Babies before business: protecting the integrity of health professionals from institutional conflict of interest

Becker, Genevieve; Ching, Constance; Nguyen, Tuan T; Cashin, Jennifer; Zambrano, Paul; Mathisen, Roger

doi:10.1136/bmjgh-2022-009640

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…The standards for evaluating COIs must be interpreted within a specific context and may have different meanings across cultures, countries, institutions, and at different time points [ 2 ]. A growing scrutiny of corporate practices has fostered calls to strengthen COI policies to prevent commercial influence on public policy, research, and practice [ 3 , 4 ]. In the United States, concerns have focused on how food and beverage firms influence nutrition research and create research biases that skew funding toward industry benefits [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the United States, concerns have focused on how food and beverage firms influence nutrition research and create research biases that skew funding toward industry benefits [ 5 ]. Defining and describing the COI context accurately is essential given the variation across institutions and professional activities [ [1] , [2] , [3] , [4] , [5] ].…”

Section: Introductionmentioning

confidence: 99%

“…Medical, nutrition, and public health practitioners could take proactive actions by adhering to the ethical codes of conduct required by professional societies to maintain their credentials [ [15] , [16] , [17] , [18] ]. Government agencies and academic settings could also strengthen institutional COI policies and procedures and enhance transparency to protect the policymaking process from undue commercial influence that may undermine the diets and health of populations [ [1] , [2] , [3] , [4] , [5] ].…”

Section: Introductionmentioning

confidence: 99%

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Perspective: Examining Conflicts of Interest for Professional Service within the 2020 Dietary Guidelines Advisory Committee

Kraak¹

2023

Advances in Nutrition

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perspective: Examining Conflicts of Interest for Professional Service within the 2020 Dietary Guidelines Advisory Committee

Kraak¹

2023

Advances in Nutrition

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“…Some health workers still viewed CMF marketing as relatively benign and welcomed research partnerships with CMF companies, despite evidence that consistently shows that these practices influence the feeding advice given to mothers, leading to negative breastfeeding outcomes (Doherty et al, 2022 ; Hernandez‐Cordero et al, 2022 ; Piwoz & Huffman, 2015 ; Rosenberg et al, 2008 ; Rothstein et al, 2021 ; Sobel et al, 2011 ). Health workers may hold the belief that partnering with the CMF industries does not create a conflict of interest as long as their professional judgement is not compromised, or may prioritise the benefits of collaboration as sponsorships for research collaborations are the most common offer for health professionals by CMF industries (Genevieve Ellen et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Commercial milk formula marketing following increased restrictions in Singapore: A qualitative study

Topothai,

Tan,

van der Eijk

2023

Maternal & Child Nutrition

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The promotion of commercial milk formula (CMF) negatively impacts breastfeeding outcomes. In 2019, Singapore updated its 1979 Code of Ethics of the Sale of Infant Foods Ethics Committee Singapore (SIFECS) to increase marketing restrictions on CMF for infants 0–12 months. However, little is known about industry tactics to undermine these restrictions. This qualitative study explores health workers' and mothers' experiences with CMF marketing in Singapore following the 2019 restrictions. We conducted a qualitative study, using semistructured interviews with 14 mothers of infants aged less than 5 months and 20 health workers with expertise in antenatal, maternity, or paediatric care. We analysed data thematically using inductive coding. Five themes were identified. Mothers and health workers reported digital marketing, product line extensions with toddlers' milk and milk for mothers, and CMF sponsorships in the healthcare setting. Expert endorsement, competitive price, nutritional claims, and brand reputation influenced mothers' infant formula choices, yet both mothers and health workers appeared to be unaware of the impact of CMF marketing tactics on their own perceptions. The restriction of CMF marketing and infant feeding practices varied widely between hospitals, with private hospitals and practices having less strict controls on CMF marketing. Despite the updated SIFECS restrictions, CMF companies continue to target mothers and health workers in Singapore. SIFECS restrictions should be tightened to align with international guidelines, by increasing their scope to include toddlers' milk and prohibiting cross‐promotion, digital marketing, and any sponsorships of events targeting health workers that may create a conflict of interest.

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“…Thus, a special investigation into the commercial determinants of maternal, infant, and young child health has been conducted (13,16). Investigating the corporate activities of the commercial actors specific to this context is pertinent to understand the corporate power that shapes first-food systems, fosters infant formula use and promotion, and jeopardizes breastfeeding on a global scale (8,13,15,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). Participation in decision-making processes is one of these corporate actions.…”

Section: Introductionmentioning

confidence: 99%

Baby food industry interference with infant feeding international regulation—A case study on the standard for follow-up formula

Silva

Castro

Carvalho

et al. 2022

Front. Public Health

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IntroductionGlobally, first-food systems have changed and breastfeeding has decreased due to the increased growth in commercial breast milk substitute (BMS) consumption, which includes both follow-up and toddler formulas. These products are manufactured by a small number of corporate leaders in international BMS sales. Discussions for global regulation of these products take place in the Codex Alimentarius and are permeated by the strong participation of these corporations in the Codex committees.ObjectiveIn the present study, the participation of the baby food industry in the review of the follow-up formula standard in the Codex Committee on Nutrition and Foods for Special Dietary Uses (CCNFSDU) was analyzed.MethodsThe analysis of the CCNFSDU documents was based on the period from 2009 to 2019 and used quantitative and qualitative approaches. Compositional and participation data from country delegations and observer organizations on the representative profiles of the involved institutions and the baby food industry's involvement in this process were established systematically.ResultsIn total, 134 out of the 189 Codex Alimentarius member countries engaged in the standard review process, of which 28% were involved in the entire process. The private sector was present in 81% of the most assiduous member state delegations to the meetings. Furthermore, ~60% of the observer organizations involved in the review process were business associations representing industry interests. Moreover, the International Special Dietary Foods Industries was the only business association with observer status in the CCNFSDU that was specifically dedicated to representing the baby food industryduring the review process.ConclusionThese research results expand the body of evidence confirming the expressive and disproportionate participation of baby food industries and their representatives in the discussion processes within the scope of the CCNFSDU. However, studies investigating the Codex and the public documents of its respective committees are limited. Thus, this was the first study to analyze the influence of the baby food industry on BMS global regulatory compliance.

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Babies before business: protecting the integrity of health professionals from institutional conflict of interest

Cited by 5 publications

References 16 publications

Perspective: Examining Conflicts of Interest for Professional Service within the 2020 Dietary Guidelines Advisory Committee

Perspective: Examining Conflicts of Interest for Professional Service within the 2020 Dietary Guidelines Advisory Committee

Commercial milk formula marketing following increased restrictions in Singapore: A qualitative study

Baby food industry interference with infant feeding international regulation—A case study on the standard for follow-up formula

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