Update: The New York Times reported March 3, 2008 that David L. Allison resigned as the incoming president of the Obesity Society. He said in his email statement that "I stand behind the scientific statements I made, my right to make them, and the manner in which I made them", however he apologized for the "distress" he might have caused the Obesity Society. The economic tensions that interfere with frank science presentation and reporting remain.
Conflict of Interest?
Would you believe a nutrition researcher working for Coca-Cola who said that restricting foods might backfire in preventing obesity because 'birds put on weight when food is scarce'? Would you choose him to be president of your "Obesity Society", if your club's mission was to "be the leader in understanding, preventing and treating obesity and in improving the lives of those affected"?
A recent New York Times article, "Conflict on the Menu", threw light on the "food fight among the nation's obesity experts". The New York State Restaurant Association hired the president-elect of the Obesity Society, Dr. David Allison, to support their suit against New York City's regulation requiring chain restaurants to list the kilocalorie values on menu items.
Allison submitted an affidavit warning that listing calories on menus might encourage overeating. According to the NYT he suggested the regulation would either tempt patrons with "the forbidden-fruit allure of high-calorie foods", or leave them so hungry they'd "later gorge themselves".
Somewhat less creatively, the American Medical Association, the American Academy of Pediatrics, the American Heart Association, the American Diabetes Association, the American Public Health Association, the California Center for Public Health Advocacy, the Medical Society of the State of New York, the Trust for America's Health, and many other organizations back the city's regulation.
Obesity & Personal Freedom
While the New York Times keeps the focus of the story on the skirmish within the Obesity Society, many stakeholders have a foot in this game. Public interest groups of all stripes, including "consumer freedom and choice" advocates, fight tooth and nail over the city's plan.
The Center for Consumer Freedom (CCF) is a group that lobbies against government regulation. They wrote histrionically about New York City's labeling plan in "Menu Labeling Meltdown", warning that "the food cop campaign will plaster our nation's menus with warning labels.." Their consolation was Dr. Allison's "damning evidence" that labeling "might be harmful". CCF reveled in the idea that Allison's affidavit dealt a "major blow" to the city's plan and that Burger King might not have to label their Whopper with its energy value: 670 kilocalories.
CCF claims to fight for Americans' right to "guilt free eating". Their stated mission is "promoting personal responsibility and protecting consumer choice" and their especially belligerent towards specific targets, individuals or groups like the Center for Science in the Public Interest (CSPI) -- "the food cops". Sourcewatch offers a more blunt profile of CCF, calling them "a front group for the restaurant, alcohol and tobacco industries". Phillip Morris started the organization under the name "Guest Choice Network" years ago for the purpose of organizing restaurants against government smoking bans.
CCF wields the same arguments that tobacco lobbyists used to oppose government smoking bans by supporting the claim that the city's rules violate the First Amendment. However Sandra Wootan, director of nutrition policy at the Center for Science in the Public Interest (CSPI), says: "The restaurant industry isn't concerned about defending the First Amendment, as its lawsuit laughably claims. It just wants to keep its customers in the dark. People need nutrition information to exercise personal responsibility and to feed their children healthy diets."
It seems like "personal freedom" stands for "corporate freedom" in this context. While personal freedom is important, governments are obliged to work on behalf of the community, for instance by mandating vaccinations, sanitary conditions in restaurants, anti-smoking laws, etc. The city regulation basically requires chain restaurants that have caloric information elsewhere, like on a website, to post in on the customer menus. This is not the cumbersome requirement that CCF makes it out to be.
Science & Policy
Despite the Center for Consumer Freedom's approval of Allison's recent position they haven't always been so friendly. In 2001 the group contested Dr. Allison's 1999 finding that obesity caused 300,000 deaths a year, calling the research "bogus". The organization accused him of "voicing support for an onerous and unnecessary 'Twinkie Tax'", and having "ties to the weight-loss industry". In 2004 and 2005 the group opposed Dr. Allison in articles like "Hypocritical Food Cops Preach 'Integrity'", accusing him of conflict of interest and citing Allison's many industry affiliations to discredit his research.
In 2005 Allison was one of ten authors on a New England Journal of Medicine paper showing that the average lifespan in the US would decrease because of the obesity epidemic. (Olshansky et al, "A Potential Decline in Life Expectancy in the United States in the 21st Century", March 17, 2005 Vol. 352:1138-1145.) The accompanying editorial said the group's assumptions were "excessively gloomy", but scientists generally thought the findings important despite the data estimates.
Although this was a science research paper, the authors pointed out policy implications, as they often do. There were possible up-sides to the research, for instance: "the U.S. population may be inadvertently saving Social Security by becoming more obese". The findings were grim, but policy interventions might reverse the death trends, they said: "Unless effective population-level interventions to reduce obesity are developed, the steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly even shorter lives than their parents."
An accompanying editorial gave more detail. "Deadweight? --The Influence of Obesity on Longevity", by Samuel Preston, Ph.D., mentioned other research showing that only "30 excess calories a day during an eight-year period for Americans 20 to 40 years of age" produced the obesity epidemic. (NEJM Volume 352:1135-1137). Given the morbid implications of small increases in daily calories, Dr. Preston said: "reversing the increase in body mass might be accomplished through small behavioral changes...the food and restaurant industries would be valuable allies in this effort..."
So the authors recommended that government interventions were critical to maintaining current longevity, and that nominal calorie reduction might help reduce obesity if restaurants cooperated. Which makes it particularly ironic that Allison, the co-author, chooses the role of a hired gun fighting calorie labeling on behalf of restaurants.
In contrast to their opinion of Allison since 2001 CCF's coverage of the current NYC regulation does an about face. Now, abruptly, his "facts showed" and "the evidence was damning". They decided not to fill their story about his affidavit for the Restaurant Association with long lists of "conflicts of interest", which served as the meat and potatoes of their previous irate stories about his research.
News of Allison's affidavit supposedly caused a fracas among members of the Obesity Society, who got ''completely mad that a president-elect of [an] organization that cares about obesity and cares about healthy eating, wants to hold back information from people that helps them make healthy choices'', according to the NYT. This forced the current president of the Obesity Society to put out a separate statement opposing Dr. Allison's that supported the city's labeling rules.
Which made me wonder -- if Allison's position is so disagreeable, why did the nominating committee and 2,000 members in the society select him to be their future president? His consulting positions were a significant piece of his resume. He has been a paid industry consultant for at least 15 years. There must be more to this story.
When Truth Pays
A professor at the University of Alabama, Dr. Allison is an obesity statistician with a background in psychology. He's more than just a statistician with an affidavit that appears to be a conflict of interest. He's has published over 300 papers and 5 books. His home page shows him clad in a sporty warm-up jacket as if back from a jog, rather than posing with the more traditional professor air, before a pile of books or a math covered blackboard . He regards the camera a little too ravenously, as if he had picked the Veggie Delite Salad (51 kcal) at Subway, instead of the Footlong Meatball Marinara (1160 kcal), and was photographed hungry, about to grab the Ben & Jerry's New York Super Fudge Chunk from the freezer. [Although, if he wasn't getting paid to introduce doubt, we wouldn't be wasting our time here because he would have sensibly chosen the 6 inch Turkey Sandwich (280 kcal) instead of the Delite.(Subway lists their calories on menus)]
For his efforts and accomplishments Dr. Allison was honored by George Bush last year in a White House ceremony for recipients of the Presidential Award for Excellence in Science, Mathematics and Engineering". The award recognizes mentoring of women, minorities, and persons with disabilities.
Dr. Allison noted that the award was not just about mentoring but also about making sure the students "understand the ethical foundation on which science is based." It's a mission he apparently takes seriously, as The Birmingham News reported: ''In science, we are not just doing a job,'' he said. ''I was chosen. I think of it like a calling. It is a special and sacred profession. Our sacred duty is truth.''
When he was questioned by the New York Times about his support of the restaurant industry he said, "I'm happy to be involved in the pursuit for truth....Sometimes, when I'm involved in the pursuit for truth, I'm hired by the Federal Trade Commission. Sometimes I help them. Sometimes I help a group like the restaurant industry."
Speaking his truth though he may, Allison remains agnostic in his choice of client. He's widely consulted by government, industry and the media for his expertise in obesity, science, and integrity. When Eric Poehlman, the University of Vermont obesity professor was accused of falsifying data on metabolism and aging in research papers and federal grant applications, Dr. Allison interviewed the media in his defense: "I believe he's innocent, and I believe that he is being broken financially to the point where he's ready to give up the fight because he has no more money to fight with, and that's the way the game works", (Boston Globe, March, 2005). Poehlman served a year in jail, paid fines and recieved penalties.
Dough Boy
The Center for Consumer Freedom discredited any research Allison was involved in except when it ran in their favor. They accused Allison repeatedly of conflict of interest especially with companies selling "weight control product and services". CCF may be a bottom feeder, but it doesn't exaggerate Allison's impressive industry ties. In the 2005 NEJM paper about obesity longevity, nine authors disclosed zero financial interests or affiliations. Dr. Allison however, gave new respect to warm-up jackets and statistics by listing about 150 organizational affiliations in a three page single spaced PDF, attached to the paper.
Dr. Allison's list of grants, monetary donations, donations of product, payments for consultation, contracts, honoria and commitments include consulting assignments for numerous parties, like lawyers engaged in litigation, pharmaceutical companies including Pfizer, Eli Lily, Wyeth Ayerst, Glaxo, as well as Corning, Frito-Lay, Coca-Cola, the Wheat Council, Kraft Foods, Nabisco, the FDA and ILSI. He has impressive experience doing everything from serving on the United Soybean Panel's Nutrition Advisory Board, to being an expert witness for defendant Lockheed Martin at $350 an hour in a groundwater contamination lawsuit.
Much of this was listed in Allison's resume, which I assume the Obesity Society recieved prior to selecting him to their leadership council. If not it was summarized at the Integrity in Science project at CSPI, or in disclosure documents in his publications. His insouciant transparency, extensive network (I assume), precocious achievement. and ethically unencumbered attitudes to choosing clients no doubt secured him a Obesity Society leadership position.
Hungry Scientists, Money
Sometimes when you travel or walk down the sidewalk you encounter kids so poor they come running up, dozens of them -- "pen"? "dollar"? "cigarette"? Science seems like this sometimes these days. It seems there's no party that doesn't have an interest in this obesity science/business -- pharmaceutical companies, lawyers, labs, product companies, insurance companies, NGO's, government. Science results create more work and profits for some, and/or less work and profits for others. You can imagine the repercussions of some of the science results we mention above.
Allison co-authored a study published in NEJM, where the policy implications proposed are the opposite of the "expertise" Allison now sells.
This costs the state in legal fees and customer choice, not to mention making a mockery of science. Poehlman's false data of age related metabolic depreciation affected policy. Doctors and researchers based study and clinical practice on his results, and granting Poehlman funding, other scientists were denied money for their research. Then there was the CDC study in 2004 which incorrectly calculated the statistics and overestimated the annual deaths from obesity. This created false public perceptions and policy implications, and raised the ire of public health advocates in other areas who eying the competitive pie of public health money (especially anti-smoking advocates who were nervous that the results would make obesity public health priority number one).
Some people think that science should remain separate from policy -- like an old TV dinner, the cut vegetables separate from meat product and the syrupy peaches, each one in its own plastic mold -- compartmentalized, never mixed. Combining "science and policy" confuses the public they say. Others, claiming pragmatism, suggest everything is already mixed up, a big stew. Indeed, this seems true when scientists recommend policy, or when results are seized upon by lobbies. In many fields results have direct policy and/or business implications.
The media impedes the first approach, separating science from politics, by blending everything together in their stories, the science, the policy, the personalities, the business, the lobbyists. This mush is extracted by the press, drained of color and interesting nutrients and doled out as an equally portioned product of pro and con, like symmetrical freeze-dried blocks. We're fed an easily digested story with the predictable arch of a food fight and a neat two part conflict: "Scientists found this...but others found that".
Unfortunately, one of the largest problems resulting from this information processing by media and various lobbies, politicians, and interest groups, is that many of us -- citizens, reporters, politicians, scientists out of their field... have not clue as to who's the lobbyist, who's the "unbiased researcher", who's the expert, and who is an apostate. If headline news runs a "science piece", separating the chaff doesn't always matter because it might ruin the storyline, and anyway, who could be bothered? But this is not and never has been an isolated conflict of interest problem, a media problem, the scientists' problem, or a government agency problem. It's a larger more thorny economic conundrum that affects us all.
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Acronym Required has previously written about obesity in public health.
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