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The sugar industry and companies that make sweet drinks and foods have spent nearly a century downplaying sugar’s role in health problems and distorting the science around fluoride — and the practice continues today, according to a new study.
The study, published in the journal Environmental Health, adds to evidence that the industry promoted fluoride as the solution to tooth decay to avoid scrutiny over sugar’s role, and details a close relationship between industry and dental associations and researchers over decades to cooperate on fluoride promotion.
“The sugar and allied industries started by promoting fluoridation as the miracle solution to tooth decay, but are now shifting their efforts to try to defend it from the emerging science showing it may have been lowering children’s IQs all along,” wrote the author Chris Neurath, a research director at the health-focused nonprofit American Environmental Health Studies Project, which advocates for removing fluoride from public drinking water.
The findings come as two states — Utah and Florida — and dozens of communities have banned fluoride in public water, with opposition growing across the US as multiple studies over the past few decades have linked children’s exposure to lowered IQs.
The controversy over fluoride has also grown in recent years due to Secretary of Health and Human Services Robert F. Kennedy Jr., who has long supported ending public drinking water fluoridation. The recently released “Make America Healthy Again” (MAHA) report — spearheaded by Kennedy and HHS — calls for the US Environmental Protection Agency (EPA) to review new science on fluoride’s potential health risks, and for the Centers for Disease Control and Prevention (CDC) to update its recommendations on water fluoridation. A federal court last year ruled that the EPA has to regulate the “unreasonable risk” posed by the fluoridation of drinking water but did not require the removal of public water fluoridation. The EPA appealed the ruling.
Public health agencies such as the CDC and dental groups such as the American Dental Association (ADA) have long hailed water fluoridation as a great public health achievement. The ADA, which did not respond to requests for comment on the new study, recognizes sugar as a critical risk factor for tooth decay but maintains that the amounts of fluoride in water are miniscule and effective in preventing tooth decay and disease.
However, Bruce Lanphear, an expert on environmental neurotoxins and a health sciences professor at Simon Fraser University in Vancouver, said there is “growing evidence of a neurotoxic effect” from fluoride exposure.
“And this new study exposes how the sugar industry essentially brainwashed us,” he said.
“Magic bullet” for dental health
Neurath examined internal documents from sugar and dental organizations and outlined a campaign that started in the 1930s by a chemist at The Sugar Fellowship, which conducted research on behalf of the Mellon Institute of Industrial Research. The chemist, Gerald Cox, conducted tests on rats investigating sugar’s impacts on their teeth. Cox was the first scientist to publicly propose adding fluoride to water. His paper on fluoride’s role in reducing tooth decay was full of contradictions, Neurath said, and did not mention his sugar industry connections.
Over the next couple decades, using Cox’s research as a foundation, internal ADA and sugar industry records show that the sugar industry worked behind the scenes to steer US dental policy away from focusing on sugar as a cause of tooth decay and instead embracing water fluoridation as a “magic bullet” for dental health.
For example, The Sugar Research Foundation’s first scientific director, chemist Robert Hockett, along with its PR consultant, a former ADA PR consultant whose father was the president of the New York State Dental Society, organized a 1944 symposium with thousands of dentists in attendance. The symposium, which featured presentations by dentists and researchers on the benefits of fluoridation, was “an opening salvo in a public campaign to promote fluoride and fluoridation as the solution to prevent tooth decay,” Neurath writes, adding that the symposium’s proceedings were also mailed to more than 100,000 other dentists across the country. Neither the symposium nor the mailings mentioned that both were funded by the sugar industry.
“This new study exposes how the sugar industry essentially brainwashed us.” – Bruce Lanphear, Simon Fraser University
Over the next two decades, documents show the sugar industry pushing to influence the ADA, and the ADA, in turn, softening its position on limiting sugar and starting to embrace fluoride. For example, executives from the Kellogg Company, a major producer of sugary cereals, chaired ADA committees that shaped dental policy. An editor of the ADA’s flagship journal who had ties to both Kellogg and the sugar industry became a key ally in advancing fluoridation while sidelining sugar’s role in cavities. It went both ways — as ADA officials also ended up on sugar committees, according to the documents.
“The sugar industry was infiltrating the dental industry and putting out this sort of promotional work based on distorted science, exaggerating the benefits of fluoride,” Neurath said.
The study also alleges sugar industry influence on the National Institutes of Health National Caries Program launched in 1971 to combat tooth decay, with the policy agenda for the program adopting language from the International Sugar Research Foundation (ISRF) (successor to the Sugar Research Foundation).
Neurath argues that this campaign mirrors tactics later used by the tobacco industry: casting doubt on inconvenient science, promoting alternative explanations and cultivating insider allies within health organizations.
Corporate influence
In recent years, the study finds the industry influence has been more blatant, including cozy relationships between CDC officials and Coca-Cola, and the beverage giant’s $1 million donation to The American Academy of Pediatric Dentistry, which has long promoted fluoridation.
In addition, the food research nonprofit International Life Sciences Institute (ILSI), which was founded by a vice-president of Coca-Cola and has been funded by Coca-Cola along with other major food companies, has been a leading proponent of continued fluoridation. When a draft report from the US National Toxicology Program (NTP) suggesting fluoride could harm children’s brains was circulated in 2020, Gerhard Eisenbrand, a German toxicologist and ILSI’s science director for Europe, co-authored a review that concluded fluoride was not toxic to children’s brains — without disclosing his ties to the sugar industry.
“[The German review] basically used the same studies in its review as NTP but the studies the NTP rated low-quality were rated high-quality and those were the ones that did not find an effect,” Neurath said. “And the ones the NTP rated high-quality and did find an effect … this German review said ‘oh no, those are low quality.’”
ILSI did not respond to requests for comment about the new study.
Documents obtained via Freedom of Information Act requests and cited in Neurath’s new study show that the Oral Health Division of the CDC arranged to meet with some of the German authors of the review. The final NTP report concluded higher fluoride exposures — exceeding what’s currently in public drinking water — “are consistently associated with lower IQ in children.”
Lanphear said one of the major downsides of the “fixation on fluoridation” over the past few decades is that other tooth decay risk factors have been ignored. “We haven’t been looking at other risk factors for tooth decay … things like lead exposure or vitamin D deficiency.”
Fluoride and brain health
The new study comes as researchers continue to debate the potential for fluoride exposure to impact kids’ brains. Lanphear pointed to multiple studies over the past 30 years — including some he co-authored — that found a link between fluoride exposure and lower IQ in children.
Most recently, a landmark paper released in January reviewed 70 published studies on the subject and concluded that those exposed to high levels of fluoride have measurably lower IQs, equivalent to a difference of nearly 7 IQ points, compared to those in the low fluoride groups.
Lanphear said the findings haven’t always been consistent but are now robust enough for public health officials to reassess the risks and benefits of fluoride, something he argued for in a recent editorial. While it’s not clear exactly how fluoride might impact brain health, researchers suspect it could be via thyroid function disruption, which would impact proper brain development.
Dental association fluoride defense
In addition to Florida and Utah, more than 60 communities have stopped putting fluoride in public water over the past year. The American Dental Association continues to push back on these moves, calling Utah’s move “disheartening” in a March statement.
“The most common chronic childhood disease is cavities. We know that when community water fluoridation stops, it’s the children and the most vulnerable of our communities who suffer,” said ADA president Brett Kessler. “We urge legislators and voters across the country not to make Utah’s significant mistake.”
“The most common chronic childhood disease is cavities. We know that when community water fluoridation stops, it’s the children and the most vulnerable of our communities who suffer.” Brett Kessler, ADA
The ADA has pushed back strongly on the MAHA movement against fluoride, and, in its defense of fluoridation, points to multiple studies — including one from December last year — that have not found a link between early childhood fluoride exposure and brain impacts.
The ADA also filed a brief on behalf of the EPA in its appeal of the ruling against the agency last year. Leaders from the association had a meeting with top EPA officials in April of this year, according to records obtained by The New Lede.
Featured image: Swanky Fella/Unsplash
