title: Sugar industry influence on the scientific agenda of the National Institute of Dental Research's 1971 National Caries Program: a historical analysis of internal documents.
abstract: BACKGROUND
  In 1966, the National Institute of Dental Research (NIDR) began planning a targeted research program to identify interventions for widespread application to eradicate dental caries (tooth decay) within a decade. In 1971, the NIDR launched the National Caries Program (NCP). The objective of this paper is to explore the sugar industry's interaction with the NIDR to alter the research priorities of the NIDR NCP.
  
  
  RESULTS
  We used internal cane and beet sugar industry documents from 1959 to 1971 to analyze industry actions related to setting research priorities for the NCP. The sugar industry could not deny the role of sucrose in dental caries given the scientific evidence. They therefore adopted a strategy to deflect attention to public health interventions that would reduce the harms of sugar consumption rather than restricting intake. Industry tactics included the following: funding research in collaboration with allied food industries on enzymes to break up dental plaque and a vaccine against tooth decay with questionable potential for widespread application, cultivation of relationships with the NIDR leadership, consulting of members on an NIDR expert panel, and submission of a report to the NIDR that became the foundation of the first request for proposals issued for the NCP. Seventy-eight percent of the sugar industry submission was incorporated into the NIDR's call for research applications. Research that could have been harmful to sugar industry interests was omitted from priorities identified at the launch of the NCP. Limitations are that this analysis relies on one source of sugar industry documents and that we could not interview key actors.
  
  
  CONCLUSIONS
  The NCP was a missed opportunity to develop a scientific understanding of how to restrict sugar consumption to prevent tooth decay. A key factor was the alignment of research agendas between the NIDR and the sugar industry. This historical example illustrates how industry protects itself from potentially damaging research, which can inform policy makers today. Industry opposition to current policy proposals-including a World Health Organization guideline on sugars proposed in 2014 and changes to the nutrition facts panel on packaged food in the US proposed in 2014 by the US Food and Drug Administration-should be carefully scrutinized to ensure that industry interests do not supersede public health goals.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America; Department of Medicine, University of California San Francisco, San Francisco, California, United States of America; Department of Orofacial Sciences, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Cristin E
authors.initials: CE
authors.lastname: Kearns
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America; Department of Medicine, University of California San Francisco, San Francisco, California, United States of America; Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, United States of America; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Stanton A
authors.initials: SA
authors.lastname: Glantz
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, United States of America; Department of Medicine, University of California San Francisco, San Francisco, California, United States of America; Clinical and Translational Science Institute, University of California San Francisco, San Francisco, California, United States of America; Department of Anthropology, History and Social Medicine, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Schmidt
mesh_terms: D000047:Academies and Institutes / Q000266:history*; D016265:Conflict of Interest; D003731:Dental Caries / Q000209:etiology / Q000266:history*; D018865:Dental Research / Q000941:ethics / Q000266:history*; D019422:Dietary Sucrose / Q000009:adverse effects / Q000266:history*; D004282:Documentation / Q000266:history; D019649:Food Industry / Q000941:ethics / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D018673:Nutrition Policy; D011634:Public Health / Q000266:history*; D012586:Science / Q000266:history; D015871:Scientific Misconduct / Q000266:history*; D014481:United States
chemical_list: D019422:Dietary Sucrose