ACSH: Off the Coke Teat, Still Trying to Suck

Last week CrossFit CEO Greg Glassman sent a letter to American Council on Health and Science President Hank Campbell. Glassman asked Campbell to lead the ACHS in an effort to “publicly commit itself to not taking any additional funds from Coca-Cola or the soda industry.”

Campbell responded to Glassman’s letter with “Fitness Fallacy: An Open Letter to CrossFit CEO Greg Glassman.” Reading Campbell’s lengthy letter yields one sole benefit: it demonstrates that Coca-Cola’s influence may not stop when the funding ends.

Off the Coke Teat …

First, the good news: ACSH is off the Coke teat. Campbell dismissed the Coke payments as something that happened “years ago.” And he may even be telling the truth; we can’t find any sign of Coca-Cola payments to ACSH since 2013.

Campbell tries to spin this fact into an argument against Glassman’s request. The ACSH President objects that “it is rather hard to stop doing something you are already not doing.” But Campbell’s spin doesn’t work. Glassman didn’t ask ACSH to stop taking money that it is in the act of taking right now. Instead, his letter asked ACSH to reject additional funds from Coca-Cola going forward.

Campbell understood what Glassman asked him, but he restated the request in his own way and turned it into something irrational in order to reject it out of hand. Maybe Campbell is afraid that if he denounces one source of industry funding, he will dissuade other corporations from funding him. Or perhaps he doesn’t want to concede that ACSH made a mistake by tolerating Coca-Cola’s influence in the past.

The anti-soda coalition is on a roll. In the past year the American College of Cardiology, Academy of Nutrition and Dietetics, American Academy of Pediatrics, the University of Colorado, the American Academy of Family Physicians, ACSM’s Exercise is Medicine, and now ACSH have all publicly announced that they’re no longer taking money from Coca-Cola.

Still Trying to Suck

Now the bad news: Campbell’s letter demonstrates that Coca-Cola’s influence is even more powerful than I thought. By now, no one can reasonably doubt that industry funding influences research. Coca-Cola-funded researchers have doubted whether there’s a relationship between food and obesity, and Gatorade-funded researchers have promoted fatal hydration guidelines. And the research on beverage industry-funded studies is clear:

The odds that a paper would report a favorable outcome were four to eight times higher when the study was funded by the manufacturer of the beverages in question than when the study was not funded by industry.

But ACSH is still spreading misinformation despite the fact that it no longer takes money from Coca-Cola. Glassman’s letter cited the Centers for Disease Control’s finding that 86 million Americans have prediabetes. Campbell denies that prediabetes exists:

that condition does not exist and we have debunked such scaremongering, which, if accepted, will lead to more people demanding prescription medication they don’t need …

You can’t be pre-diabetic any more than you can be pre-pregnant.

Denying Prediabetes: “A Major Untruth”

I shared this article with Dr. Axel Pflueger, the Director of the Mayo Clinic’s Diabetes and Chronic Kidney Disease Clinic for 15 years. Dr. Pflueger now works as a nephrologist in private practice, and as an employee for CrossFit Inc. Dr. Pflueger responded to Campbell’s prediabetes claims:

This is a major untruth. Strongly recommend that Hank reads up on the Diabetes Atlas 2015 about pre-diabetes/glucose intolerance … suggested reading can be found in the Textbook of Diabetes, various textbooks of Endocrinology, the American Diabetes Association, the Centers for Disease Control, the International Diabetes Federation, just to name a few …

He is comparing pregnancy with a chronic disease condition … Pregnancy is a physiological status of health whereas pre-diabetes is glucose intolerance coupled with insulin resistance which has not met the randomly chosen criteria for diabetes in general a fasting glucose of 126 mg/dL.

What Dr. Pflueger is suggesting is that health, prediabetes, and diabetes exist on a continuum, much like sickness, wellness and fitness. Take glycated hemoglobin, i.e., A1c, which indicates the average level of plasma glucose concentration over the past few months. According to the National Institutes of Health, “A normal A1c level is below 5.7 percent. An A1c of 5.7 to 6.4 percent indicates prediabetes … A level of 6.5 percent or above means a person has diabetes.” You can read Dr. Pflueger’s longer statement on Campbell’s claims here.

Fasting blood glucose follows a similar continuum (like blood pressure, body fat percentage, muscle-mass, and many other biomarkers). Healthy fasting blood glucose levels are below 100 mg/dL. Levels between 100-125 mg/dL indicates prediabetes, and 126 or above indicates full on type-2 diabetes. Unlike pregnancy, a binary condition, diabetes is a chronic disease, which develops gradually. To deny the existence of prediabetes as Campbell did is to deny that type-2 diabetes is a chronic disease.

While Dr. Pflueger detected in Campbell a “lack of basic scientific insight,” my investigation suggests that the true reason for Campbell’s denial of prediabetes might be even worse.

ACSH Acknowledged Prediabetes Before it Denied It

I searched the ACSH’s website for mention of prediabetes and found that the ACSH first admitted the existence of prediabetes, and then turned to denial:

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What changed?

Why would ACSH declare that prediabetes is “bogus” two years after warning that patients should take it “seriously?” Reading ACSH’s original recommendations for prediabetes gives a clue:

This is a situation that can only be improved by motivating individuals to improve their lifestyles … However, ‘treatment’ in this case is not as simple as taking a pill daily — serious changes in exercise and eating habits may be required.

What corporations would lose money if 86 million Americans made “serious changes” to “their lifestyles”? One easy way to answer that question is to peruse the list of companies that have funded ACSH:

Coca-Cola; Pepsico; McDonald’s; The Sugar Association; the National Soft Drink Association; Nestle; Burger King; the Dr. Pepper Snapple Group; Kellogg; General Mills; Kraft General Foods; the Pillsbury Company; the world’s largest tobacco company, Altria Group (formerly Phillip Morris); Pfizer; and the aptly-named Big Pharma lobbying organization, PhRMA.

Unfortunately, ACSH has not disclosed its funding sources during the 2014-2016 period, so we cannot identify a particular source that may have been responsible for Campbell’s shifting position on prediabetes. The NY Post reports that ACSH “stopped revealing its donors in the 1990s after it was denounced as a manufacturers’ front group.”

Eliminating transparency might not be an effective way to convince the public you’re not an industry front group.

If a conflict of interest affected Campbell’s prediabetes position, would he disclose that fact? It seems unlikely. ACSH has publicly advocated for pro-industry positions without disclosing industry funding. For example, it advocated for unregulated tobacco product sales, without disclosing its tobacco industry funding. Similarly, it supported fracking in the Daily Caller, without disclosing its energy industry funding. 

If Campbell would like to assist CrossFit’s evaluation of ACSH as a potential donation recipient, he should provide a complete list of the ACSH’s funding sources. We would be grateful to receive and analyze it.

Campbell’s False Claims

Does Campbell lack respect for the truth, or did he simply fail to review his article before publishing? It’s not clear, however we will quickly review Campbell’s misstatements.

Campbell claimed that Glassman’s letter “included no contact information.” This is false, the letterhead included an address in Washington, DC. 

Glassman introduced himself as the Founder and CEO of CrossFit, Inc. Campbell portrayed this introduction as a “logical fallacy.” This is false. Glassman’s title would have been a logical fallacy if and only if he had used his position as a premise to support an unrelated conclusion. He did not.

Campbell asserted that CrossFit “has never shown any interest in promoting science and health that he is not profiting from.” Perhaps Campbell can explain how CrossFit made money by warning the public about the dangers of soda and hyponatremia. Surely it would have been more profitable for CrossFit to accept PepsiCo and Coca-Cola funding and promote the consumption of sugar water, rather than spending millions to advocate for soda warning labels and to hold a scientific conference dedicated to preventing hyponatremia.

Glassman’s letter described the ACSH-Coca-Cola relationship as a “health and wellbeing partnership.” Campbell objected, claiming that “we were never part of any Health and Well-Being Partnership, nor did they ask us to ‘form’ one.” In that case, Campbell should direct his complaint to his former sponsor Coca-Cola, which used precisely that language to describe its relationship with ACSH and other such organizations on its funding list.

Campbell also proclaimed that ACSH’s efforts have made them “trusted guides for the public on complex science and health issues, and explained, “We’ve done that for 38 years and never killed anyone. Mr. Glassman’s CrossFit program cannot say that.” Perhaps Campbell did not read his source, however, since it does not actually provide any evidence of CrossFit killing anyone. Instead, it describes the potential consequences of rhabdomyolysis, a condition which can result from spinningdistance runningswimmingtriathlon training, “low intensity bodybuilding and many other training methods. CrossFit is unique among training methods for raising awareness about rhabdomyolysis, not for causing it. In contrast, ACSH is famous as “a front group for the tobacco, agrichemical, fossil fuel, pharmaceutical and other industries.”

Campbell took to social media to defend the ACSH. The confusion has continued. He tweeted that he’s “not paid by a corporation,” then one tweet later admitted that ACSH takes “unrestricted grants” from corporations:

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A Partial History of an Industry Front Group

Not only has Coca-Cola stopped funding ACSH, but it seems other corporations may have begun to doubt ACSH’s utility. In 2014 ACSH was in the hole for over $200,000.

Campbell asked CrossFit Inc. to help keep ACSH afloat by paying it $85,000. Would that be a wise investment? Let’s look at some key events in ACSH’s history.

ACSH was co-founded by one of the most prominent shills for sugar in the history of nutrition, Frederick Stare. Stare’s department took millions from Big Food and Big Sugar without disclosing his conflicts of interest, helping Big Sugar to bias the whole of US federal food policy in the process. Stare was an essential element of the Sugar Association’s PR strategy, as revealed by internal documents in the UC San Francisco sugar archives. His report on sugar, “Sugar in the Diet of Man,” influenced the FDA’s decision not to regulate sugar in the seventees. Of course, his report didn’t disclose the fact that it was funded by Big Sugar. Stare also procured funding from Big Tobacco to exonerate its products.

ACSH’s longtime medical director and Executive Director, Dr. Gilbert Ross, was fined over $600,000 and served 23 months in prison for an $8 million Medicaid fraud scheme. New York State revoked his medical license. Dr. Ross claimed, on behalf of ACSH, that arsenic in pressure-treated wood poses “no risk to human health.”

ACSH listed multiple dead scientists as scientific advisers on its website. In 2012 the NY Post discovered that, “The still-listed Dr. Charles Gallina, a nuclear physicist, died seven years ago.” Furthermore, ACSH included scientists on its advisory list against their wishes. One struggles to imagine how a scientist can advise ACSH against his will.

Like Dr. Richard Kahn, ACSH advocated for the food industry’s “Smart Choices” program. “Smart Choices” suggested that Froot Loops and Lucky Charms are healthy, but the program was shut down after the FDA warned that it was misleading consumers. In 2009, ACSH defended Froot Loops and Lucky Charms, alleging,

They have sugar in them, but they also contain half of a person’s daily requirement of some vitamins. If we’re able to give kids those nutrients, it should be okay to give them some sugar.

After reviewing this evidence, should CrossFit Inc. keep ACSH afloat by paying it $85,000? While ACSH may have come off the Coke teat, ACSH’s denial of prediabetes suggests that it is still spreading messages favorable to Big Soda’s interests. A former ACSH board member said it best,

” … you’d be foolish to give them money.”

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