ArticlePDF AvailableLiterature Review

Abstract and Figures

Objective: To describe the influence of the food industry in health research, observing how funding influences health outcomes and the quality of the studies. Method: We performed a systematic review in MEDLINE, Cochrane Library Plus and Scopus using the MESH "Food Industry", "Food-Processing Industry", "Biomedical Research", "Research Support as Topic", and the keywords "Industry Sponsorship" and "Funding Source". The quality was assessed using the PRISMA guidelines. Results: We revised 1,506 articles and 10 were included; two reviewed the relationship between funding-outcomes and quality-outcomes; six focused on the funding-outcomes relationship; and the other two focused on methodological quality. Six showed that funding from the food industry resulted in more favourable outcomes for their products. No differences in quality were found in relation to the funding source, but those which did not declare their funding had a worse quality. Conclusion: Studies funded by the food industry showed favourable results for their products. However, this fact did not affect the quality of the studies.
Content may be subject to copyright.
Gac
Sanit.
2017;31(4):320–323
Original
breve
Una
evaluación
crítica
de
la
relación
entre
la
industria
alimentaria
y
la
investigación
en
salud
Josep
León
Mengíbara,,
María
Pastor-Valeroa,be
Ildefonso
Hernández
Aguadoa,b
aDepartamento
de
Salud
Pública,
Historia
de
la
Ciencia
y
Ginecología,
Universidad
Miguel
Hernández,
Alicante,
Espa˜
na
bCIBER
en
Epidemiología
y
Salud
Pública
(CIBERESP),
Espa˜
na
información
del
artículo
Historia
del
artículo:
Recibido
el
1
de
julio
de
2016
Aceptado
el
21
de
octubre
de
2016
On-line
el
7
de
abril
de
2017
Palabras
clave:
Industria
alimentaria
Investigación
biomédica
r
e
s
u
m
e
n
Objetivo:
Describir
la
influencia
de
las
corporaciones
alimentarias
en
los
resultados
de
la
investigación
en
salud.
Método:
Revisión
sistemática
en
MedLine,
Cochrane
Library
Plus
y
Scopus
usando
los
MESH
“Food
Indus-
try”,
“Food-Processing
Industry”,
“Biomedical
Research”
y
“Research
Support
as
Topic”,
y
las
palabras
clave
“Industry
Sponsorship”
y
“Funding
Source”.
La
calidad
fue
evaluada
mediante
las
directrices
PRISMA.
Resultados:
Se
revisaron
1506
artículos
y
se
incluyeron
10,
de
los
cuales
dos
analizaban
la
relación
entre
financiación
y
calidad
respecto
a
resultados;
seis,
la
relación
entre
financiación
y
resultados;
y
dos,
la
calidad
metodológica.
Seis
mostraron
efectos
favorables
a
los
productos
de
las
industrias
financiadoras.
En
cuanto
a
la
calidad,
no
se
observaron
diferencias
según
la
financiación,
pero
una
peor
calidad
en
aquellas
que
no
la
declaraban.
Conclusión:
La
financiación
por
parte
de
la
industria
alimentaria
de
investigaciones
en
salud
se
asocia
a
resultados
favorables
a
sus
productos,
aunque
no
afecta
a
la
calidad
de
los
estudios.
©
2017
SESPAS.
Publicado
por
Elsevier
Espa˜
na,
S.L.U.
Este
es
un
art´
ıculo
Open
Access
bajo
la
licencia
CC
BY-NC-ND
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
A
critical
assessment
of
the
relation
between
the
food
industry
and
health
research
Keywords:
Food
industry
Biomedical
research
a
b
s
t
r
a
c
t
Objective:
To
describe
the
influence
of
the
food
industry
in
health
research,
observing
how
funding
influences
health
outcomes
and
the
quality
of
the
studies.
Method:
We
performed
a
systematic
review
in
MEDLINE,
Cochrane
Library
Plus
and
Scopus
using
the
MESH
“Food
Industry”,
“Food-Processing
Industry”,
“Biomedical
Research”,
“Research
Support
as
Topic”,
and
the
keywords
“Industry
Sponsorship”
and
“Funding
Source”.
The
quality
was
assessed
using
the
PRISMA
guidelines.
Results:
We
revised
1,506
articles
and
10
were
included;
two
reviewed
the
relationship
between
funding-
outcomes
and
quality-outcomes;
six
focused
on
the
funding-outcomes
relationship;
and
the
other
two
focused
on
methodological
quality.
Six
showed
that
funding
from
the
food
industry
resulted
in
more
favourable
outcomes
for
their
products.
No
differences
in
quality
were
found
in
relation
to
the
funding
source,
but
those
which
did
not
declare
their
funding
had
a
worse
quality.
Conclusion:
Studies
funded
by
the
food
industry
showed
favourable
results
for
their
products.
However,
this
fact
did
not
affect
the
quality
of
the
studies.
©
2017
SESPAS.
Published
by
Elsevier
Espa˜
na,
S.L.U.
This
is
an
open
access
article
under
the
CC
BY-NC-ND
license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Introducción
La
influencia
de
las
industrias
sobre
las
políticas
globales
y
locales,
la
investigación
y
la
práctica
de
la
salud
pública
es
conocida.
Las
comparaciones
entre
las
industrias
del
tabaco,
far-
macéuticas
y
alimentarias
sugieren
que
las
corporaciones
utilizan
una
serie
de
tácticas
comunes
cuyo
objetivo
final
es
defender
sus
productos,
garantizar
los
beneficios
empresariales
y
establecer
una
Autor
para
correspondencia.
Correo
electrónico:
jleon
92@hotmail.com
(J.
León
Mengíbar).
determinada
agenda
de
salud
pública
global1.
Estas
tácticas
inclu-
yen,
entre
otras,
sembrar
dudas
sobre
los
efectos
deletéreos
en
la
salud
de
diversos
productos
industriales
y
farmacéuticos
mediante
la
contratación
de
científicos
con
proyección
o
la
financiación
de
estudios
de
investigación2,
modificar
o
impedir
regulaciones
para
conseguir
sus
intereses
comerciales3,
e
influir
mediante
lobbies
en
todas
las
esferas
públicas
nacionales
e
internacionales
sobre
el
control
de
los
estándares
de
salud,
calidad,
medio
ambiente,
etc.1.
Además,
la
financiación
de
la
investigación
científica
por
parte
de
las
corporaciones
crea
dependencia
y
conflictos
de
intereses,
e
influye
en
los
resultados2.
Algunos
autores
han
descrito
los
efectos
de
la
financiación
de
la
industria
alimentaria
sobre
los
resultados
en
http://dx.doi.org/10.1016/j.gaceta.2016.10.012
0213-9111/©
2017
SESPAS.
Publicado
por
Elsevier
Espa˜
na,
S.L.U.
Este
es
un
art´
ıculo
Open
Access
bajo
la
licencia
CC
BY-NC-ND
(http://creativecommons.org/licenses/by-nc-
nd/4.0/).
J.
León
Mengíbar
et
al.
/
Gac
Sanit.
2017;31(4):320–323
321
salud
de
algunos
productos
concretos
(bebidas
azucaradas,
zumos,
leche
o
componentes
inherentes
de
las
mismas)4,
aunque
no
se
ha
realizado
una
revisión
sistemática
que
describa
todo
el
cono-
cimiento
científico
disponible
en
este
terreno.
El
objetivo
de
este
estudio
es
analizar
cómo
la
financiación
de
las
corporaciones
ali-
mentarias
influye
en
los
resultados
y
en
la
calidad
metodológica
de
la
investigación
en
salud.
Método
Se
realizó
una
búsqueda
en
las
bases
de
datos
MedLine,
Coch-
rane
Library
Plus
y
Scopus
hasta
febrero
de
2016,
completando
los
resultados
con
el
listado
bibliográfico
de
los
artículos
seleccionados.
La
ecuación
de
búsqueda
final
para
su
empleo
en
Med-
Line/PubMed
quedó
como
sigue:
(“Food
Industry”[Mesh]
OR
“Food-
Processing
Industry”[Mesh]
OR
“Food
Industry”[Title/Abstract]
OR
“Food-Processing
Industry”[Title/Abstract])
AND
(“Biomedi-
calResearch”[Mesh]
OR
“Biomedical
Research”[Title/Abstract]
OR
“Research
Support
as
Topic”[Mesh]
OR
“Research
Support
as
Topic”[Title/Abstract])
OR
(“Industry
Sponsorship”[Title/Abstract]
OR
“Funding
Source”[Title/Abstract]).
Se
utilizó
el
filtro
(límite):
“humanos”.
Los
criterios
de
inclusión
fueron
que
se
tratara
de
estudios
observacionales,
experimentales
y
revisiones
sistemáti-
cas
relacionados
con
el
objetivo
en
estudio,
y
poder
acceder
al
texto
completo
del
trabajo
en
inglés,
espa˜
nol
o
portugués.
Se
excluyeron
aquellos
trabajos
que
no
aportaban
estimaciones
empíricas
sobre
los
efectos
en
salud,
así
como
cartas,
editoriales
y
artículos
de
opi-
nión.
La
selección
de
los
artículos
pertinentes
la
realizó
uno
de
los
autores
de
la
revisión
(JLM).
La
calidad
de
los
artículos
seleccionados
se
revisó
utilizando
las
directrices
PRISMA5.
Resultados
De
1506
referencias
identificadas,
se
incluyeron
10
revisiones
sistemáticas
(Fig.
1)
cuyas
características
se
describen
en
la
tabla
1.
Los
estudios
procedían
de
MedLine
(n
=
7,
70%),
Scopus
(n
=
1,
10%)
y
los
listados
bibliográficos
(n
=
2,
20%).
Ocho
revisiones
ana-
lizaban
la
relación
entre
financiación
y
resultados
en
salud,
dos
de
las
cuales
consideraban
además
su
calidad6,7,
y
las
otras
dos
revisiones
(20%)
solo
evaluaban
la
calidad8,9.
Seis
estudios4,6,7,10–12
concluyeron
que
las
investigaciones
financiadas
por
la
industria
alimentaria
tenían
más
probabilidades
de
alcanzar
conclusiones
favorables
hacia
sus
productos
(olestra,
lácteos,
bebidas
azucara-
das
y
suplementación
con
probióticos,
prebióticos
y
simbióticos).
En
cambio,
otros
trabajos13,14 no
observaron
una
asociación
sig-
nificativa
entre
la
financiación
por
parte
de
la
industria
y
sus
conclusiones.
Por
su
parte,
Diels
et
al.14 observaron
que
los
estu-
dios
cuya
financiación
no
estaba
establecida,
o
que
los
autores
estaban
afiliados
a
la
industria,
ofrecían
resultados
favorables
a
la
industria,
con
RR
=
1,1
(p
=
0,036)
y
RR
=
1,31
(p
<
0,001),
res-
pectivamente.
Si
se
daban
las
dos
situaciones,
financiación
de
la
industria
y
autores
pertenecientes
a
la
industria,
la
asociación
tenía
el
mismo
sentido,
con
RR
=
1,25
(p
=
0,005).
Al
evaluar
la
calidad
mediante
las
directrices
PRISMA,
las
puntuaciones
osci-
laron
entre
10
y
20
(mediana
14)
en
los
27
ítems
examinados
(tabla
1).
En
general,
no
se
encontró
relación
entre
la
financiación
y
la
calidad5–7,
excepto
en
los
estudios
cuya
financiación
no
estaba
esta-
blecida,
en
los
que
se
observó
que
eran
de
peor
calidad
(odds
ratio:
4,97;
p
<
0,001;
intervalo
de
confianza
del
95%:
2,76-8,25)9;
es
decir,
aquellos
estudios
en
los
que
la
financiación
no
estaba
establecida
tenían
cinco
veces
más
probabilidades
de
ser
de
peor
calidad.
Sin
embargo,
Mugambi
et
al.6detectaron
que
los
estudios
financia-
dos
por
la
industria
alimentaria
tenían
un
riesgo
menor
de
pérdida
de
datos
(90%
frente
a
un
64%
los
no
financiados
por
la
industria
y
un
56%
sin
financiación
o
cuya
fuente
de
financiación
no
que-
daba
esclarecida;
p
=
0,005).
Por
otro
lado,
un
88%
de
los
estudios
financiados
por
la
industria
presentaban
un
menor
riesgo
de
ses-
gos
(frente
a
un
73%
de
los
no
financiados
por
la
industria
y
un
56%
de
aquellos
sin
financiación
o
cuyo
patrocinio
no
quedaba
claro;
p
=
0,038).
1506 estudios identificados y
evaluados potencialmente
relevantes
1437 estudios
descartados
basándose en el
título o el resumen
59 estudios excluidos:
- 41 no eran estudios observacionales o
experimentales o revisiones sistemáticas
- 15 estudios no estaban relacionados
con el principal objeto de estudio
- 3 estudios no se pudo tener acceso
completo al texto
69 estudios incluidos para
una evaluación más
exhaustiva
10 estudios
incluidos
definitivamente
Figura
1.
Selección
de
artículos
a
incluir
en
la
revisión.
322
J.
León
Mengíbar
et
al.
/
Gac
Sanit.
2017;31(4):320–323
Tabla
1
Características
y
resultados
principales
de
los
estudios
seleccionados
en
la
revisión
sobre
efectos
de
la
financiación
de
trabajos
científicos
por
la
industria
alimentaria
y
sus
efectos
en
la
salud
Estudio
Tipo
de
artículo
Ntotal
estudios
revisados
Objetivo
de
estudio
Resultados
en
salud
Conflictos
de
intereses
y
fuente
financiación
PRISMA4
Levine
et
al.10,
2003
Revisión
sistemá-
tica
+
encuesta
67
(ensayos,
revisiones)
Relación
financiación
industria
Procter&Gamble
(P&G)
respecto
a
olestra
Los
estudios
con
financiación
industrial
mostraban
resultados
más
favorables
(p
<
0,001)
No
presenta
10
Lesser
et
al.4,
2007
Revisión
sistemática
111
(ensayos,
observacionales
y
revisiones)
Relación
financiación
industria
de
bebidas
azucaradas,
zumos
y
leches
Los
estudios
con
financiación
industrial
mostraron
un
papel
protector;
OR:
7,61
(1,27-45,73)
No
menciona
fuente
financiación
14
Nkansah
et
al.13,
2009
Revisión
sistemática
19
ensayos
aleatorizados
Relación
financiación
industria
de
suplementos
de
calcio
en
infancia
No
se
encontró
asociación
entre
la
financiación
y
las
conclusiones
(p
=
0,53)
No
presenta 12
Myers
et
al.9,
2011
Revisión
sistemática
2539
(intervenciones,
observacionales,
revisiones)
Evaluación
de
la
calidad
de
los
estudios
incluidos
No
hay
diferencias
según
financiación
(p
=
0,069),
excepto
cuando
no
se
establece
(OR:
4,97)
No
menciona
fuente
de
financiación
16
Diels
et
al.14,
2011
Revisión
sistemática
94
(intervenciones,
analíticos
o
simulaciones)
Relación
financiación
industria
alimentaria
y
alimentos
derivados
de
cultivos
modificados
genéticamente
No
asociación
entre
financiación
y
resultados
(p
=
0,631);
cuando
no
estaba
establecida
(p
=
0,0036)
y
con
autores
afiliados
(p
<
0,001)
No
menciona
fuente
de
financiación
13
Kaiser
et
al.8,
2012
Revisión
sistemática
38
ensayos
clínicos
aleatorizados
Relación
financiación
industria
y
calidad
en
obesidad
No
hay
diferencias
según
financiación
(p
=
0,334)
No
presenta
11
Wilde
et
al.11,
2012
Revisión
sistemática
79
estudios
Relación
financiación
industria
en
productos
lácteos
Hubo
resultados
más
favorables
con
financiación
industrial
(p
<
0,001)
No
menciona
fuente
de
financiación
15
Bes-Rastrollo
et
al.12,
2013
Revisión
sistemática
17
revisiones
sistemáticas
Relación
financiación
industria
en
bebidas
azucaradas
Hubo
resultados
más
favorables
con
financiación
industrial
(RR:
5,16)
No
menciona
fuente
de
financiación
19
Mugambi
et
al.6,
2013
Revisión
sistemática
67
ensayos
controlados
aleatorizados
Relación
financiación
en
resultados
y
calidad
en
simbióticos,
probióticos
y
prebióticos
Hubo
resultados
más
favorables
con
financiación
industrial(p
=
0,037),
menor
pérdida
de
datos
y
menos
sesgos
No
menciona
fuente
de
financiación
15
Massaoughbodji
et
al.7,
2014
Revisión
sistemática
20
revisiones
sistemáticas
Relación
financiación
en
resultados
y
calidad
en
bebidas
azucaradas
Hubo
resultados
más
favorables
con
financiación
industrial
(p
<
0,01),
sin
diferencias
en
calidad
No
presenta
20
OR:
odds
ratio;
RR:
riesgo
relativo.
Por
último,
se
buscaron
otros
estudios
de
los
autores
incluidos
en
esta
revisión
(tabla
1)
con
el
objetivo
de
saber
si
habían
declarado
conflictos
de
intereses
relacionados
con
la
industria
alimentaria,
y
no
se
hallaron
en
ninguno
de
ellos.
Discusión
Nuestros
resultados
muestran
que
la
mayoría
de
los
estudios
financiados
por
la
industria
alimentaria
se
asociaron
a
resultados
favorables
en
salud,
ignorando
en
algunos
casos
la
evidencia
sobre
los
efectos
adversos
encontrados
por
otros
estudios
sin
conflictos
de
intereses
con
productos
como
las
bebidas
azucaradas
o
los
lácteos.
No
hubo
evidencias
de
sesgo
de
patrocinio
en
el
estudio
de
suple-
mento
de
calcio
en
la
infancia,
suplementación
con
probióticos,
simbióticos
y
prebióticos,
y
alimentos
derivados
de
cultivos
genéti-
camente
modificados.
Respecto
a
la
calidad,
nuestra
revisión
indica
que
los
artículos
financiados
por
la
industria
alimentaria
tenían
una
calidad
similar
que
la
de
aquellos
con
financiación
gubernamen-
tal
o
de
otra
índole.
No
obstante,
en
los
artículos
en
los
que
no
se
declaraba
el
tipo
de
financiación
la
calidad
era
peor.
El
reducido
número
de
estudios
encontrados,
su
heterogeneidad
y
la
diversidad
de
productos
alimenticios
examinados
impidie-
ron
calcular
un
estimador
ponderado
global.
Por
otro
lado,
aunque
en
los
criterios
de
búsqueda
se
incluían
estudios
observacionales,
experimentales
y
revisiones
sistemáticas,
los
10
estudios
encon-
trados
fueron
revisiones
sistemáticas,
probablemente
debido
a
que
son
el
único
tipo
de
estudio,
por
sus
características
intrínsecas,
que
puede
dar
respuesta
al
objetivo
de
esta
revisión.
Sin
embargo,
esta
revisión
recoge
todo
el
conocimiento
disponible
hasta
la
fecha
en
la
literatura
científica
sobre
la
relación
entre
la
financiación
por
parte
de
la
industria
alimentaria
y
su
influencia
en
los
resultados
en
salud
y
en
la
calidad
metodológica.
Nuestros
resultados
muestran
la
importancia
de
la
supervisión
de
las
relaciones
entre
la
industria
alimentaria
y
la
investigación
en
salud,
en
la
cual
deben
primar
el
beneficio
público,
la
calidad
y
la
veracidad
del
conocimiento
generado.
Los
profesionales
e
inves-
tigadores
de
la
salud
pública
deben
proteger
su
independencia
y
evitar
los
conflictos
de
intereses
con
la
industria,
y
ser
conscientes
del
papel
que
las
compa˜
nías
transnacionales
desempe˜
nan
en
la
epi-
demia
global
de
las
enfermedades
crónicas15.
Las
políticas
de
salud
J.
León
Mengíbar
et
al.
/
Gac
Sanit.
2017;31(4):320–323
323
pública
tienen
que
garantizar
la
independencia
de
la
salud
pública
respecto
de
las
corporaciones
alimentarias
en
todos
los
ámbitos,
incluida
la
investigación16.
¿Qué
se
sabe
sobre
el
tema?
Las
industrias
relacionadas
de
manera
directa
o
indirecta
con
la
salud
usan
diversas
estrategias
para
influir
en
la
ciencia
y
en
la
práctica
de
la
salud
pública.
Se
ha
apuntado
que
las
industrias
alimentarias
influyen
en
la
investigación
sobre
los
efectos
sobre
la
salud
de
algunos
alimentos
concretos.
¿Qué
a˜
nade
el
estudio
realizado
a
la
literatura?
La
financiación
de
estudios
en
salud
por
parte
de
la
industria
alimentaria
se
asocia
sistemáticamente
a
resultados
favorables
a
sus
productos,
que
incluyen
bebidas
azucaradas,
lácteos,
suplementos
de
probióticos,
simbióticos
y
prebióti-
cos,
y
grasas
sustitutivas,
como
olestra,
pero
exceptuando
la
suplementación
con
calcio
en
ni ˜
nos
y
los
alimentos
derivados
de
cultivos
modificados
genéticamente.
El
tipo
de
finan-
ciación
no
influye
en
la
calidad,
salvo
cuando
la
fuente
de
financiación
no
está
declarada.
Editor
responsable
del
artículo
Miguel
Ángel
Negrín
Hernández.
Declaración
de
transparencia
El
autor
principal
(garante
responsable
del
manuscrito)
afirma
que
este
manuscrito
es
un
reporte
honesto,
preciso
y
transparente
del
estudio
que
se
remite
a
Gaceta
Sanitaria,
que
no
se
han
omi-
tido
aspectos
importantes
del
estudio,
y
que
las
discrepancias
del
estudio
según
lo
previsto
(y,
si
son
relevantes,
registradas)
se
han
explicado.
Contribuciones
de
autoría
J.
León
e
I.
Hernández
concibieron
la
idea.
J.
León
realizó
la
recogida
de
datos.
J.
León,
I.
Hernández
y
M.
Pastor-Valero
partici-
paron
en
el
dise˜
no,
el
análisis
y
la
interpretación
de
los
resultados.
J.
León
escribió
el
primer
borrador
del
manuscrito.
Las
tres
personas
firmantes
contribuyeron
en
la
redacción
del
manuscrito
final
y
aprobaron
su
envío.
Financiación
Beca
de
colaboración
para
estudios
universitarios
2015-2016
del
Ministerio
de
Cultura,
Educación
y
Deporte.
Conflictos
de
intereses
Ninguno.
Bibliografía
1.
Wiist
WH.
The
corporate
playbook,
health,
and
democracy:
the
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their
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C,
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ResearchGate has not been able to resolve any citations for this publication.
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: Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols.
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Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations have influenced the formulation of certain policies with an impact on health, such as those related to the tobacco industry, the chemical industry, nutrition, alcohol, pharmaceuticals, and health technology. The main areas in which these companies can influence policies are science, education, politics, and society in general. In this scenario, public health associations should take an active role in ensuring the independence of political decisions via actions such as the following: supporting strategies that guarantee the independence of public health policies and apply criteria of impartiality and transparency; rejecting those public-private partnerships launched to prevent health problems partly caused by these corporations; establishing partnerships to achieve independent training of health professionals and an institution with scientific authority in order to improve public health communication and counteract the lack of sound public health information; promoting a critical analysis of the definition of health problems and their solutions, and establishing related agendas (scientific, political and media) and alliances, so that continuing training for health professionals is independent. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
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The role of sugar-sweetened beverages (SSBs) in increasing obesity is of great scientific, clinical, and public health interest. Many reviews have been published on this topic in recent years with very different conclusions. We sought to assess the scientific quality and other characteristics that may be associated with the conclusions of reviews regarding the causal relation between SSB consumption and body weight. A systematic search of reviews in English language-published peer-reviewed journals in 2006-2013 was performed. Their methodologic quality was assessed by 2 judges using 2 scoring systems: the Assessment of Multiple Systematic Reviews and the American Dietetic Association Quality Criteria Checklist. The conclusions were blindly assessed by 11 independent readers using a Likert scale ranging from a position score of 0 = no evidence of a causal relation to 5 = strong evidence of a causal relation. Twenty reviews were identified: 5 meta-analyses, 3 qualitative systematic reviews, and 12 qualitative nonsystematic reviews. Four received funding from the food industry. Quality scores were neither correlated with the readers' perception of conclusions nor with the source of funding. However, industry-funded reviews were more likely to suggest that evidence supporting a causal relation between SSB consumption and weight gain was weak (mean position score = 1.78), whereas evidence was generally considered well-founded in other reviews (mean position score = 3.39; P ≤ 0.01). For a complex and controversial scientific issue, it is important to minimize perceived or actual threats to scientific objectivity and methodologic quality. More refined tools are needed to better assess their scientific quality and to identify factors and mechanisms that may influence authors' conclusions.
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