How the Sugar Association’s genius PR campaign in 1976 changed the course of nutrition science

The 1970s did not start well for the Sugar Industry.

In December 1971, the Federal Trade Commission (FTC) accused the Sugar Association (SA) of falsely advertising that eating sweets before meals helps people to reduce weight. SA was forced to run corrective advertisements because the ads’ weight reduction claims were false and misleading.
Three years later, a spike in the price of sucrose caused the FTC to investigate the sugar industry for collusion

In 1972 Dr. Atkins’s hugely successful Diet Revolution book caused a major shift in the Nutrition Universe, by departing from traditional nutritional advice to reduce fat. The diet was endorsed by celebrities and promised people they could lose weight while eating their favorite foods. Plenty of meat, cheese, cream, eggs, and other low-carb foods was back in fashion for dieters who wanted to lose weight

The same year another book got published which blamed sugar not just for our growing waistlines but the growing number of heart failures. It was generally accepted that the alarming recent increase in the incidence of coronary heart disease (CHD) was due to the excessive consumption of animal fat.

Dr. John Yudkin’s a British nutritionist and former Chair of Nutrition at Queen Elizabeth College in his latest book the Pure, White and Deadly suggested that this view was wrong. He blamed the excessive consumption of sugar for the nations growing numbers of CHD.
For his views, he suffered a tsunami of criticism from the processed-food manufacturers and Ancel Keys, and who sought to ridicule Yudkin’s work

But the already negative public mood got even worse three years later.
In 1975, William Dufty published his newest menace book, Sugar Blues, which became a dietary classic with over 1.6 million copies printed. Dufty delves into the history of sugar and the history of medicine with a conclusion that sugar is as addictive as nicotine and as harmful as heroin. He also provided details on how the sugar lobby has kept the lid on reports about sugar’s harmful effects from authorities.

“We’re in a period of the rediscovery of the obvious.
We have to recover our memory. Our level of sugar addiction is so high.
We have to reach the point again where we can appreciate the natural taste of natural, unsweetened food”
William Dufty, Sugar Blues 1975

What raised the book’s profile though is that the author’s partner was legendary Hollywood actress Gloria Swanson. She used her A-list status to share her philosophies and the negative effects of sugar while giving nationwide publicity for Dufty’s book. The couple set out on a promotional tour of the US. and appeared in packed lecture halls discussing the detrimental effects of sugar on the body.

Hollywood icon, Gloria Swanson was a frequent guest in TV Shows talking against sugar

The couple was outspoken. They went head-to-head in various television talk shows with MDs, Nutritionists, and representatives of the agricultural industry, and using sound logic they made the audience question the scientific narrative about sugar. Public opinion swayed against the white enemy.

The sugar industry was rightfully concerned that the media criticism about sugar’s addictive nature was causing concerns in health opinion leaders, including physicians and dentists, nutritionists, and government health officials. As a response and hired a prestigious PR Agency to execute a crisis communication campaign to influence to sway public opinion about sugar.

The campaign was run by Carl Byoir and Associates landmark Public Relations firm. A genius spin doctor who was known to use any means for ‘devious opinion manipulations, his firm applied a sophisticated strategy to defend the sugar industry’s interest in 3 main areas:

The medical community and nutrition professionals:

One of the main allies in the scientific domain was Dr. Fredrick J. Stare, the chairman of Harvard’s nutrition department. He and another two Harvard scientists were paid by SA to publish a 1967 review of research on sugar, fat, and heart disease. The studies used in the review were handpicked by the sugar group, and the article was published in the prestigious New England Journal of Medicine, minimized the link between sugar and heart health, and cast aspersions on the role of saturated fat.

This time, the largest sugar manufacturer Amstar, took the lead in recruiting Food and Nutrition Advisory Council (FNAC) to help with a scientific backup to tackle the increasing attacks on sugar.

One of the Sugar Industry’s favorite scientists, Fredrick John Stare. In 1942, he founded the Department of Nutrition at Harvard School of Public Health, which he led as a professor of nutrition until his retirement

Not surprisingly, a key member of FNAC was Dr. Stare who as a first step, compiled an 88-page book series titled “Sugar in the Diet of Man” (SITDOM) . The sugar defending document was published in the World Review of Nutrition and Dietetics where Dr. Stare was the editor. SA also ordered 25,000 reprints of SITDOM commissioned a digest of its key points, and packaged it together with a press release which is disseminated to the media and to government health officials.

The document exemplifies an opinion/knowledge dissociation, in which a corporation denies guilt by arguing that critics’ claims are opinions. The purpose of the document was to balance hypotheses against known facts and to put them into perspective which will provide a useful evaluation of the value of sugar in nutrition :

“Currently there are many voices reaching the public ear who make accusations against sugar as a food. These accusations vary from ascribing overweight and obesity to sugar, rather than to overeating, to much more serious charges, such as that sugar is an important cause of coronary heart disease. In fact, there are some who claim that sugar is not a food and not even a nutrient”

“Sugar in the Diet of Man” has become the primary sugar source document for dietitians and home economists, in that it provides the scientific facts to teach and convey the sugar story. Direct contact through the regional Information Program, mailings, convention sessions, and participation in programs has established the Council as a ready source of substantiated information.

More importantly, the campaign helped FNAC to has established credibility and respect among doctors and major shape a positive impression about sugar in the medical community

Media:

In the media, their primary strategy was counterattack, in which an organization claims that their accusers are at fault and denies guilt. According to the playbook, they described sugar’s critics as “food faddists,” pseudoscientists, promoters,” or “opportunists” who were motivated by selling books and magazines (e.g. Adele Davis, Rodal Press, John Yudkin), ratings on TV or radio (e.g. Merv Griffin and Carlton Fredricks), selling alternative sweeteners (e.g. the health food industry),or selling vitamins to supplement a diet of highly refined foods (Linus Pauling, Emanuel Cheraskin)

The campaign’s overarching narrative was that restricting sugar, which it claimed was a valuable food that makes healthy foods more palatable would cause harm and that claims to the contrary were made by opportunists, pseudoscientists, food-faddists, lay nutritionists, or those who had been misled by them.

To execute the plan successfully, a strategic media communication framework has been developed to handle public and medical criticism with key counterclaims with science-backed reasonings:

Anti-sugar Claim: Diets restricting sugar will lead to weight loss
SA Counterclaim: Diets restricting sugar will not lead to weight loss
Reasons:

  • Because only total calories matter, it does not help weight control to restrict only starches or sugars. Like protein, they provide some four calories to the gram. Some restrictions on fats may be useful, however, for they have nine calories to a gram.
  • For example, low-carbohydrate diets are pointless and may be hazardous. And when such diets emphasize meats they prove to be very high in fat. Although they seem to work for some people, they can cause nausea, loss of appetite, and dehydration.
  • The most successful programs of caloric restriction. Any excess of calories, be it from food, alcohol, or inactivity, is inevitably stored as body fat. It is this excess of calories, and not the type or amount of sugars, starches, protein, or fat in foods. that results in obesity.
  • Even skipping meals is self-defeating. The body tends to deposit more fat with only one or two meals a day than with several, although the caloric intake is the same.

Anti-sugar Claim: Sugar is not a nutrient or a food
SA Counterclaim: Our primary nutrition need is energy. The bulk of our energy has to come from carbohydrates. Sugar is a compact, economical carbohydrate energy source.

Reasons:

  • Such charges against sugar are disturbing, for we use sugar not as a sweet extra but as a basis of our food supply. In the United States last year, slightly over 100 lbs. of sugar disappeared from the market for each living American, about 15 to 20% of our total calories. If sugar were removed from the market, all the calories needed to feed at least 36 million Americans would be lost.”
  • About 15 to 20% of a typical American’s calories come from sugar — about 12% for adults and 20% or more for teenagers. That sugar is seen by scientists as a compact source of energy, our primary nutrition need.
  • As Dr. Stare points out, energy can come from any of three food sources — proteins, fats, or carbohydrates. Protein is expensive and scarce; it provides only about 15% of our calories.
  • Excess fats may offer health hazards. So the bulk of our energy has to come from carbohydrates.
  • Dr. Stare concludes that in the absence of a compact carbohydrate energy source, such as sugar, it could be hard to give youngsters enough calories without giving an unhealthful excess of fat.”

Anti-sugar Claim: Sugar causes obesity
SA Counterclaim: Sugar does not cause obesity
Reasons:

  • The fat cells can be filled or emptied depending on how many calories of energy we get in food
  • and how many we burn with exercise. It does not matter which food the calories come from.
  • Any excess is stored as fat. Most such excesses seem small and steady. The experts conclude that often they result from learning to deal with emotional stress by eating more.
  • Conversely, excesses may result from declines in inactivity, as with aging.
  • Three University of Pittsburgh teachers of medicine — Drs. Thaddeus Danowski, Sean Nolan, and Thorsten Stephan — review the evidence and conclude it does not.

Anti-sugar Claim: Emerging evidence links sugar to CVD
SA Counterclaim Dr. John Yudkin’s work — the primary source linking sugar to CVD — has been discredited

Reasons:

  • Dr. John Yudkin (author of nearly all the medical papers linking sugar to CVD) says that 20 of his heart patients ate more sugar than usual. But nine other studies controvert this finding. In two of them, the heart patients ate less. In one, Canadian veterans with CVD averaged 47 g of sugar a day; but a matched group of healthy veterans ate 65 g!

Anti-sugar Claim: Sugar is harmful to diabetics
SA Counterclaim: Carbohydrates are not harmful to diabetics, and may help diabetics live longer

Reasons:

  • Newer studies indicate that carbohydrates seem not only to stimulate the body to produce insulin but also to trigger enzymes that put sugars in the blood to work. Experiments using diets up to 80% sugar actually improved the glucose (blood sugar) tolerance of both normal people and diabetics.
  • Bierman and Nelson cite evidence that total calorie control is the main nutritional need of diabetics. If there is such control, diabetics can eat as much carbohydrate as the normal American — 45% or more of the calories they consume.

Anti-sugar Claim: Diabetics should restrict their carbohydrate intake
SA Counterclaim: Diabetics do not need to restrict their carbohydrate intake

Reasons:

  • In 1971 the American Diabetes Association surprised many with a statement that:
  • “There no longer appears to be any need to restrict disproportionately the intake of carbohydrates in the diet of most diabetic patients.””
  • According to Dr. Edwin Bierman and Ralph Nelson note that today patients rarely die of the direct effect of diabetes. They are lost to ills of the heart, blood vessels, and kidneys, all of which may be related to high-fat diets. And a diet low in carbohydrates, such as the traditional diabetic diet, is high in fat. As the ADA statement observes: “A liberalized carbohydrate intake will necessarily be associated with a decrease in dietary fat and cholesterol.”

Anti-sugar Claim: Sugar is addictive
SA Counterclaim: Americans would not consume a healthy balanced diet full of vitamins, minerals without sugar to make foods palatable

Reasons:

  • Though they carry with them no vitamins, minerals, or protein, Dr. Stare notes that sugar is rarely eaten alone. And often it makes more palatable many foods such as cereals and fruits that supply other valuable nutrients.

Anti-sugar Claim: Sugar is not safe
SA Counterclaim: In general they conclude that sugar, like any other widely used food, is harmless when eaten in reasonable amounts.

Reasons:

  • According to Dr. Stare, sugar, a pure carbohydrate, is an important nutrient and food in the U.S. diet when used in moderation. Studies of actual intake suggest that the percentage of calories taken as sugar are higher during the growing and adolescent years when energy demands are high, and lower during adult and later years. There is no valid evidence to the contrary, this rate of intake (between 10 and 30% of total calories, with the average at 15 to 20%) may be considered moderate. At these levels sugar contributes to good nutrition, to the enjoyment of our meals; and it is safe.

As a result, attacks on sugar in the media have diminished sharply, and those that appear tend to be far more objective. Positive commentary has helped establish reportorial balance. Some major magazines now maintain they tacitly endorse sugar. In challenging the networks, the SA has been able to gain valuable TV response time. Having gotten to know the national food editors, the SA. frequently has the opportunity to respond in print to local attacks while becoming a source of reliable information and a vehicle for introducing scientists to the media.

Government Health Officials and Politics

SA believed that the growing negative opinion on sugar had inspired California to propose “to tax sugar at the manufacturing level to fund a program of nutrition education for the state,” and to” tax soft drinks and its correlated advertising to raise $100 million to finance a socialized dental program. SA was concerned about the agenda-setting power of the media relative to two upcoming safety reviews of sugar with regulatory implications sponsored by the FDA.

As part of the long-term strategy, the goal was to establish with the broadest possible audience the safety of sugar as a food and that in moderation it plays an important role in a balanced diet.

As the Sugar Association president John Tatem explained :

“We try never to lose sight of the fact that no confirmed scientific evidence links sugar to the death-dealing diseases. This crucial point is the lifeblood of the association.”

The first review to be conducted by the Federation of American Societies for Experimental Biology was part of a re-evaluation of the FDA’s previous decisions about the safety of food substances deemed to be generally recognized as safe for consumption by the general population.

The second, to be conducted by the National Academy of Sciences had been scheduled in 1974 to discuss concerns about the safety of saccharin, then, according to sugar executives, was “expanded to include sugar and a variety of health-related issues”.

The campaign successfully influenced the FDA’s decision not to regulate sucrose as a food additive, which would have given the agency the power to limit the amount of sucrose added to processed foods. Thanks to the successful PR campaign, the two major announcements have been highly supportive of sugar, and sugar was exempt from legislative restriction in the coming decades.

Thanks to the scientific consensus that a low-fat diet is the solution for the growing obesity problems the food industry began replacing fat with sugar in processed foods,

More importantly, the campaign shifted the tone of the obesity debate among government health officials. In 1973, the US Senate Select Committee on Nutrition and Human Needs was established to focus attention on the ‘overnourished’ and what to do about the rising rates of chronic disease.

While both fat and sugar were listed as contributing to these diseases, the panel’s final set of dietary goals, issued in December 1977, ‘Dietary Goals for the United States, also referred to as the McGovern Report, manifested these findings into low-fat, high-carbohydrate recommendations.

American Society of Clinical Nutritionists, the American Heart Association, and the National Cancer Institute all fell in line and produced their own
low-fat recommendations and a scientific consensus were emerging which promoted a low-fat diet as the appropriate diet not only as a preventable measure for those at risk of heart disease and cancer but
the entire population.

British Diabetic Association (BDA), in line with the changes made following the McGovern Report, The 1980s ‘Dietary Recommendations’ the new guidelines for diabetics recommended a maximum of 35% of dietary energy from fat and 55% from carbohydrate:

“The traditional view that restriction of carbohydrate is an essential part of the dietary management of diabetics can no longer be regarded as correct. Provided that the energy content of the prescribed diet does not exceed the individual requirements, the proportion of energy consumed as carbohydrate is immaterial to diabetic control.”

The final evidence in obesity/heart disease studies came in 1983 with the publication of an article based on the Framingham studies, which cited obesity as an independent risk factor for heart disease.

This finding lent further support to the low-fat approach because scientists believed that the low-fat diet might not only prevent coronary heart disease but also could promote weight loss, thereby reducing the incidence of obesity, and by 1984, the scientific consensus was that the low-fat diet was appropriate not only for high-risk patients but also as a preventive measure for everyone except babies.

In other words: Within 8 years, thanks to the genius PR campaign by Carl Byoir and Associates, the Sugar Association was not just able to turn the sugar bashing public opinion around, but by presenting their own scientific studies, government officials made their vote for the low-fat diet.

The result has been decades of nutritionally reductive, one size fits all guidelines and food aisles in the abundance of low-fat products, which have ultimately failed to curb rates of diet-related disease. Sugar Association had managed to win a ‘Silver Anvil’ award for ‘the forging of public opinion at the 1976 conference of the Public Relations Society of America.

Sources:

https://pubmed.ncbi.nlm.nih.gov/18296750/
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7401-1
https://www.ncbi.nlm.nih.gov/books/NBK542158/
https://agris.fao.org/agris-search/search.do?recordID=US201302606314
https://apps.prsa.org/SearchResults/View/6BW-7604C/0/The_Sugar_Association_Inc#.YLMq-n0za1t
https://www.pbs.org/newshour/health/sugar-industry-artificially-sweetened-harvard-research
http://www.alicerap.eu/blog/102-sugar,-industry-documents-and-research-on-corporate-influences-on-addiction.html
https://www.dietdoctor.com/study-low-fat-products-are-just-as-full-of-calories
https://gloriousswanson.wordpress.com/2020/01/19/health-food-crusader-was-gloria-swanson-ahead-of-the-curve-pt-ii/

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