddar contains twice as much sodium as unprocessed cheddar, at 532mg per portion (26% of WHO recommended amount), so it would seem better to opt for the unprocessed version on that basis (although this may have higher levels of saturated fat and less calcium).
The definition of a processed cheese is a product manufactured from cheese and products obtained from milk, which is heated and melted, with or without added emulsifying salts, to form a homogeneous mass.
Such products can be produced more cheaply, last longer and are more convenient to use and so are a popular product for kids’ school lunchboxes. Current concerns over increasing childhood obesity in Australia means its important to keep an eye on fat and energy contents of children’s foods.
Kraft singles and Bega Stringers both contain a little less energy, substantially less saturated fat, and about the same amount of sodium and calcium per portion as regular cheddar cheese. Meanwhile, Philadelphia cream cheese contains even less energy and much less sodium but is higher in saturated fat.
A recent meta-analysis of 15 studies, that suggested moderate cheese consumption (up to 40g per day) was associated with reduced heart disease risk, didn’t differentiate between low and full fat cheeses.
The authors (two of whom incidentally work for a leading dairy company in Asia) suggested the calcium, protein, vitamins or minerals (not specified) in cheese might explain the apparent protective health benefits.
Cheese is a good source of calcium and we need calcium for bones and teeth as well as regulating muscle and heart functions.
The recommendations are for most adults and children aged nine and above to eat 1,000-1,300mg of calcium a day. A 40g serving of cheddar cheese contains around 320mg. So you would need to eat at least three portions if you were to get your calcium requirements just from cheese.
So what’s the verdict?
For maximum health outcomes I’d stick to the advice to eat two to three serves of dairy (mainly low fat) per day. This may include one serve of low-fat cheese, with maybe one serve each of low-fat milk and yoghurt to ensure you get enough calcium. I’d also stick with the recommendations to limit full-fat cheeses to two to three serves per week.
Enjoy sparingly (two to three times a week): full-fat cheeses, hard cheeses, feta, halloumi, blue cheese.
Coca-Cola has announced details of Powerade’s new Australian Summer campaign ‘Smash the Sweat’.
The campaign is designed to encourage consumers to smash the sticky, humid conditions associated with the season through the launch of limited edition Powerade sport-themed ‘shrink packs’ aimed at generating cut-through during the key summer period.
The strategy, said the company, revolves around tapping into the Aussie’s love of sports through collectable summer sports-themed packaging, featuring imagery from a range of sports including rugby, cricket, basketball, tennis, soccer and athletics.
The signature packs are signed by sporting legends and Powerade Ambassadors Greg Inglis, Mitchell Johnson and Andrew Bogut.
Appearing from early November, the limited edition packs will be promoted in-store at point-of-sale and supported on social media channels in the build up to summer.
As the summer sport season kicks off, the campaign will be boosted through outdoor media calling on consumers to ‘Smash the Sweat’.
Sarah Illy, Brand Activation Manager, Powerade, said: “We all love an Aussie summer, but with the hot, sticky conditions it becomes even more important to stay hydrated. So this summer we are challenging people to ‘Smash the Sweat’. Being a sports-obsessed nation, we decided to tap into that trend through our collectable sport-themed packs to encourage people to be active and stay hydrated.”
“The limited edition bottles have been inspired by Australian sporting legends with the objective of keeping Powerade ION4 top of mind for rehydration needs. Powerade ION4… is scientifically formulated to help replace four of the electrolytes lost in sweat and is an ideal way to ‘Smash the Sweat’ this summer,” said Illy.
Almost half of Australian consumers say they wished there were more ‘all-natural’ food products on the shelves, showcasing a clear gap in the market that could drive healthier bottom lines for manufacturers and retailers, research has revealed.
Findings from Nielsen’s Global Health and Ingredient-Sentiment Survey highlights that consumers are adopting a back-to-basics mindset where a focus on simple ingredients and fewer artificial or processed foods is a priority.
“Informed and savvy consumers are demanding more from the foods they eat and are happy to pay more if they believe it is better for them,” explained Michael Elam-Rye, Associate Director – Retail at Nielsen.
“This presents an opportunity for food manufacturers to increase share by offering and marketing products that are formulated with good-for-you ingredients, and an opportunity for retailers to trade consumers up with more premium priced products.”
For Australian consumers, animal products that contain antibiotics or hormones are the most worrying, with six in 10 consumers saying that they actively avoid these products.
The top 10 ingredients that Australian consumers avoid include antibiotics/hormones in animals products, MSG, artificial additives, foods with BPA packaging, sugar, genetically modified foods, and sodium.
Close to nine in 10 respondents said they avoid specific ingredients because they believe them to be harmful to their own or their family’s health; while six in 10 consumers said they are concerned about the long-term health impact of artificial ingredients in their diet.
Should we eat breakfast every day? How much dairy should we have? Should we use artificial sweeteners to replace sugar? If we had the answers to these questions, we could address some of today’s biggest public health problems such as heart disease, cancer, diabetes and obesity.
Consumer choice is often guided by recommendations about what we should eat, and these recommendations also play a role in the food that’s available for us. Recommendations take the form of dietary guidelines, food companies’ health claims, and clinical advice.
But there’s a problem. Recommendations are often conflicting and the source of advice not always transparent.
In September, a JAMA Internal Medicine study revealed that in the 1960s, the sugar industry paid scientists at Harvard University to minimise the link between sugar and heart disease. The historical papers the study was based on showed researchers were paid to shift the blame from sugar to fat as responsible for the heart disease epidemic.
The paper’s authors suggested many of today’s dietary recommendations may have been largely shaped by the sugar industry. And some experts have since questioned whether such misinformation can have led to today’s obesity crisis.
We’d like to think industry influence of this scale won’t happen again. We’d like to have enough systems in place to shine a spotlight on any potential bias, or risk of it, as soon as it happens. But the reason it took so long to expose the sugar industry’s tactics is bias can be well hidden. To avoid the potentially huge ramifications, we need much better systems in place when it comes to nutrition research.
How are national guidelines put together?
Governments issue national dietary guidelines to inform people’s food choices and the nation’s food policies. To be credible and scientifically sound, they should obviously be built on rigorous evidence.
Best practice for creating guidelines includes beginning the process with a systematic review, which is a study that identifies all the available evidence on a particular research question. This ensures studies favourable to a particular party can’t be cherry-picked. But systematic reviews are only as valid as the studies out there.
An important part of any systematic review is to evaluate the biases in the studies included. Public health dietary guidelines and policies are influenced by political, economic and social factors. That’s inescapable. But if the evidence on which these decisions are based is flawed, the entire foundation for systematic reviews, guidelines and policy, crumbles.
Bias in research is the systematic error or deviation from true results or inferences of a study. Pharmaceutical, tobacco or chemical industry funding of research biases human studies towards outcomes favourable to the sponsor.
Even when studies use similar rigorous methods – such as keeping study information away from participants (blinding) or removing selection bias between groups of patients (randomisation) – studies sponsored by a drug’s manufacturer are more likely to find the drug is more effective or less harmful than a placebo or other drugs.
This bias in pharmaceutical industry sponsored studies is just like the sugar industry sponsored studies that downplayed sugar’s link to heart disease while putting the blame on fat.
Financial conflicts of interest between researchers and industry have also been associated with research outcomes that favour companies researchers are affiliated with.
So how does this happen? How can industry-funded studies use methods similar to non-industry funded studies but have different results? Because bias can be introduced in several ways, such as in the research agenda itself, the way research questions are asked, how the studies are conducted behind the scenes, and the publication of the studies.
Industry influences on these other sources of bias in research often remains hidden for decades.
It did this by funding “distracting” research through The Center for Indoor Air Research, which three tobacco companies created and funded. Throughout the 1990s, this centre funded dozens of research projects that suggested components of indoor air, such as carpet off-gases or dirty air filters, were more harmful than tobacco. The centre did not fund research on secondhand smoke.
There is a high risk of bias when the methodology of the study (how the study is designed) leads to an error when assessing the magnitude or direction of results. Clinical trials with a high risk of methodological bias (such as those lacking randomisation or blinding) are more likely to exaggerate the efficacy of drugs and underestimate their harms.
A 2007 paper that compared over 500 studies found those funded by pharmaceutical companies were half as likely to report negative effects of corticosteroid drugs (used to treat allergies and asthma) than those not funded by pharmaceutical companies.
Many industry-sponsored studies of drugs are conducted for regulatory approval and the regulators require certain methodological standards. So often, the design of industry-sponsored studies is pretty good and the bias is elsewhere. It can be in how the questions are framed or another common form: publication bias.
Publication bias occurs when entire research studies are not published, or only selected results from the studies are published. It is a common myth publication bias comes about because scientific journal editors reject studies that don’t support the hypothesis or question the studies were asking. These are called negative or statistically non-significant studies. But negative research is as likely to get published as positive research. So it’s not that.
Analysis of internal pharmaceutical industry documents from 1994 to 1998 shows the pharmaceutical industry had a deliberate strategy to suppress publication of sponsored research unfavourable to its products. Industry-funded investigators were not allowed to publish negative research that did not support the efficacy or safety of the drugs being tested.
This has contributed to a clinical literature dominated by studies demonstrating the efficacy or safety of drugs. The tobacco industry also has a history of stopping the publication of research it funded if the findings didn’t lean in favour of tobacco products.
Previous research on bias in tobacco, pharmaceutical, and other industry-sponsored research is relevant here because the biases that affect research outcomes are the same, regardless of the exposure or intervention being studied. When it comes to nutrition research, we actually know little about how corporate sponsorship or conflicts of interest might bias the research agenda, design, outcomes and reporting.
Industry influence on nutrition research
The credibility of nutrition research has come under attack because the funding source is often not transparent and industry-funded research affects food policy. But we actually know very little about how sponsorship biases nutrition research.
Our systematic review, published this week in JAMA Internal Medicine, identified and evaluated all studies that assessed the association between food industry sponsorship and published outcomes of nutrition studies.
We were surprised to find few studies examining the effects of industry sponsorship on the actual, numerical findings of the studies. Only two of 12 studies assessed the association between food-industry sponsorship and the statistical significance of research results, and neither found a link.
Only one paper found studies sponsored by the food industry reported significantly smaller harmful effects of consuming soft drinks than those without industry sponsorship. Overall, our review showed we know very little about the association between industry sponsorship or authors’ conflicts of interest and the actual results of nutrition research.
More studies assessed the association of industry sponsorship with authors’ conclusions or interpretations of their findings (not the results). Eight reports, when taken together, found industry sponsored studies had a 31% increase in risk, compared to non-industry sponsored studies, of having a conclusion favouring the sponsor’s product.
So what we know is that food industry sponsorship is associated with researchers interpreting their findings to favour the sponsor’s products. Conclusions don’t always agree with results but can be spun to make readers’ interpretations more favourable.
For example, a study might find that a particular diet leads to weight loss and an increase in heart disease but the harmful effects of heart disease are omitted from the conclusion. Only the weight loss is mentioned. This spin on conclusions is a tactic in other industries and can influence how research is interpreted.
But it is the results (the research data) that really matters. From the standpoint of developing systematic reviews and evidence-based recommendations, the results are more important than conclusions because only the data, and not a researchers interpretation of them, are included in the reviews.
We need more rigorous investigation of the effects of industry sponsorship on the results of both primary nutrition studies and reviews. For example, our recent study examined 31 reviews of the effects of artificial sweeteners on weight loss. We found reviews funded by artificial sweetener companies were about 17 times as likely to have statistically significant results showing artificial sweeteners use is associated with weight loss, compared to reviews with other sponsors.
Nutrition research agenda
Our studies mentioned above didn’t identify any differences in the quality of industry-sponsored and non-industry sponsored nutrition research. But, similar to research sponsored by the pharmaceutical or tobacco industries, sponsors could affect outcomes by setting the research agenda, framing the questions or influencing publication.
A research agenda focused on single ingredients (such as sugar) or foods (such as nuts) rather than their interactions or dietary patterns may favour food-industry interests. This is because it may provide a platform to market a certain type of food or processed foods containing or lacking specific ingredients, such as sugar-free drinks.
Most data sources used to study publication bias in other research areas are not available for nutrition research, which make it more difficult to detect.
Researchers have identified publication bias in pharmaceutical and tobacco research by comparing the full reports of drug studies submitted to regulatory agencies with publications in the scientific literature. Researchers have also compared data released in legal settlements with published research articles. There are no similar regulatory databases for foods or dietary products.
It is possible to use statistical methods to estimate publication bias in large samples of nutrition research, as in other research areas. Interviewing industry-funded researchers could be another way to identify publication bias.
Another obstacle to rigorously assessing bias in nutrition research is the lack of transparency about funding sources and conflicts of interest. Our review of artificial-sweetener studies found authors of 42% of them had conflicts of interest not disclosed in the published article.
Also, about one third of the reviews didn’t disclose their funding sources. Although disclosure in journals is improving over time, not all journals enforce disclosure guidelines for author conflicts of interest and research funding sources.
Reducing bias in nutrition research
Studies on research bias related to pharmaceutical and tobacco industry sponsorship and conflicts of interest has led to international reforms. These have been in the area of government requirements for research transparency and data accessibility, stricter journal and university standards for managing conflicts of interest, and methodological standards for critiquing and reporting evidence (and conducting systematic reviews). Similar reforms are needed in nutrition research.
Further studies will determine which mechanisms to reduce bias should be urgently implemented for nutrition research. Options include:
refined methods for evaluating studies used in systematic reviews
enforced policies for disclosing, managing or eliminating financial conflicts of interest across all nutrition-related journals and professional associations
mechanisms to reduce publication bias, such as study registries that describe the methods of ongoing studies, or providing open access data
revised research agendas to address neglected topics and to produce studies relevant to population health, without corporate sponsors driving the agenda
independent sources of funding for nutrition research, or, at a minimum, industry sources pooling their funding with research funds administered by an independent party.
In the current economic climate, in which industry funding is encouraged by universities, studying bias is important and contentious research.
Research institutions should implement strategies that reduce the risk of bias when industry sponsors research. They could do this by a risk-benefit assessment for accepting industry sponsorship of research. This would evaluate the sponsor’s control of the design, conduct and publication of the research, as well as any risk to the institution’s reputation.
The full effects of industry sponsorship and financial conflicts of interest on nutrition research remain hidden. An evidence base as rigorous and extensive as the the one on bias in pharmaceutical and tobacco research is needed to illuminate how nutrition research is at risk of bias.