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The Guardian - US
The Guardian - US
World
Neil Barsky

Does the American Diabetes Association work for patients or companies? A lawsuit dared to ask

‘Over 100 million Americans have diabetes or prediabetes, and 100,000 die from the condition annually.’
‘Over 100 million Americans have diabetes or prediabetes, and 100,000 die from the condition annually.’ Photograph: Andreas Nageli/Alamy

A cloak of silence has descended over the recent whistleblower lawsuit claiming that the American Diabetes Association, or ADA, accepted corporate money in return for recommending recipes that threatened the health of people with diabetes.

Elizabeth Hanna, the ex-ADA chief nutritionist who alleged that her former employer fired her over her refusal to endorse Splenda-filled salads, has quietly settled her case. In a statement to the Guardian, Hanna’s attorney, Lauren Davis, said that “the matter has been resolved”. No details were provided either by Davis or by a spokesperson for the ADA, which declined to comment.

For Hanna, accepting a settlement from the ADA was no doubt a simpler and less stressful and risky alternative to a trial, but for me and the country’s other 38 million people with diabetes, it is a letdown. What a great opportunity a trial would have been to expose the inner workings of the ADA, the patient advocacy organization up to its eyeballs in big-business funding.

I recently wrote about Hanna’s lawsuit as part of our series Death by Diabetes: America’s Preventable Epidemic. My view is that diabetes is an urgent national scandal. Over 100 million Americans have diabetes or prediabetes, and 100,000 die from the condition annually. In addition, every year hundreds of thousands of people with diabetes have limbs amputated or suffer blindness or kidney disease. Diabetes costs our country $400bn annually to treat.

And although type-2 diabetes is often reversible through a low-carbohydrate diet, the ADA and the pharmaceutical industry don’t seem very interested in acknowledging that. Instead, they promote a laundry list of corporate deals and pharmaceutical treatments that have failed to stem the disease’s lethal and expensive impact on American life.

Hanna’s complaint, filed last year in a New Jersey court, alleged a litany of wrongdoings by one of the country’s most powerful patient advocacy organizations. Hanna said that ADA higher-ups pressured her to approve recipes that included generous helpings of the artificial sweetener Splenda, despite research published in the ADA’s own scientific journal finding that artificial sweeteners may raise consumers’ risk of type-2 diabetes.

Hanna further alleged that the pressure was the result of a $1m contribution made to the ADA by Heartland Food Products Group. Finally, she said the ADA was a revolving door of nutrition directors, with seven leaders coming and going over the past four years – largely because, she asserted, her predecessors “were either terminated by the ADA when they refused to comply with the ADA’s unethical and unlawful practices or were constructively terminated by the ADA by the abusive and hostile work environment they faced for refusing to comply”.

The ADA rejects the allegations in the lawsuit. The Heartland Food Products Group, which was not named in the lawsuit, has also said that it rejects any allegations of wrongdoing, and indicated it would continue working with the ADA. “Heartland will continue to support the ADA and honorably provide recipes and educational information to help people successfully reduce sugar levels and live happier and healthier lives,” Heartland said in a statement.

By settling, the ADA manages to avoid the discovery process, and the potentially embarrassing revelations that might have come with it.

Hanna’s lawyers appear to have grasped the implications of her lawsuit, and originally suggested her quest could take on heroic dimensions. “Hanna’s story could be the next movie that Americans need to see to understand what is going on behind closed doors between major for-profit corporations and the not-for-profit health sector,” they wrote in their legal complaint.

Although she chose to settle with the ADA, in reality Hanna has already performed a giant public service. Her legal complaint is a public document open for the ADA’s board of directors, clinicians across the US and the world, and members of Congress to read. Her meticulous account depicts the world’s most important diabetes patient advocacy organization as a cynical fund-raising machine, anxious to please its corporate overlords at the expense of the millions of people with diabetes it is supposed to be trying to help.

“The defendant’s conduct shows that they were party to a scheme to defraud the American people by approving and endorsing recipes submitted by Splenda to be lauded by the ADA as a healthy choice for people with diabetes, when the ADA knew that those recipes were contrary to the ADA’s guidelines and well-established and emerging scientific principles,” the complaint reads.

In case you’re curious, the ADA and Splenda appear to be still at it. As I write this, the ADA’s Diabetes Food Hub web page still features no fewer than 203 recipes – some marked “sponsored”, some not – that include Splenda, whose parent company’s $1m contribution has brought to light the utter insanity of our diabetes epidemic.

Isn’t it long overdue for the ADA’s board to act?

  • Neil Barsky, a former Wall Street Journal reporter and investment manager, is the founder of the Marshall Project

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