Researchers from Oxford’s Department of Primary Care Health Sciences published several articles in the British Medical Journal questioning the quality of much sports nutrition science and the manner in which it has been employed by companies like GlaxoSmithKline (GSK) to back claims on products such as Lucozade Sport.
One article written by the Department’s senior clinical scientist Matthew Thompson, reader in evidence based medicine Carl Heneghan, and investigations editor Deborah Cohen, targeted EFSA’s Panel on Dietetic products, Nutrition, and Allergies (NDA) for lacking expertise, being inconsistent in its scrutiny of trials and systematic reviews, and rushing its work.
“…we set out to assess the scientific evidence and the scientific rigour of EFSA’s methods,” they wrote. “We found a major discrepancy between what they set out to do, and what they actually did.”
Totality of evidence
“…the methods used by EFSA to assess the ‘nature and quality of the totality of the evidence’ do not measure up to ... transparent and reproducible methods in several respects.”
They said the NDA overly relied on commercially-funded research like that of GSK, did not search widely enough for other data, lacked criteria to grade evidence types and was not transparent about its assessment methods.
EFSA defence
EFSA communications chief, Steve Pagani, said that while the NDA had indeed issued positive opinions for improved water absorption during exercise and maintenance of endurance for electrolyte drinks, it had rejected many others.
“EFSA did not accept all claims related to the consumption of sports drinks, and rejected other sports-associated claims such as those linked to glucosamine and maintaining normal joint cartilage,” Pagani said.
“In fact, overall, EFSA has rejected over 80% of the more than 4,000 claims submitted by commercial operators due to a lack of substantiating evidence.”
Commercially-derived research was considered because the nutrition and health claims regulation (NHCR) stipulated that is should be considered, he noted.
“Commercial operators seeking such an authorisation are required to provide the necessary information and data according to EFSA guidance, supporting the causal relationship between the substance and the desired effect.”
Pagani said the agency did take it upon itself to conduct broader searches for evidence to validate submitted claims.
“EFSA stands by the rigorous methodologies it uses to verify the scientific substantiation of submitted health claims by industry.”
Oxford prosecution
But the Oxford researchers, in regard to the two approved claims in question at least, said the studies had problems like small numbers of participants, blinding issues, unrealistic study protocols, non-comprehensive systematic reviews, and were often not conducted on ‘the general population’.
“There is a risk that claims approved by EFSA will be used to market sports drinks to people for whom the evidence does not apply,” they wrote.
“Moreover, public organisations that monitor advertisements for accuracy, such as the Advertising Standards Authority in the UK, will simply defer to published EFSA opinions when fielding complaints about adverts, rather than looking at scientific evidence themselves.”
“There should be a process in place to challenge EFSA’s decisions on claims - both those upheld and those rejected.”
The NDA opinion on the claims can be found here.
That opinion came with the rather detailed condition that carbohydrate-electrolyte solutions could only carry claims if they contained, “80-350 kcal/L from carbohydrates, and at least 75% of the energy should be derived from carbohydrates which induce a high glycaemic response, such as glucose, glucose polymers and sucrose."
"In addition, these beverages should contain between 20 mmol/L (460 mg/L) and 50 mmol/L (1,150 mg/L) of sodium, and have an osmolality between 200-330 mOsm/kg water. The target population is active individuals performing endurance exercise.”
The BMJ article is here.