Posts Tagged ‘research funding’
By: Valerie Miller, Ph.D.
Earlier this spring, before a congressional panel, the vice president for health and safety of the National Football League (NFL) admitted for the first time that there is a connection between head injuries sustained playing football and chronic traumatic encephalopathy (CTE), which causes devastating memory and psychological problems. Despite the NFL’s longstanding denial of the connection between head injuries sustained playing football and CTE, these comments were made based on the work of Dr. Ann McKee, professor of neurology and pathology at Boston University (BU). Dr. McKee leads the famed “Brain Bank,” which has been collecting and examining the brains of former NFL players, finding that nearly 100 former players brains’ exhibited the degenerative disease. However, the science behind CTE is still in its infancy, and many questions remain unanswered. For example, it is unknown how much risk of developing CTE each player faces, what percentage of players develop CTE or why some players may be more susceptible than others. Additionally, the link between psychological problems that some former players exhibit and changes in (their) brain pathology remains tenuous. Adding to the confusion, CTE can only be diagnosed after a person has died and their brain can be examined. Clearly, a number of larger studies are needed to begin addressing these important questions. Although it would seem that the NFL would be most interested in answering these questions in order reduce player injury and risk while protecting their industry and product, the NFL has been less than forthcoming regarding the risks of concussions and traumatic brain injury, and has attempted to control the science produced regarding concussions.
Flawed Concussion Research
In 1994, amid growing concerns regarding player safety and concussions, the NFL formed a “concussion committee” to investigate the rate of concussions and the long-term harm they may cause players. The committee, comprised mostly of physicians associated with NFL teams, began a study that tracked all concussions diagnosed by team physicians on all teams from 1996-2001, and published a series of 13 peer-reviewed articles in the journal Neurosurgery based on this data. The league has used these articles as evidence that there is no connection between concussions sustained playing football and long-term effects in players. However, a recent New York Times investigation showed that the NFL studies omitted over 100 diagnosed concussions that were reported to the league, more than 10% of the total number. The NFL’s studies, based on this incomplete data, gave the appearance of a reduced rate of concussion among its players. The NFL has long stood by its research, claiming the legitimacy of the published papers because they underwent rigorous scientific peer-review. However, the New York Times received pages of comments and questions between peer reviewers and the committee, showing that reviewers wanted to stop the publication of the papers, with one reviewer stating “many of the management of concussion suggestions are inappropriate and not founded on facts.” The committee rebuffed the criticism and the articles were published.
NFL Tries to Influence Independent Concussion Research
In 2012, the NFL donated $30 million to the Foundation for the National Institutes of Health to study the effects of traumatic brain injury (TBI), including concussions. The research would be overseen by the NIH, and the NFL stated at the time that they would have no influence on how the money was used. Five studies were to be funded, including a seven-year, $16 million grant that would be awarded to study the progression of CTE, with the goal of determining how to detect CTE in living patients. After a rigorous scientific review process and additional review by an NIH advisory council, the National Institute of Neurological Disorders and Stroke (NINDS) awarded the grant to a team of 50 researchers at 17 institutions, led by Dr. Robert Stern, the director of clinical research at BU’s CTE Center. However, as first reported by ESPN’s Outside the Lines, the NFL reneged on its deal to fund the study, and instead tried to lobby the NIH to fund a proposal submitted by the NFL’s own researchers. In response to these allegations, members of the House Committee on Energy and Commerce launched an investigation, and issued a 91-page report detailing the ways in which the NFL publically claimed to fund impartial studies, only to privately attempt to influence the direction of concussion research. BU researcher Dr. Stern has long been critical of the NFL and their denial of the relationship between head injury and brain degeneration. Claiming that Dr. Stern would be unable to perform unbiased research, the NFL instead suggested funneling the $16 million grant to a different project lead by members of the NFL’s brain injury committee, avoiding the peer-review process by the NIH. This plan was subsequently rejected by NIH Director Francis Collins. According to Dr. Walter Koroshetz, Director of NINDS, the actions by the NFL are unprecedented, and that he “was aware of no other instance” in which private donors lobbied the NIH or attempted to direct the grant funding process. Ultimately, the NIH determined that the NFL’s allegations against Dr. Stern were unfounded. The study, which launches this June, is still funded by the NIH, but is being paid for by US tax dollars.
Where Do We Go from Here?
At this point, the general public has been made aware of the potential risks that concussions pose. The issues regarding repeated TBIs were brought to the forefront with the release of the 2015 movie Concussion, detailing the work of Dr. Bennet Omalu, who first discovered CTE. An increasing number of NFL players have been speaking out about player safety and are retiring early due to injury. Also, players have expressed interest in donating their brains to CTE research after death. In addition, rules are changing at all levels of play to reduce the incidence of concussions, and, as parents are becoming more wary of the risks of injury, participation in youth football is declining, although a great deal of questions surrounding concussion and CTE remain unanswered. Most importantly, the public is also now aware that the NFL has been less than forthcoming regarding the risks to player health. It can only be speculated what changes to the sport of football we will see in the upcoming months, years and decades, but for now, the NFL has been put on notice.
By: Danielle Friend, Ph.D.
This story is not a new one. A company develops a product and uses mass media to market the product to people all over the globe. The product becomes a household name. Several years later, scientists discover that the product contains ingredients that are unhealthy and may actually cause health problems. In response, the company attempts to place blame elsewhere, tries to discredit scientific findings, and confuse the consumer. This time, however, we are not describing the Tobacco industry. No, this time it is the soda industry.
Although obesity rates may no longer be on the rise as they were between the years of 1988 and 2000, rates are anything but declining. In 2014 it was estimated that 29 percent of American adults were obese and even a greater percentage were overweight. It will likely not surprise anyone to know that production and consumption of sugary beverages, like soda, have tracked with obesity rates surprisingly well. In fact, soda sales and consumption were at their highest during the years in which obesity rates showed the steepest increase, and now as soda production and consumption have decreased, obesity rates have plateaued. What led to this decrease in soda sales and consumption is likely a mix of several factors. Government agencies implementing “Soda Taxes,” regulations regarding the availability of soda in schools, and the restrictions on marketing towards children have all likely made an impact. In fact, American consumption of full calorie sodas has decreased by 25 percent since the 1990s indicating that these regulations have encouraged consumers to make healthier choices.
However, to counteract consumers’ growing concerns about “cutting calories” (and potentially their products), Coca-Cola, the largest producer of sodas, has recently gone to great lengths to shift consumers’ concerns regarding the obesity epidemic from what they eat to how much they exercise. In August of 2015, the New York Times reported that Coca-Cola had spent more than $1.5 million on the establishment of what was known as the Global Energy Balance Network or GEBN, a “voluntary public-private, not-for-profit organization dedicated to identifying and implementing innovative solutions – based on the science of energy balance – to prevent and reduce diseases associated with inactivity, poor nutrition and obesity.” When developing the GEBN, Coca-Cola appointed Dr. Steven Blair, a professor of Exercise Science and Epidemiology and Biostatistics at the University of South Carolina’s School of Public Health, and Gregory A. Hand, Dean of the School of Public Health at West Virginia University as GEBN administrators, and James O. Hill, director of the Center for Human Nutrition at the University of Colorado Health Science Center the president of the GEBN. Most shockingly, early on in the establishment of the GEBN, Coca-Cola’s role in appointing the group’s leaders, establishing the mission statement, and funding of the program were hidden from the public. In addition to establishing the GEBN, since 2010, Coca-Cola has gifted more than $21.8 million to scientific research and an additional $96.8 million to other health and wellness partnerships that tote the company’s moto “when it comes to weight don’t worry about what you eat, focus on exercising”, a statement that no doubt would help hurting soda sales. In addition to teaming with scientists to dissipate the blame on the soda industry for the rise in obesity, Coca-Cola has also spent more than $120 million since 2010 to support other partnerships, including more than $3 million to the American Academy of Pediatrics to launch another website known as Healthychildren.org, and more than 1.7 million to the Academy of Nutrition and Dietetics.
In addition to the report in the New York Times, in August of 2015, the advocacy group, The Center for Science in the Public Interest, released a letter signed by 37 scientists and public health experts accusing the GEBN of “peddling scientific non-sense.” In response to this criticism, in August, the Chief Technical Officer at Coca-Cola released a statement, “I was dismayed to read the recent New York Times’ inaccurate portrayal of our company and our support of the [GEBN]. The story claimed Coke is funding scientific research to convince people that diets don’t matter – only exercise does. In fact, that is the complete opposite of our approach to business and well-being and nothing could be further from the truth.” He goes on to say that “At Coke, we believe that a balanced diet and regular exercise are two key ingredients for a healthy lifestyle and that is reflected in both our long-term and short-term business actions.”
Despite the denial that Coke attempted to mislead the consumer, as of November 30th 2015, GEBN had been shut down and the home page for the public-private partnership website states “Effective immediately, GEBN is discontinuing operations due to resource limitations. We appreciate the commitment to energy balance that the membership has demonstrated since our inception, and encourage members to continue pursuing the mission “to connect and engage multi-disciplinary scientists and other experts around the globe dedicated to applying and advancing the science of energy balance to achieve healthier living.” In addition, Coca-Cola’s chief science and health officer and cofounder of the GEBN, Rhona D. Applebaum, stepped down from her position. The University of Colorado also stated in November that they will be returning a $1 million grant received from Coca-Cola. The returned money, Coca-Cola states, will be donated to the Boys and Girls Club of America. The American Academy of Pediatrics and the Academy of Nutrition and Dietetics have both stated that their relationship with Cocoa-Cola has been severed.
This situation emphasizes how scientific funding from private sources with an agenda can be of concern to both science and public health. In fact, a recent publication in PLOS Medicine suggested that science funded by large soda companies such as Coca-Cola or the American Beverage Association are five times more likely to report no link between sugary drink consumption and weight gain compared to science that does not have a financial conflict of interest. Increased transparency regarding scientific and advocacy funding could be one way in which consumers would be better protected from misguided information in the future. Scientists and medical professionals are already required to declare financial conflicts of interest, however media coverage of privately funded research findings should emphasize the potential bias. Furthermore, public health organizations and advocacy programs, such as the GEBN, must be required to fully disclose funding sources.