Influence of corporate money on study of nutrition questioned

When Forbes.com wrote last winter about the proper diet for preventing colds and the flu, the article included an age-old bit of advice from nutritionist, author and former TV host Lisa Hark:

Drink orange juice.

While vitamin C's value as a cold-fighter is unclear, Hark, who works at the University of Pennsylvania, said a regular glass of 100 percent OJ helps her immune system.

One thing Hark failed to mention: She was being paid by the Florida orange industry to promote the health benefits of its product - in a six-month contract for $24,800.

The seductive influence of corporate money on academia has attracted lots of attention when it comes to drug companies. Less well known are the close ties that often exist between nutritionists and the food industry. While the dietitian may have the best of intentions, some leading members of the field say industry funds can skew the credibility of science - and in the worst cases, result in little more than paid product endorsements.

In a telephone interview, Hark said it was "ridiculous" to suggest that the money would color what she said. Hark defended her work for industry clients, which have included dairy producers and Tyson Foods, saying it was common practice.

She may be right about that. Consider:

The incoming president of the Obesity Society, a prominent academic research group, was a paid consultant for the New York state restaurant industry as it fought a proposal to list calories on menu boards. Amid fierce criticism, David B. Allison stepped aside in February before taking the job.

Last month, the federal government announced a new 13-member panel to review dietary guidelines for all Americans. Six of the 13 have received funding from the food or pharmaceutical industries, according to the nonprofit Center for Science in the Public Interest.

The American Dietetic Association, the largest organization of nutrition professionals, has accepted millions of dollars from the food industry to support research and outreach.

Hark, who helped create the nutrition education program at Penn's medical school, courts corporate clients on her Web site, which begins with the words: "Are you looking for a media expert to help promote and market your company?"

Until recently, Hark's site also featured Penn's logo - unbeknownst to medical school officials.

When The Inquirer asked about the site earlier this year, Penn Medicine's chief of staff Susan Phillips labeled it "unbelievably shocking" because the logo was alongside Hark's sales pitch.

At Penn's request, Hark removed all references and links to the school. "You can't have anything on the Web that can be construed as an endorsement or any commercial use of the university's name," Phillips said.

The Penn executive also took issue with how Hark was identifying herself. On her Web site, in numerous media appearances and in a 2007 Penn news release, Hark is described as director of the school's Nutrition Education and Prevention Program.

Phillips said Hark should no longer use that title because the nutrition program ceased being a separate entity several years ago. Hark works part-time in an administrative capacity, developing teaching materials on nutrition in minority populations, Phillips said, adding that the title in the news release was a mistake.

Hark is moving to a job at Wills Eye Institute in January to develop educational materials for doctors. The switch is not related to the Web site or corporate funds, Phillips said.

After the initial phone interview, Hark did not respond to subsequent requests for comment about her title and changes to her Web site.

The former host of Honey, We're Killing the Kids, a weight-loss reality TV show, Hark helped create Penn's nutrition education program in the early 1990s - a topic that had long received short shrift in the nation's medical schools - and she has received national recognition for it. She edited a widely used nutrition textbook and she won a 2005 award for excellence in nutrition education from the American Society for Nutrition.

Thanks to Hark's work, Penn "is right up there with a small number of other schools that are really active," said University of North Carolina professor Martin Kohlmeier, who studies nutrition programs.

She has been widely quoted in magazines and newspapers, including The Inquirer, giving sensible advice on weight loss and nutrition.

But in several instances where Hark was paid, some experts quibbled with her statements.

Orange juice, for example, does contain important nutrients, but so do other fruits and vegetables. It also has lots of sugars, and there is scant evidence to support its reputation as a cold-fighter.

"There's nothing special about orange juice, other than the fact that it has a huge industry behind it," said Marion Nestle, professor of nutrition and food studies and public health at New York University.

"The fact that she's paid for it changes the equation," added Nestle, who said she does not accept any funds directly from food companies.

Hark's $24,800 fee was for work she did from September of last year through February, said Karen Mathis, a spokeswoman for the Florida Department of Citrus, a state agency funded by the industry. Hark did media relations on the benefits of OJ, Mathis said.

"It was a great campaign for us," Mathis said. "She was able to generate more than 132 million media impressions," meaning the number of times consumers were reached by various media.

In the one brief interview she gave in July, Hark said she was not then working for any company, and that she had nothing to hide about such efforts. Asked to identify various companies she had worked for, she declined.

"I do not feel comfortable getting into this whole negative thing that you're trying to do," Hark said.

Her Web site now bills her as a "Best-Selling Author," replacing the words "Medical Nutrition Educator."

The site still contains the following words:

"Do you want to add credibility to your brand, consult with a nutrition expert, hire a spokesperson, or develop an Advisory Board? Dr. Lisa Hark has the academic background and media experience to help your company successfully reach both consumers and health professionals."

She holds a masters from the Institute of Human Nutrition at Columbia College of Physicians and Surgeons and a Ph.D. in education from Penn. Hark also worked for one year as host of the reality weight-loss show on TLC, in which parents were shown projections of how their overweight children might look as grown-ups unless they changed their eating habits.

On one occasion, a company that hired Hark became ensnared in controversy.

When Tyson Foods began selling chicken last year that was touted as being "raised without antibiotics," it enlisted Hark to comment in a news release.

"This is great news for American consumers who have made it clear they pay attention to the use and presence of all sorts of antibiotics in the environment," the company quoted her as saying.

The U.S. Department of Agriculture later ordered the company to stop using the "raised without" label after the company admitted it injects eggs with antibiotics.

There is no indication that Hark knew anything about the use of the antibiotics. She referred a question on the subject to a Tyson spokesman, who confirmed that she had been hired by the company but declined to comment further, citing litigation on the antibiotics.

Hark also was hired twice to speak about bone health: by the National Dairy Council from September to December in 2006 and by McNeil Nutritionals of Fort Washington, marketer of a calcium supplement called Viactiv, in 2004.

A dairy council spokeswoman declined to say how much Hark was paid for her work, in which she urged people to consume three servings of low-fat dairy a day.

A McNeil spokeswoman said Hark was engaged for one event, but that she didn't know the details because the organizers had left the company.

Like orange juice, NYU's Nestle said, dairy "can be part of a healthy diet" but is not essential. There's no evidence that vegetarians have poorer bone quality, she said.

As with funding from drug companies, financial support from the food industry can have a corrosive effect, said Kelly D. Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University.

"For professionals to take money and believe they remain unbiased is contrary to both scientific evidence and common sense," Brownell said. "Otherwise, why would industry pay all that money?"

In a 2007 study in the online journal PLoS Medicine, researchers reported that nutrition studies funded entirely by the beverage industry were four to eight times more likely to reach a conclusion favorable to the sponsor than those with no industry-related funding.

The efficacy of marketing also is acknowledged by the American Dietetic Association. On its Web site, the group advises potential corporate sponsors of the ability to "leverage benefits to achieve marketing objectives."

One option is to sponsor a "nutrition fact sheet" for $20,000. These sheets are inserted in the Journal of the American Dietetic Association - "perforated for easy removal" - so they can be used for patient education.

One sheet touts the purported benefits of chewing gum, such as the relief of "life's everyday stresses." Its sponsor: the Wrigley Science Institute.

An association spokeswoman directed a reporter to the group's guidelines, which call for scientific accuracy and "clear separation of ADA messages and content from brand information or promotion."

"All of our positions are based on science," said the spokeswoman, Doris Acosta.

Yet elsewhere on its Web site, the group acknowledges that corporate support can affect the opinions of those who attend its annual conference.

Of those corporations who buy "event sponsorships" - $21,500 a pop for this year's function in Chicago - 62 percent of conference attendees "said they would be more willing to purchase and/or recommend the company's products or services."