Harvard Scientists Were Paid to Blame Fat for Heart Disease. The Documents Are in JAMA.
In 2016, JAMA Internal Medicine published the results of an investigation into internal Sugar Research Foundation documents showing that the industry paid three Harvard scientists $6,500 to produce a literature review concluding that dietary fat, not sugar, was the primary dietary driver of cardiovascular disease. The investigators were Cristin Kearns, Stanton Glantz, and Laura Schmidt at the University of California, San Francisco. The funding was not disclosed in the published paper. The NEJM did not require funding disclosure in 1967. The Sugar Research Foundation timed the project to exploit that gap.
The lead author of that literature review, D. Mark Hegsted, subsequently became the administrator of the USDA Human Nutrition Center and helped write the 1977 Dietary Goals for the United States and the 1980 Dietary Guidelines for Americans. Both told Americans to reduce saturated fat and replace it with carbohydrates. The food industry replaced dietary fat in processed products with sugar, corn syrup, and refined starch. American obesity rates began their sustained rise in 1980.
The JAMA Documents and What They Showed
The Sugar Research Foundation identified a research problem in 1964. John Yudkin at Queen Elizabeth College in London had been publishing work implicating sugar, specifically sucrose and fructose, as a primary dietary contributor to cardiovascular disease. His research was gaining traction in academic circles. The SRF needed to counter it.
Internal SRF documents examined by Kearns and colleagues showed the industry's approach. The SRF proposed Project 226: commission a comprehensive literature review of dietary research on fat, cholesterol, and heart disease. The review would be written by credentialed academic researchers. The industry would select the research question, guide the framing, review drafts before publication, and use the resulting paper to refute the sugar hypothesis.
The SRF's project director, John Hickson, described the objective in internal communications: the review needed to "refute" Yudkin's sugar research and build the scientific case for dietary fat as the cardiovascular culprit. Internal correspondence shows Hickson communicating with the Harvard researchers about framing and draft content before submission to the NEJM. The final paper cited research selectively: studies supporting fat as the driver were emphasized, and sugar research was minimized or dismissed.
The paper was published without any disclosure of the SRF's funding or involvement. The NEJM subsequently required funding disclosure, but the 1967 paper had already been cited hundreds of times and had helped establish the dietary fat hypothesis as scientific consensus before that requirement took effect.
What the JAMA 2016 analysis established: this was not a case of researchers with industry affiliations reaching independent conclusions. The project was conceived by the industry to produce a specific conclusion. The conclusion was produced to specification.
(Evidence level: 5. The JAMA paper analyzes the SRF's own internal documents. The relationship between those documents and the published NEJM paper is direct and traceable. Kearns and Glantz previously applied the same archival analysis methodology to tobacco industry documents, establishing the investigative framework.)
The Harvard Researchers and What They Published
The three researchers the SRF hired: D. Mark Hegsted, professor of nutrition at Harvard School of Public Health. Robert McGandy, also at Harvard. Fredrick Stare, chairman of the Harvard Department of Nutrition.
Their paper: "Dietary fats, carbohydrates and atherosclerotic vascular disease," was published in two parts in the New England Journal of Medicine on August 3 and 10, 1967. A literature review covering existing research on dietary fat, cholesterol, and heart disease.
The conclusions: saturated fat and dietary cholesterol were the primary dietary drivers of cardiovascular disease. Sugar's potential role was assessed as weak. Research raising concerns about sugar, specifically Yudkin's, was characterized as methodologically inadequate. The paper's framing positioned fat as the settled dietary villain and sugar as a secondary question that did not warrant further concern.
The payment: $6,500 total to the three researchers. Approximately $50,000 in 2016 dollars. The SRF's internal documents show the project was managed as a contracted deliverable, not an independent research grant. The industry reviewed and communicated about draft content. The researchers delivered a conclusion consistent with what the industry needed.
No funding source was disclosed in the published paper. When the Kearns analysis was published in JAMA Internal Medicine in 2016, the NEJM editor at the time, Dr. Jeffrey Drazen, added a note acknowledging the revelations but also noting that the NEJM's conflict-of-interest policy at the time of the 1967 publication did not require the disclosure of the SRF, and the researchers had chosen to omit it.
(Evidence level: 5. All facts documented in the JAMA 2016 paper from primary SRF documents.)
What Hegsted Did After: The 1977 Dietary Guidelines
Hegsted's career after the 1967 NEJM review shows how industry-shaped research moves into policy.
Hegsted was appointed administrator of the USDA Human Nutrition Center, one of the federal agencies responsible for translating nutritional research into public guidance. In 1977, the Senate Select Committee on Nutrition and Human Needs, chaired by Senator George McGovern, issued "Dietary Goals for the United States," the first federal document to set specific numerical targets for Americans' dietary intake of fat, saturated fat, cholesterol, and carbohydrate. Hegsted was a primary scientific advisor to the committee. The report recommended that Americans reduce fat to 30% of total calories, specifically saturated fat, while increasing carbohydrate intake to 55-60% of total calories.
The 1980 Dietary Guidelines for Americans, the first edition of the biennial federal dietary guidelines published jointly by USDA and HHS, reinforced this direction. Hegsted contributed to that document as well. The guidelines that shaped school lunch programs, SNAP food assistance, military nutrition, and public health campaigns over the following four decades were built on a research framework whose foundation included a study funded by the sugar industry to produce a specific conclusion.
The researcher who produced that conclusion became the federal official who codified it into national policy.
(Evidence level: 4. Hegsted's role in the dietary guidelines is historically documented. His 1967 NEJM paper's influence on the scientific consensus that preceded the guidelines is documented. The full causal chain involves additional researchers and political factors, but Hegsted's presence in both the original research and the guideline development is a matter of record.)
Project 259: The Study of the SRF Terminated
Kearns, Apollonio, and Glantz published a second analysis in PLOS Biology in 2017 documenting a different form of industry research management.
The Sugar Research Foundation funded Project 259, an animal study at the University of Birmingham that examined the relationship between sucrose consumption, blood lipid levels, and carcinogenicity in germ-free rats. The study compared rats fed sucrose versus starch as their primary carbohydrate source and tracked blood lipids and tissue changes over time.
When the preliminary findings began showing that sucrose-fed rats had elevated triglycerides and evidence of bladder cancer, the SRF terminated the study's funding. The research was stopped. The results were never published. The PLOS Biology paper documents this sequence using the SRF's internal records: the timing of termination relative to the findings, the communication between the SRF and the researchers, and the preliminary data available at the time of termination.
The 1967 NEJM paper involved funding research to produce a favorable conclusion. Project 259 involved stopping research that was yielding unfavorable results. Together, they document a systematic approach to controlling what the scientific record would contain: commission research heading in the right direction, terminate research heading in the wrong direction.
This pattern is not unique to the sugar industry. It is the same pattern Stanton Glantz documented in tobacco industry documents. The same investigator applied the same methodology to a different industry and found the same behavior.
(Evidence level: 5 for the documented termination of Project 259 using the SRF's own internal records. The PLOS Biology paper is the primary source.)
The Low-Fat Era and What It Produced
When the 1977 and 1980 dietary guidelines told Americans to reduce dietary fat, the food industry reformulated its products accordingly. Fat was removed. Something had to replace it to maintain palatability, texture, and shelf life. That something was sugar, high-fructose corn syrup, modified food starch, and industrial additives.
Fat-free salad dressing replaced oil with corn syrup and modified starch. Low-fat yogurt replaced milk fat with sugar and artificial flavors. Reduced-fat crackers replaced fat with refined wheat flour and additional carbohydrates. Fat-free cookies were reformulated to match the caloric density of the originals while removing the fat that had contributed to satiety. Snackwell's Devil's Food Cookie Cakes became a symbol of the era: a fat-free product that Americans consumed in large quantities because it was labeled healthy, with no meaningful reduction in caloric intake.
American per capita sugar consumption increased during the low-fat era. The USDA food availability data show that sugar and sweetener availability rose through the 1980s and 1990s. The obesity rate, which had been relatively stable for decades, began rising in 1980, the year the first dietary guidelines were published, and continued during the period when compliance with the low-fat recommendation was highest.
The dietary fat hypothesis had predicted that reducing fat intake would reduce cardiovascular disease and obesity. Neither outcome materialized at the population level during the low-fat era. The independent research that would explain why was buried.
(Evidence level: 4 for the food supply shift toward low-fat products with increased sugar content, documented by USDA food availability data and food composition records. Level 4 for the correlation between guideline implementation and obesity rate trends. documented in CDC surveillance data. Correlation does not establish causation, but the timing is documented, and the mechanism is consistent with the recovered trial data below.)
The Buried Controlled Trials
Two large controlled trials conducted during the period when the fat-heart hypothesis was being established produced results that contradicted it. Both were not published in full by the original investigators. Both were recovered from archives by NIH researchers and published in the BMJ decades later.
The Sydney Diet Heart Study randomized Australian men recovering from heart attacks to replace saturated fat with safflower oil (a polyunsaturated vegetable oil). The intervention group replaced animal fats with the seed oil. The cholesterol levels of the intervention group dropped as predicted. Cardiovascular and all-cause mortality increased in the intervention group compared to controls. The group instructed to replace saturated fat with vegetable oil died at a higher rate.
The original investigators did not publish the full results. Christopher Ramsden at the National Institute on Aging, part of the NIH, and colleagues recovered the raw data from archives and published the re-analysis in the BMJ in 2013.
The Minnesota Coronary Experiment, run from 1968 to 1973 with more than 9,000 participants in institutional settings, randomized participants to replace saturated fat with vegetable oil. Cholesterol levels dropped in the intervention group. Cardiovascular mortality increased compared to controls. The full data were not published by the original investigators, one of whom was a colleague of Ancel Keys, the researcher most associated with the dietary fat-heart disease hypothesis.
Ramsden and colleagues recovered the Minnesota data from the garage of a deceased investigator's son and published the re-analysis in the BMJ in 2016. The recovery was funded by the NIH. No funding from the food or pharmaceutical industry was involved.
Both recovered trials pointed in the same direction: replacing saturated fat with polyunsaturated vegetable oil lowered cholesterol but did not reduce cardiovascular mortality, and in some analyses, increased it. Both findings had been available to the researchers who produced them. Neither had been published.
(Evidence level: 4 for the recovered trial findings. Large controlled trials with direct outcome measurement. The limitation is selective non-publication by the original investigators, which Ramsden's recovery and re-analysis directly addresses.)
Follow the Funding
The Sugar Research Foundation funded research to produce the fat-blame conclusion in 1967. It funded and then terminated the 1970 animal study that implicated sugar. The researcher whose industry-funded literature review helped establish the fat-blame consensus wrote the federal dietary guidelines in 1977 and 1980. The food industry reformulated products to replace fat with sugar, producing a more profitable processed food supply sold under the "healthy" low-fat label.
The seed oil industry benefited from the dietary shift toward vegetable oils. The Sugar Association (the SRF's current name) continues to fund research and lobby against sugar regulation. The controlled trials showing vegetable oil replacement increased cardiovascular mortality were not published by researchers who were participants in the scientific culture that had built its consensus on the fat-blame hypothesis.
The researchers who recovered the buried trials, Ramsden at the NIH's National Institute on Aging, had no food industry funding. The researchers who initially produced the conflicting data and then failed to publish it were participants in a scientific environment shaped by decades of industry-funded research.
Stanton Glantz, who co-led the sugar industry document analysis, is the same researcher who exposed the tobacco industry's internal documents showing it had manipulated research to conceal the harms of smoking. The methodology is the same. The behavior documented is the same. The industry is different.
What Is Proven, Plausible, and Unknown
Proven (Level 4-5 evidence):
The Sugar Research Foundation paid three Harvard scientists $6,500 in 1967 to produce a literature review that blamed dietary fat for heart disease, without disclosing the funding (Level 5. JAMA Internal Medicine 2016 primary document analysis). D. Mark Hegsted participated in writing the 1977 Dietary Goals and the 1980 Dietary Guidelines for Americans (Level 5. Federal records). The SRF terminated Project 259 before its results linking sucrose to bladder cancer and microbiome disruption could be published (Level 5. PLOS Biology 2017 primary document analysis). The Sydney Diet Heart Study recovered data showed that replacing saturated fat with safflower oil increased cardiovascular and all-cause mortality (Level 4; BMJ 2013; large controlled trial). The Minnesota Coronary Experiment recovered data showed replacing saturated fat with vegetable oil increased cardiovascular mortality despite lowering cholesterol (Level 4. BMJ 2016, large controlled trial). American per capita sugar consumption increased, and obesity rates rose during the low-fat era following the 1980 guidelines (Level 4. USDA food availability data, CDC obesity surveillance).
Plausible: consistent evidence direction, full causal attribution complex (Level 2-3):
The 40-year low-fat dietary guideline, built substantially on industry-funded research, worsened American metabolic and cardiovascular health by redirecting the food supply toward sugar and refined carbohydrates rather than reducing dietary fat from whole food sources (Level 3. Consistent direction across recovered trials, epidemiological cohort data, and Mediterranean diet research; full causal attribution involves multiple variables). Saturated fat from whole food sources does not drive cardiovascular disease at the rate the guidelines predicted, and the independent evidence supporting that conclusion was suppressed, buried, or never funded in the first place (Level 3. Consistent with recovered trials and observational data on traditional dietary fat consumption in low-cardiovascular-disease populations).
Unknown (Level 1-2):
The total count and scale of industry-funded research interventions in dietary science have not yet been recovered through archival analysis similar to what Kearns and Ramsden conducted. The counterfactual cardiovascular mortality trajectory if the guidelines had followed Yudkin's sugar evidence rather than the industry-funded fat-blame evidence.
The Risk/Reward Verdict
ATH Verdict: Safer Alternative Exists
The safer alternative to fat-free processed food products is the whole food fats they replaced: butter, ghee, tallow, and lard from quality animal sources; cold-pressed olive oil; and coconut oil. The evidence for these whole-food fats from the recovered controlled trials, the Mediterranean diet research (PREDIMED), and observational data on traditional populations does not support the recommended avoidance guidelines. The fat-free products that replaced them were built on a fraudulent research foundation, were filled with fat-removal products containing sugar and industrial additives, and contributed to the metabolic trajectory documented above.
What To Do Today
Replace fat-free and low-fat processed products with whole-food originals.
Butter instead of margarine, vegetable oil spreads, or fat-free butter alternatives. Butter from grass-fed animals provides conjugated linoleic acid and fat-soluble vitamins A, D, E, and K2 that industrially produced alternatives do not. Full-fat yogurt with no added ingredients instead of low-fat flavored yogurt. The full-fat version has fewer ingredients, no added sugar, and provides the fat-soluble vitamins present in whole dairy. Whole eggs instead of egg whites or egg substitutes. The yolk is where the nutrition is: choline, lutein, vitamins D and B12, and the fat that slows glucose absorption from the meal.
Read ingredient labels on any product marketed as "fat-free," "reduced fat," or "low fat." If the fat has been replaced by sugar, corn syrup, modified food starch, or a long list of additives, the reformulated product is worse than the original. The low-fat label is not a health claim backed by independent evidence. It is the legacy of a dietary guideline built on industry-funded research.
For cooking, olive oil, butter, coconut oil, tallow, and lard are stable, whole-food options. The industrial seed oils (soybean, corn, canola, cottonseed, sunflower) are produced through industrial extraction and are covered in detail in article #43 on seed oils and the AHA funding trail.
Whole food fats from verified sources in the ATH Food and Pantry collection meet the standard that independent evidence supports.
Go Verify
Read the JAMA Internal Medicine 2016 paper directly. Search "Kearns Schmidt Glantz sugar industry coronary heart disease JAMA 2016." It is publicly available. Read the section documenting communication between the SRF's John Hickson and the Harvard researchers before publication. Note the specific language Hickson used about what the review needed to accomplish.
Read the BMJ 2016 paper on the Minnesota Coronary Experiment. Search "Ramsden Minnesota Coronary Experiment BMJ 2016." Note that the data was found in the garage of a deceased investigator's son. Calculate the gap between when the trial ended (1973) and when the full data were published (2016).
Find the original 1967 McGandy, Hegsted, and Stare paper in the NEJM. Compare its conclusions with what Kearns documented in the 2016 JAMA paper. Then read the NEJM editor's note that accompanied the 2016 revelation.
Read the 1977 Dietary Goals for the United States and the 1980 Dietary Guidelines for Americans. Both are publicly available as federal documents through the Government Publishing Office. Note the specific recommendations on fat and carbohydrate intake.
Ask your physician or a registered dietitian: given that the two largest controlled trials of fat reduction, Sydney and Minnesota, were recovered showing vegetable oil replacement increased cardiovascular mortality, and given that neither was published by the original investigators, what dietary fat guidance is currently based on independent rather than industry-funded evidence?
Sources and Citations
- Kearns CE, Schmidt LA, Glantz SA. "Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents." JAMA Internal Medicine. 2016;176(11):1680-1685.
- McGandy RB, Hegsted DM, Stare FJ. "Dietary fats, carbohydrates and atherosclerotic vascular disease." New England Journal of Medicine. 1967;277(4):186-192, 245-247.
- Kearns CE, Apollonio D, Glantz SA. "Sugar industry sponsorship of germ-free rodent studies linking sucrose to hyperlipidemia and cancer: An historical analysis of internal documents." PLOS Biology. 2017;15(11):e2003460.
- Ramsden CE, Zamora D, Leelarthaepin B, et al. "Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis." BMJ. 2013;346:e8707.
- Ramsden CE, Zamora D, Majchrzak-Hong S, et al. "Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73)." BMJ. 2016;353:i1246.
- Senate Select Committee on Nutrition and Human Needs. "Dietary Goals for the United States." US Government Printing Office. 1977.
- US Department of Agriculture and US Department of Health and Human Services. "Dietary Guidelines for Americans, 1980." First Edition. US Government Printing Office. 1980.
- Estruch R, Ros E, Salas-Salvado J, et al. (PREDIMED Study Investigators). "Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts." New England Journal of Medicine. 2018;378(25):e34.