In a past blog of mine (Partnership Between Family Physicians and Coca-Cola Poses Ethical Problem) I wrote, “What does my national academy of family physicians, the AAFP (American Academy of Family Physicians), and Coca-Cola have in common? The common sense answer should be, ‘Nothing.’ The actual answer is, ‘$500,000.’ Ouch!”
Now, the family medicine professor I featured in the previous blog has written the following to me. I’d be interested in your take, dear reader, on this issue:

Dear Walt,

As a fellow family physician, I am sure you know about the AAFP’s decision to accept money from Coca Cola to develop “health education materials” regarding beverages, hydration and sweeteners on familydoctor.org.

True to their word, they have done this. What disturbs me most, now, is that the AAFP has allowed Coke to post (an article) The Lowdown about Low Calorie Sweeteners.

This biased monograph does not address the fact that low-calorie beverages, although they may not contribute as much to obesity or tooth decay, nonetheless fill up the stomach, displacing milk and healthier foods in the diet.

There are additional concerns that hyperintensely sweeteners (1000x sweeter than sugar) may alter children’s palates to favor extremely sweet tastes over less sweet (fruit) or unsweet (vegetable) foods.

Thus, even if sweeteners are weight neutral – o  even if they promote modest weight loss – o er the long term they may contribute to poor dietary intake.

(Another) interesting factoid is that in rats, saccharine has been shown to be preferred over cocaine even among cocaine addicted rats.

Finally, the monograph is not evidence based, does not include search items; study design evaluation; strength of evidence; or stength of recommendaiton.

Since the AAFP’s own journal (AFP, for which you used to write) now requires this approach in review articles, it borders on shady ethics to for the AAFP to paid off, essentially, to bypass their own standards

Anyway, you can spread these ideas far and wide. Public shame might have a slim chance of working.

Sincerely,

John Spangler, MD, MPH

Professor of Family Medicine

Wake Forest University School of Medicine