15 April, 2026
Edition: Food, Sugar & Industry
Vol 2, Edition 8
How the Sugar Industry Paid Harvard to Blame Fat for Heart Disease
In 1967, the New England Journal of Medicine published a landmark review concluding that fat and cholesterol caused heart disease — and that sugar was not the problem. Internal documents revealed fifty years later that the sugar industry secretly paid the scientists who wrote it.
Published By: MAP30 Challenge | Authored By: John Shaw
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There is a document sitting in a university archive in San Francisco. It is a letter, dated 1966, written by Dr. D. Mark Hegsted — a nutrition professor at Harvard's School of Public Health. In it, Hegsted writes to his contact at the Sugar Research Foundation, the trade organization representing the American sugar industry, about a problem that has arisen in the review he is writing.
A new set of studies from an Iowa research group had just been published — studies that linked sugar consumption to heart disease risk. Hegsted writes that this will require revising a section of the review. Not to incorporate the new evidence fairly. To rebut it.
The word is worth sitting with. Not re-examine. Not reconsider. Rebuttal. The Harvard professor writing a supposedly independent scientific review for the New England Journal of Medicine was describing, in writing, the adversarial relationship he had with evidence that didn't serve his funder's interests.
The Sugar Research Foundation never disclosed its financial support for the Harvard review when it was published in 1967. The journal did not require it. The payment — approximately $6,500 at the time, roughly $50,000 in today's terms — was invisible to the scientific community, to policymakers, and to the public for nearly fifty years.
This is the story of how that happened. And why it still matters.
"Every time the Iowa group publishes a paper we have to rework a section in rebuttal."
— Dr. D. Mark Hegsted, Harvard School of Public Health, letter to the Sugar Research Foundation, 1966
The Setting: A Scientific Debate the Sugar Industry Needed to Win
To understand what the sugar industry did in the 1960s, you have to understand what it was afraid of. So let me take you back to the early 1950s, where a genuine scientific debate had emerged about the primary dietary cause of coronary heart disease — the leading cause of death in the United States.
One camp, championed most prominently by physiologist Ancel Keys, held that dietary fat — specifically saturated fat — raised blood cholesterol and caused heart disease. Another camp, led by British physiologist John Yudkin, held that the primary dietary culprit was sugar — specifically sucrose and its fructose component — which raised triglycerides and drove the metabolic conditions associated with heart disease
I would strongly recommend reading John Yudkin’s book, or audio book (which is what I have), called “Pure White And Deadly.”
Both hypotheses were plausible. Both had supporting evidence. The science was genuinely contested. And that contested state was precisely the problem for the sugar industry. In 1954, an internal sugar trade association document noted something remarkably candid: if Americans adopted low-fat diets, per-capita sugar consumption could increase by more than one-third. A fat-blaming narrative was not merely scientifically possible — it was financially advantageous.
By the early 1960s, evidence linking sugar intake to elevated blood cholesterol and triglycerides was growing in both the scientific literature and the popular press. Yudkin's work was receiving attention. The industry needed to respond before the scientific debate resolved in the wrong direction. In 1964, a man named John Hickson gave them the strategy.
The 1964 Memo: A Plan to Refute the Detractors
John Hickson was the vice president and director of research at the Sugar Research Foundation — the trade organization representing approximately thirty international sugar producers and refiners. In 1964, he circulated an internal memo that would later become the clearest documentary evidence of the industry's deliberate strategy.
Hickson proposed what he called a major program to counter what he described as negative attitudes towards sugar. The objective, stated plainly in the internal document, was to refute our detractors. Not to engage with their science. Not to fund research that might clarify the question. To refute.
The plan was systematic: identify the scientists producing the most credible evidence against sugar, fund research specifically designed to counter their findings, and place that funded research in the most prestigious journals available — giving industry-directed conclusions the imprimatur of independent scientific authority. It was a public relations strategy built into the architecture of scientific publication.
Hickson's first move was to recruit Fredrick Stare — the founding chair of Harvard's Department of Nutrition — onto the Sugar Research Foundation's scientific advisory board. Stare's name and institutional affiliation were valuable currency. From there, Hickson approached two of Stare's colleagues for the most important project in the plan.
$6,500
paid to Harvard scientists for Project 226 — equivalent to approximately $50,000 today. The payment was not disclosed in the 1967 NEJM review.
Kearns CE, Schmidt LA, Glantz SA — JAMA Internal Medicine, 2016
Project 226: Harvard Takes the Industry's Money
In 1965, the Sugar Research Foundation approved what it internally called Project 226 — a commission to Harvard School of Public Health nutrition researchers to produce a literature review on diet and coronary heart disease for the New England Journal of Medicine. The Harvard scientists who would write it were Dr. D. Mark Hegsted and Dr. Robert McGandy — both researchers in Stare's department.
What the academic community would later learn, through years of archival research by a UCSF dental researcher named Cristin Kearns, is that this was not a grant in the traditional sense. The Sugar Research Foundation did not simply provide funding and step back. It set the review's objectives. It provided the Harvard scientists with a specific list of studies to be addressed — including studies it described as ones it was really not happy with. It received drafts of the manuscript.
Hegsted's 1966 letter about reworking sections in rebuttal is the most explicit documentation of how the arrangement worked in practice. But it was consistent with the broader picture the documents revealed: a funder directing the content of supposedly independent scientific work, with the specific goal of producing conclusions that would protect the industry from regulatory and public health scrutiny.
"As the saying goes, he who pays the piper calls the tune."
— Dr. Stanton Glantz, senior author, JAMA Internal Medicine, 2016
The 1967 Review: What It Said and What It Concealed
In 1967, the New England Journal of Medicine published Hegsted and McGandy's literature review on diet and coronary heart disease in two parts. The review was authoritative in tone, comprehensive in scope, and influential in effect. Its central conclusion was stated with confidence: there was, the authors wrote, no doubt that the only necessary dietary interventions for preventing coronary heart disease were to reduce dietary cholesterol and replace saturated fat with polyunsaturated fat.
The treatment of the sugar evidence in the review was correspondingly dismissive. Studies linking sucrose to heart disease risk were criticized sharply and at length. Studies investigating dietary fats received far more favorable scrutiny. The review's methodology was not balanced — it was adversarial toward one hypothesis and accommodating toward the other. That asymmetry was not accidental. It was the product of direction from the funder.
What the review did not mention: the Sugar Research Foundation had commissioned it, funded it, provided its source material, reviewed its drafts, and had a direct financial interest in its conclusions. To readers — scientists, physicians, policymakers — the review appeared to be exactly what it claimed to be: an independent, authoritative synthesis of the best available evidence. It was not.
The Sugar Industry's Secret Campaign: 1954–2016
The Sugar Industry's Secret Campaign: 1954–2016
From internal strategy memo to Harvard payoff to fifty years of buried documents
Industry recognizes the commercial opportunity
Internal documents note that if Americans adopt low-fat diets, per-capita sucrose consumption could increase by more than one-third. The industry's financial interest in promoting a fat-blaming narrative becomes explicit.
Hickson memo: "Refute our detractors"
SRF VP John Hickson writes an internal memo proposing a major program to counter negative attitudes towards sugar — framing the goal as refuting critics rather than evaluating science. The strategy is set.
Project 226 — Harvard scientists hired
SRF commissions Harvard researchers Hegsted and McGandy to write an NEJM literature review. Payment: $6,500 (≈$50,000 today). SRF sets objectives, provides studies, and receives drafts. The Sugar Research Foundation is directing the research, not just funding it.
Hegsted writes the rebuttal letter
Hegsted writes to SRF: every time the Iowa group publishes new sugar-critical findings, he has to rework a section "in rebuttal." A Harvard professor is writing adversarially on behalf of the industry paying him.
NEJM publishes the review — no disclosure
The review concludes there is "no doubt" that fat and cholesterol cause heart disease — and that sugar is not a meaningful risk factor. SRF's funding and editorial role are not disclosed. The world reads it as independent science.
Federal guidelines tell America to avoid fat
McGovern Committee dietary guidelines — shaped by the consensus the 1967 review helped create — tell Americans to reduce fat and eat more carbohydrates. Hegsted himself helps develop these guidelines at the USDA. His industry work was unknown.
Low-fat era — fat replaced with sugar
The food industry removes fat from products and replaces it with refined carbohydrates and added sugars. Americans eat more sugar than ever while following advice shaped by an industry with a financial interest in the outcome. The obesity and metabolic disease epidemics accelerate.
UCSF researchers find the documents
Cristin Kearns, Stanton Glantz, and Laura Schmidt publish their analysis of 340 internal SRF documents (1,582 pages) in JAMA Internal Medicine. Project 226, the Harvard payments, and fifty years of editorial influence finally become public.
Fifty Years of Hidden Documents
The 1967 NEJM review was not a secret. It was a published, peer-reviewed, widely cited academic paper. What was secret — buried in industry archives for decades — was everything that had happened before it was published.
Cristin Kearns was a dental researcher at UCSF who had become interested in the sugar industry's historical influence on public health research. In 2012, while reviewing archives at the University of Illinois, she discovered a collection of internal Sugar Research Foundation documents. Working with UCSF colleagues Stanton Glantz and Laura Schmidt, she spent years analyzing more than 340 internal industry documents — 1,582 pages of correspondence, memos, contracts, and reports — that documented the SRF's relationship with Harvard scientists in unprecedented detail.
The picture that emerged was systematic rather than episodic. The 1967 NEJM review was not an isolated instance of industry influence. It was the centerpiece of a broader pattern in which the sugar industry sponsored research programs through the 1960s and 1970s specifically designed to cast doubt on sugar's role in heart disease while amplifying the case against dietary fat. The documents showed an industry that was not merely funding nutrition research — it was commissioning, directing, and shaping it toward predetermined conclusions.
Kearns, Schmidt, and Glantz published their analysis in JAMA Internal Medicine in 2016, concluding that the Sugar Research Foundation had sponsored research that successfully cast doubt on the hazards of sucrose while promoting dietary fat as the main culprit in coronary heart disease — and that the industry's undisclosed role in the 1967 NEJM review had rendered its provenance, in their words, very misleading. (Kearns CE, Schmidt LA, Glantz SA — JAMA Internal Medicine, 2016)
The Consequences: Fifty Years of Misdirected Dietary Policy
The question of what the sugar industry's campaign actually cost in terms of public health is impossible to answer with precision. I truly believe, however, that this is one of the most consequential episodes of scientific manipulation in modern history — and that its downstream effects on the health of millions of people deserve to be named plainly rather than hedged into abstraction.
The dietary fat hypothesis that the Harvard review helped cement became the foundation of American nutritional policy. The 1977 McGovern Committee dietary guidelines — the first federal dietary guidelines — told Americans to reduce fat consumption and increase carbohydrates. As covered in the Food Pyramid article in this library, the food industry responded by removing fat from products and replacing it with refined carbohydrates and added sugars. Low-fat everything flooded the market. Americans ate more sugar than at any point in history while believing they were eating healthier.
D. Mark Hegsted — the Harvard scientist who had been reworking sections in rebuttal on behalf of the sugar industry — went on to become the lead nutritionist at the USDA who helped develop those 1977 dietary guidelines. His undisclosed industry work was not publicly known while he held that position.
The obesity epidemic, the diabetes epidemic, the metabolic syndrome epidemic — all of them accelerated through the precise decades during which Americans were following guidance that had been shaped, at its origin, by an industry with a financial interest in the outcome. The connection is not a conspiracy theory. It is a documented historical sequence
The Parallels to the Tobacco Industry Playbook:
Cultivating apparently independent academics whose credibility lent authority to industry-friendly conclusions
Funding research specifically designed to counter unfavorable findings rather than advance scientific understanding
Using financial relationships that were not publicly disclosed, allowing industry-directed research to appear independent
Targeting the most credible critics and producing research specifically designed to rebut them
Shaping which evidence appeared authoritative through editorial influence and selective citation
What the Science Actually Shows — Now That We Know
When I first went deep into this history — the memos, the payments, the letters, the suppressed trials — it reframed everything I thought I understood about why people eat the way they eat. We didn't arrive at a high-sugar, low-fat dietary culture by accident. We were guided there by advice that had been shaped by people with a financial interest in the guidance. Understanding that was part of what drove me to build MAP30 around a fundamentally different set of principles.
I want to be clear about what the science does and does not show. The 1967 Harvard review's conclusions have not simply been reversed — the relationship between diet and cardiovascular disease is genuinely complex, and any honest account of it has to acknowledge that complexity. What has changed is that the dismissal of sugar as a cardiovascular risk factor — the central project of Project 226 — has not held up.
Fructose (which I write about in depth) — the component of sucrose that the liver processes almost exclusively — drives de novo lipogenesis: the conversion of dietary sugar directly to liver fat. It raises triglycerides. It promotes non-alcoholic fatty liver disease. It drives hepatic insulin resistance. These are all documented mechanisms for cardiovascular risk that the 1967 review minimized by focusing narrowly on blood cholesterol as the only meaningful biomarker. The mechanisms Yudkin was describing in the 1960s, which Hegsted was working to rebut on behalf of his funder, have been validated by decades of subsequent research.
The diet-heart hypothesis — the idea that saturated fat raises LDL and LDL causes heart disease — has proven far more complicated than the 1967 review suggested. The Minnesota Coronary Experiment, a rigorous randomized trial whose results were similarly suppressed for decades, found that lowering cholesterol with vegetable oils did not reduce cardiovascular mortality. As covered in the Seed Oils article in this library, the evidence that fat-blaming dietary guidance improved cardiovascular outcomes has proven thin.
What has held up — with growing rather than diminishing evidence — is the connection between excess added sugar consumption, insulin resistance, metabolic syndrome, and cardiovascular risk. The science the sugar industry paid to suppress has been repeatedly confirmed. The science it paid to amplify has proven more fragile than the guidelines it produced ever acknowledged.
There is now a considerable body of evidence linking added sugars to hypertension and cardiovascular disease, yet health policy documents are still inconsistent in their guidance on sugar consumption.
The dietary guidelines have evolved since 1967. The science has evolved. The sugar industry's methods have been documented and exposed. But the cultural legacy of fifty years of fat-blaming nutritional guidance — the fear of butter, the trust in vegetable oil, the belief that a low-fat label means a healthy product — persists in the habits and assumptions of people who were never told how that guidance was originally manufactured. The first step toward changing how you eat is understanding why you believed what you believed about food in the first place.
This article is part of our Food, Sugar & Industry series. Food, Sugar & Industry
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John Shaw
MAP30 Challenge
John Shaw is a Certified Nutrition Educator and the founder of the MAP30 Challenge. What began as a personal health journey at 294 pounds, and pre-diabetic, evolved into a structured 30-day metabolic reset program grounded in nutritional science. John's mission is simple: give people the biological education that the diet industry never did.
FAQ's
1. Did the sugar industry really pay Harvard to blame fat for heart disease?
Yes — and this is fully documented. In 2016, UCSF researchers Cristin Kearns, Laura Schmidt, and Stanton Glantz published an analysis in JAMA Internal Medicine based on more than 340 internal Sugar Research Foundation documents. The documents showed the SRF paid Harvard nutrition researchers approximately $6,500 in the 1960s — roughly $50,000 today — to write an NEJM review concluding fat caused heart disease and that sugar was not a risk factor. The payment was never disclosed in the published review.
2. Who were the Harvard scientists involved?
The primary researchers were Dr. D. Mark Hegsted and Dr. Robert McGandy, both at Harvard's School of Public Health. Dr. Fredrick Stare, the founding chair of Harvard's nutrition department, served on the Sugar Research Foundation's advisory board and facilitated the arrangement. Hegsted later helped develop the 1977 federal dietary guidelines at the USDA — while his undisclosed industry work remained unknown.
3. What was Project 226?
Project 226 was the internal name the Sugar Research Foundation gave to its commission of the Harvard literature review on diet and coronary heart disease, initiated in 1965. The SRF set the project's objectives, provided specific studies for inclusion — including ones it was really not happy with — and received drafts. The resulting two-part review was published in the NEJM in 1967 without disclosing the industry's role.
4. What was the dark history of the sugar industry and science?
The 1967 Harvard NEJM review was the most documented episode, but not the only one. The UCSF analysis found a broader pattern through the 1960s and 1970s in which the sugar industry sponsored research specifically designed to cast doubt on sugar's role in cardiovascular disease while amplifying concerns about dietary fat. The strategy closely paralleled the tobacco industry's decades-long campaign to manufacture scientific uncertainty about smoking's health effects.
5. How did this affect dietary guidelines?
The dietary fat narrative the 1967 NEJM review helped cement became the scientific foundation for the 1977 McGovern Committee dietary guidelines — the first federal dietary guidelines. Those guidelines told Americans to reduce fat and increase carbohydrates. The food industry replaced fat with refined carbohydrates and added sugars. D. Mark Hegsted — the Harvard scientist funded by the sugar industry — later became the lead nutritionist at the USDA who helped write those guidelines.
6. Is the sugar industry still influencing nutrition research?
The specific undisclosed payment arrangements documented by the UCSF researchers were products of a 1960s regulatory environment in which conflict-of-interest disclosure was not required. Disclosure requirements have since improved. But the broader practice of industry funding for nutrition research — with the selection biases and framing effects that accompany it — remains an active concern in nutrition science. The 2016 UCSF paper prompted renewed debate about how industry-funded research should be disclosed and weighted in dietary guideline development.
Sources
Kearns CE, Schmidt LA, Glantz SA — 'Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents' (JAMA Internal Medicine, 2016) — https://pubmed.ncbi.nlm.nih.gov/27617709/
Nestle M — 'Food industry funding of nutrition research: the relevance of history for current debates' (JAMA Internal Medicine, 2016) — https://doi.org/10.1001/jamainternmed.2015.6633
PBS NewsHour — 'How the sugar industry artificially sweetened Harvard research' (September 12, 2016)
UCSF News — 'Sugar Papers Reveal Industry Role in Shifting National Heart Disease Focus' (September 11, 2016) — https://www.ucsf.edu/news/2016/09/403961
NPR — '50 Years Ago, Sugar Industry Quietly Paid Scientists To Point Blame At Fat' (September 12, 2016)
University of California — 'Sugar's sick secrets: How industry forces have manipulated science to downplay harm' (January 9, 2019)
Harvard Law School — 'Sugar stands accused' (Harvard Law Today, November 12, 2023) — https://hls.harvard.edu/today/sugar-stands-accused/
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