title: Textual analysis of sugar industry influence on the World Health Organization's 2015 sugars intake guideline.
abstract: OBJECTIVE
  To determine whether sugar industry-related organizations influenced textual changes between the draft and final versions of the World Health Organization's (WHO's) 2015 guideline Sugars intake for adults and children.
  
  
  METHODS
  Stakeholder consultation submissions on the draft guideline from seven sugar industry-related and 10 public health organizations were assessed using the Wordscores program. Document scores were rescaled using the Martin-Vanberg transformation to improve comparability. Draft and final guidelines were compared to identify changes influenced by the sugar industry and public health organizations.
  
  
  RESULTS
  There was a small shift in transformed Wordscores score between the draft and final guidelines, from 0.25 to 0.24, towards the industry position. The change was linked to increased use of the word "low" to describe the quality of the evidence, consistent with industry arguments. There was also a shift from use of the word "consumption" to "intake", irrespective of policy position. Scores for World Sugar Research Organisation and Sugar Nutrition UK submissions ( 0.11 and 0.18, respectively) represented strong pro-industry positions and scores for European Public Health Alliance and Wemos submissions (1.00 and 0.88, respectively) represented the strongest public health positions. Industry tactics included challenging the quality of the evidence, distinguishing between different types of sugar and advocating harm reduction.
  
  
  CONCLUSIONS
  There was little change between draft and final versions of the WHO sugars intake guideline 2015, following industry consultation. The main change was linked to emphasizing the low quality of the evidence on sugar's adverse effects. Guideline development appeared relatively resistant to industry influence at the stakeholder consultation stage.
authors: Department of Sociology, University of Oxford, Manor Road Building, Oxford, OX1 3UQ, England .
authors: David
authors: D
authors: Stuckler
authors: International Inequalities Institute, London School of Economics and Political Science, London, England .
authors: Aaron
authors: A
authors: Reeves
authors: Department of Sociology, University of Oxford, Manor Road Building, Oxford, OX1 3UQ, England .
authors: Rachel
authors: R
authors: Loopstra
authors: Department of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, England .
authors: Martin
authors: M
authors: McKee
mesh_terms: D000073417:Dietary Sugars / Q000008:administration & dosage*; D017408:Guidelines as Topic; D007221:Industry; D008119:Lobbying; D000073893:Sugars; D014944:World Health Organization
chemical_list: D000073417:Dietary Sugars; D000073893:Sugars