The Secret Story of the Government and the Sugar Companies

Find out how the biggest sugar companies in America influenced its dental policies. The true story of how ‘big sugar’ fought attempts to prevent tooth decay.

the secret story of the government and sugar companies

Image from Stefan on Flickr


In March 2015, the dental industry once again made headline news, after a cache of historical documents shed new light on its development, particularly within the sixties and seventies. According to an archive of industry letters dating back to the 1950s, and now preserved as valuable artefacts, key figures within the sugar industry successfully influenced government regulations on the consumption of sugar.

During this period, the major players within the sugar sectors were extremely powerful. They not sat on the very committees designed to direct dental care policies, they also worked closely with doctors and dental experts. And as the evidence shows, with great power comes even greater opportunity. Even though it was very clear at this point that sugar was the leading cause of tooth decay, the government was skilfully persuaded to avoid tighter regulations.

There are more than 300 internal industry documents to pore over. They include old letters and meeting minute records from high profile committee sessions. And they all show evidence of the quietly influential hand of the sugar industry. On the one hand, we know that modern policies are designed in such a way as to avoid this very situation. These days, objectivity is essential for the success of medical and dental research.

We no longer allow business interests to drive public policy, for example. It would now be considered suspect and immoral for, say, a candy manufacturer to be asked for its opinion on whether or not people should eat less candy. But the question is, how much of this impartiality is genuine? Do our food (and particularly our sugar) companies really have no influence over dental policies or is their participation just more subtle now?

The Sneaky Tactics of the Sugar Barons

Well, this is an interesting question, because there have been a number of recent controversies over decisions relating to sugary drinks and snacks. In 2009, the government unveiled plans to place a federal excise tax on sugary drinks. In response, the American Beverage Association, Coca Cola, and PepsiCo invested a combined $40 million to try and stop the policy from being approved.

The attempt was unsuccessful, but it says an awful lot about how hard the sugar companies are willing to fight to prevent scientific research from becoming the dominant force in policy creation. In recent years, the sugar leaders have also tried to prevent the government from placing warnings about ‘added sugar’ on nutritional labels.

The American Bakers’ Association, the American Beverage Association, the Corn Refiners Association, the American Frozen Food Institute, the International Dairy Foods Association, and the National Confectioners Association were all on the warpath, in 2014, after the government proposed a warning system for the amount of sugar added to products after processing. They wrote a mutual letter to the FDA imploring it to scrap the suggested policy.

So, on the one hand, things have clearly changed. The sugar companies are not being granted the all-powerful influence that they once had. It is no longer enough to simply throw money at the problem, because policymaking is, for the most part, very public now. The general public want to know where their food is coming from, what it will do their bodies, and which companies have a vested interest in clouding or concealing the facts.

A Time When Sugar Had It All Its Own Way

The most damning evidence of the close relationship between the government and the sugar companies dates back to the sixties. During this time, there was a lot of debate about cavity prevention. The impact of a sugary diet was just beginning to make itself known among the general population and an increasing number of people needed treatments for cavities.

In a bid to decrease the prevalence of tooth decay and disease, the US government set up a research program. It was called the National Caries Program (NCP) and its objective was to completely eliminate tooth decay by the close of the seventies. So, only a little ambitious then. Yet, the real problem was not over ambition, but its overly close association with the biggest sugar enterprises in the country.

The task force committee established to create research agendas for the NCP included a number of doctors and scientists affiliated with the sugar companies. Many of the committee contributors were also part of another organisation called the International Sugar Research Foundation. It is hardly surprising then that when it came time to lay out strategies for cavity prevention, the government policies were strikingly similar to suggestions from the most powerful members of the committee – the sugar barons.

In fact, around 80% of the ideas directly proposed by the sugar companies actually made it into the policies. For the most part, medical research that was critical of the industry in any way did not make it very far. Research focusing on the links between sugar and tooth decay were not investigated by the government or included in its final NCP report. In the end, around 40% of the approved proposals were taken, word for word, from an industry review created by the International Sugar Research Foundation.

The Dangers of Letting Sugar Shape Dental Policies

The NCP report carefully avoided having to advise citizens to lower their sugar consumption. Instead, it focused on measures that might be successful without having to resort to working against powerful industry friends. For example, the report emphasised the benefits of fluoride and sealants as part of a daily dental care routine. Ultimately, it deemed tighter restrictions on sugar and sugar consumption as being unlikely to have a positive impact.

At this point, the government was well aware that consuming less sugar would reduce the incidence and likelihood of tooth decay. But it wasn’t yet willing to side with medical research over business interests. This led to a number of ill-advised suggestions, many of which did not come to fruition or were not very successful when they did. The best example of this is the government helmed attempt to create a sugar substitute.

A team of government scientists spent years combining fructose and glucose, in a number of different ways, in a bid to find a healthier replacement. It took the better part of a decade for this research to be deemed ineffectual and finally wrapped up. There were also plans to manufacture an additive that could neutralize the contribution of sugar to the development of tooth decay. This research was abandoned quickly.

In the sixties and seventies then, the government did everything but the one thing that it knew would be successful. It knew this because independent medical research had proved an undeniable link between elevated sugar consumption and the incidence of tooth decay and cavities. So, the cache of letters currently being preserved and held by the University of Illinois has been very revealing indeed, as far shedding light on the development of dental policies.

Determining How Much Has Changed for Policymakers

The actions of companies like PepsiCo and Cocoa Cola show that, even if that historical level of influence, is no longer present, the modern sugar barons are still keen to make their mark on government policies. The assortment of groups and organisations opposing the ‘added sugar’ warning on processed products actually claimed that the proposal was ‘unconstitutional’ and trampled on their rights.

But should the rights of big business ever come before the interests of the people and public health? If independent evidence is brought forward that makes unambiguous assertions about dental care provisions, should the government be obligated to investigate it? Again, it is an interesting question and a highly relevant one, considering the recent controversy surrounding mercury amalgam fillings.  

In what feelings like a similar situation, the government recently rejected calls from the FDA to place tighter restrictions on the use of mercury in dental fillings. This proposal came as quite a surprise to many, because the FDA had previously spent many decades defending its use. So, for the organisation to turn and around and completely change its mind is not only concerning, it makes the hasty government rejection worthy of more scrutiny.  

It is not entirely clear what parts of the industry, if any, had an influence on the decision to veto. While a large proportion of the modern dental industry supports and defends the use of mercury in fillings, a huge chunk of it has stopped using mercury anyway. Today, only around half of all dentists still offer mercury amalgam fillings and they are mostly surgeries serving low income patients, the elderly, the homeless, or the unemployed.

Taking a Closer Look at the Battle for Mercury

The government has been curiously cagey about its rejection. In fact, the veto was only made public almost five years after the proposal was submitted. There has been no investigation into claims that mercury causes serious sickness in human beings, or at the very least, there have been no public enquires. Consequently, rumours abound that the government is thinking with its purse and, therefore, could be putting public health at risk in order to save money.

For many years, critics and safety campaigners have been lobbying for a ban or tighter restrictions on the use of mercury. A number of countries across Europe have no completely banned its use within the dental industry. The claims are that it can cause a multitude of serious health problems; everything from respiratory conditions to lung and kidney issues, coronary disease, brain degeneration and more.

According to the FDA proposal, there is a strong likelihood that mercury fillings could be harmful for young children, pregnant and nursing mothers, and those with low immune systems. It stopped short of calling for an outright ban on its, but it did strongly suggest that dentists offer alternative fillings where possible. The most common substitute for mercury is a composite resin filling – they cost more, but they are safer, and provide a close shade match.

Mercury amalgam fillings cannot be manufactured to match the shade of natural teeth as composite resin materials can, so they don’t even have the draw of looking authentic. What they do have is price on their side. They are around $100 cheaper than the most affordable composite resin filling. And as they are only really available now at low income clinics, this is a good explanation for why some patients would still choose them over composites.

The Fight for the Heart of Dental Policy

So, it is clear to see that public health isn’t necessarily the top priority when it comes to changing and updating things like medical and dental policies. There are times when profit rules the roost, potentially at the expense of public wellbeing. The influence of the sugar barons is a good example of this, because while we have learned a lot about the impact of sugar on tooth decay over the last thirty years, our love affair with sugar has not abated.

Today, approximately 80% of the US (adult) population has some form of dental decay, cavity, or infection. Gum disease is particularly prevalent and it keeps dentists busy all the time, performing root canals and routine extractions, in cases where the decay has progressed too far for teeth to be saved. It is a serious issue and a very public once, because it is inextricably linked to the American obsession with sugar and additives.    

It goes right back to the way that people eat, as well as what they eat. As a nation, we know that a sugary diet is bad for the teeth. We understand the cause and correlation between consuming too much sugar and ending up at the dentist with cavities. But we do it anyway. So, where should the degree of intervention end, if you believe that it should at all? Should the government be responsible for the choices that we make, even if we have made them in full and frank possession of all the facts?



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