Recently, a series of investigations has exposed the undue influence of the sugar lobby on public health authorities in Australia.

Unrestricted grants and paid advisory roles are just some of the ways commercial interests co-opt the loyalty of health professionals to promote company-sponsored studies and marketing messages.

The focus now turns to Australia’s National Heart Foundation (NHF), which brands itself as one of the nation’s most trusted consumer health organizations. It boasts a reach of 1.57 million Aussies who turn to it for advice about how to use diet and medications to reduce the risk of heart disease.

But how independent is the advice, and is it being influenced by vested interests?

Junk food promotion

The NHF first became mired in controversy when its highly recognized Heart Foundation Tick Program was criticized for being an endorsement of the junk food industry. The Heart Foundation struck a lucrative deal with McDonald’s and began endorsing a range of meals, one of which contained 36 grams of sugar per serving, far exceeding the World Health Organization’s recommended daily intake.

Original image available here.

After a high-profile campaign to scrap the controversial program, the Tick was finally dumped. But not before leaving the public with questions about the NHF’s credibility and with concerns over what has been called the “corporate colonization of health activism.”

Ties with the drug industry

The NHF has a history of financial ties with the pharmaceutical industry. Between 2010 and 2017, the NHF established a Heart Foundation Pharmaceutical Roundtable, which brought together members from 10 leading drug companies in Australia. These included manufacturers of cholesterol-lowering statin medications and other drugs used in the treatment of heart disease.

The NHF stated the Pharmaceutical Roundtable developed positions on medications that may be prescribed for heart disease, “focusing on advice for health professionals.”

Professor Joel Lexchin of York University in Toronto is critical of the policy: “There are examples in the U.S. of consumer groups that have received funding from drug companies developing campaigns around conditions and drugs that clearly benefit the interests of the drug companies,” Lexchin says.

“Drug companies, like any commercial enterprise, are in business to make a profit and this presents an inherent contradiction when profits come into conflict with public health,” Lexchin adds.

Though it dissolved the Pharmaceutical Roundtable in 2017, the NHF says it still receives funding from pharmaceutical companies. It confirmed receiving unrestricted grants from three drug companies — Sanofi, AstraZeneca and Amgen — totaling $690,000 over three years. The funds reportedly went toward “developing community resources including pamphlets about heart health checks and cholesterol.”

The NHF defended its decision to accept drug company money, stating the funds represented only 0.4% of its total revenue. But regardless of the size of the funding, Lexchin says the perception is that the NHF is endorsing its sponsors’ positions.

Lexchin claims, “This undermines public confidence in the public health goals of the NHF. Furthermore, if the amount that the NHF is taking from drug companies amounts to only 0.4% of its budget, that raises the question of why it is even taking the money in the first place.”

Advertising processed foods?

The NHF confirmed it has formed a partnership with Sanitarium and will receive $25,000 every year for three years. The organization stated that it “shared goals” with the cereal manufacturer and has allowed the display of the NHF logo on Sanitarium’s cholesterol-lowering Weet-Bix™.

According to the NHF, over 35 percent of Australians are more likely to buy a product if it has the Heart Foundation logo on it.

Health economist and dietitian Melanie Voevodin says the partnership represents a clear endorsement of the cereal.

“It’s a heart-healthy halo for the brand, worth every cent of the marketing budget for Sanitarium,” Voevodin says. “The NHF is essentially making scientific claims about Sanitarium’s cereal, claims which are largely derived from a small study funded by Sanitarium.”

“What the food industry is doing, with the support of the NHF, is ‘medicalising’ the food supply, instead of telling the public to avoid eating highly processed food,” Voevodin adds.

The NHF is brazen about advertising the benefits of its corporate sponsorship program. It states that it provides corporate partners with “the chance to increase sales and associated brand awareness,” and that sponsorship of its lifestyle programs deliver “unprecedented, cost-effective access to a targeted audience.”

“Disclosing funding sources does not protect scientific integrity, nor does it absolve the NHF of its responsibility to provide impartial advice to the public,” Voevodin says. “The Heart Foundation’s income may increase but the trade-off is scientific integrity, evidence-based policy, and informed consent for consumers.”

U.S.-registered dietitian and Ph.D. Adele Hite of North Carolina State University agrees: “The primary responsibility of the NHF should be advocacy for, and protection of, individuals with heart disease. Not to help a particular food manufacturer reach a ‘targeted audience’ no matter how ‘healthy’ a product is deemed to be.”

“That the evidence behind claims that refined cereal products really are ‘healthy’ is highly contested and should make health professionals and the NHF take up the role of watchdog in airing concerns about these products, rather than acting to promote them,” Hite says. “Clearly, they are failing in their responsibility to individuals with heart disease.”

The NHF rejects the criticism, stating its “strict governance process ensures that potential partners are never involved in the process of developing health positions and guidelines,” and that any health claims by its potential partners “must be backed by clinical evidence.”

Considering the increasingly apparent role that consumer groups have in education, advocacy, and health policy, strategies to prevent undue influence from corporate donors are more vital than ever before.

Dr. Maryanne Demasi is a well-known investigative journalist whose work on scientific documentaries has been praised by the National Press Club of Australia for exhibiting “excellence in health journalism.”

Demasi earned a Ph.D. in rheumatology from the University of Adelaide in 2004. She currently works as a researcher for the Nordic Cochrane Centre.