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This article is an edited instructor post from our Plant-Based Nutrition Certificate Program, in reference to the critical analysis assignment. In this assignment, students critically review published health claims and receive feedback from the instructor team. You can learn more about the program here. Our goal is not only to increase nutrition literacy but also to empower students to continue learning after they have finished the coursework.
Recently, a student reviewed the following article for the Module 1.20 critical analysis assignment: “Animal source foods, rich in essential amino acids, are important for linear growth and development of young children in low‐ and middle‐income countries.“[1] They did an excellent job and highlighted the clear conflict of interest given that several of the article authors work for FrieslandCampina, one of the largest dairy cooperatives in the world.
Reading the article, I was struck by how the article’s findings and recommendations could come across as relatively benign, making them even more nefarious.
The authors argue that children in low- and middle-income countries are chronically undernourished following breastfeeding because of a lack of diet diversity and consequent amino acid deficiencies.[1] They claim (though don’t provide much evidence within the article) that what these children need most are “nutrient‐dense animal source foods from 6 to 23 months.” They don’t specify the type or amount of “nutrient‐dense animal source food,” and the word dairy is mentioned only three times in the entire article.
As far as corporately funded research goes, this feels like a somewhat mild example of bias. While the takeaway to focus on animal foods is not supported with much evidence, other examples of corporate-funded research often seem more blatantly biased. In this case, the article does not aggressively push for any specific product. Compare it to other articles that champion the product of the funders. Here’s one on avocados; you can find many similar examples on Marion Nestle’s Food Politics blog.
Many readers understand intuitively that industry involvement can sway findings, as confirmed by research. According to one study, more than 55 percent of articles with food industry involvement “reported findings favourable to relevant food industry interests, compared to 9.7% of articles without food industry involvement.”[2] However, even though the results of this article are favorable to the animal foods industry generally, the average reader might not see the bias as clearly. After all, these researchers are just highlighting the needs of undernourished kids, right? The need for more essential amino acids seems pretty important, right? Many readers might even feel that this research is socially positive and responsible.
And that’s the point!
In this case, a little more context is needed, in the form of two additional pieces of information the average reader most likely won’t be aware of: (1) in addition to being one of the largest dairy cooperatives in the world, FrieslandCampina is also one of the largest formula manufacturers in the world, and (2) the fastest-growing formula market in recent years is for formula targeted at infants after six months, particularly those between six and twenty-three months, precisely the age range that the authors highlight as a period of greater need.
In an article from 2021, “Globalization, first-foods systems transformations and corporate power: a synthesis of literature and data on the market and political practices of the transnational baby food industry,” the authors, Baker et al, highlight how Big Formula produces research to support their products and image, and ultimately solidify and expand their power.[3]
Such research enables Big Formula to exercise discursive power, and institutionalise certain beliefs and practices in several ways. First, to drive sales by actively portraying their products ‘as close as possible to breastmilk’, and to amplify this message through actual or implied claims about the health and developmental benefits of their products, to both health professionals and consumers (see marketing strategies) . . . By framing these efforts as part of corporate social responsibility initiatives, this science further legitimises their image as responsible corporate actors and desirable policy partners.
The link between research and marketing is very normal. As Baker et al describe,
Many claims have no publically available evidence, or only poor-quality evidence, to support them. The evidence that does exist, often cites studies directly sponsored by Big Formula. Claims made on product labels include inter alia those relating to brain, eye and immune system development, reduced allergies, and to specific outcomes linked with normal infant behaviours, including sleeplessness, fussiness and regurgitation.
It’s easy to imagine how the scientific article on essential amino acids could later be used in FrieslandCampina marketing initiatives for their formulas that target 6-to-24-month-olds. In fact, you don’t have to imagine. The article is cited on the FrieslandCampina Institute website as evidence for why toddlers and children should drink milk.
Again, though, the average reader giving a cursory glance to the article after being redirected from the FrieslandCampina website could very easily miss these conflicts of interest. On its face, the article seems to support the product without ever specifically mentioning it. (Like I mentioned above, the word milk or dairy barely appears in the article.)
Let’s consider the history of Big Formula. Baker et al (2021) do a fantastic job of outlining this history, but I will try to briefly summarize it.[3]
Essentially, due to aggressive marketing practices by Big Formula companies, worldwide breastfeeding rates drastically declined in the 50s, leading to the lowest ever rates by the 60s. This aggressive marketing included some really egregious, unethical tactics, including having salespeople dress up as health professionals to visit maternity wards and share false information with mothers shortly after childbirth.
In the 70s, an international boycott was organized, and a massive international movement developed to curb the types of marketing and the claims that formula companies could make. This led to a new international trade group from Big Formula, the International Council of Infant Food Industries (ICIFI), and a coordinated effort to (1) increase public opinion while still advertising directly to consumers, (2) prevent policies limiting marketing, and (3) expand their market.[4] And it has worked!
Let’s take a side journey for a second to think about how this industry has reshaped their image and grown significantly despite pushback during the 70s. The idea of the two faces of power, popularized by political scientists Peter Bachrach and Morton S. Baratz in the 60s, can help us understand how the formula industry has exerted itself.[5]
This concept emphasizes the need to focus on not only the overt power to create or set laws and rules (the first face) but also the less visible power to shape preferences, agendas, and discussions (the second face). As Bachrach and Baratz observed, when individuals and groups effectively use their second face of power, they can often largely avoid having to use their overt power. If the preferred options of the powerful are the only options discussed and considered, they can rest assured that any chosen outcome will favor them. This can greatly reduce the need for lobbying, for example.
Keeping this concept in mind, let’s zoom out to also consider the spheres of influence discussed in Module 5 [“Evaluate Food Policy and Politics,” in the Plant-Based Nutrition Certificate]. Normally, we focus on the individual situated at the center of these spheres of influence; however, for the purpose of this discussion, consider all the ways industry influences the other spheres (and therefore influences the individual). As demonstrated already, the industry successfully aims to influence policy around regulation and marketing; given the freedom to more aggressively market their products, they persuade people in every sphere of the nutritional value of formula, often to the detriment of breastfeeding rates; by targeting health professionals and funding research that favors their enterprises, they shape the culture and make mothers feel that formula is superior and even safer than breast milk. Ultimately, these efforts mean that more people in any given community use formula, making it seem like the more normal, if not the best, choice.
Again, Baker et al (2021) bring these concepts together well:[3]
The capacity to deploy the marketing techniques described above is only possible because of the large investments the baby food industry makes in fostering policy, regulatory and knowledge environments conducive to such marketing in the first place. We find extensive evidence of the industry’s political practices, coordinated on a global scale, to achieve this. When considered together, these demonstrate two faces of corporate power – a more hidden, covert one, involving strategies to constrain critical discourse, co-opt opponents, and curtail regulatory threats; and a more visible public-facing one, to foster an image of corporate social responsibility, and maintain their ‘social license’ to operate. These practices are broadly consistent with those identified in studies on the tobacco, alcohol and ultra-processed food industries, and how neo-liberal economic globalization has markedly strengthened the power of these industries, to grow and sustain their markets, e.g.
Big Formula, like other large industries, has developed complex systems composed of multiple methods to establish, aggregate, and maintain power. Scientific research is, in this system, a tool. In addition to fueling the perceived need for their products, it fosters a positive image by suggesting social responsibility. Often, research is used to create evidence that can be cited as justification for an “innovative” new product.
A single research article within this larger structure may not feel especially significant or aggressive. But we must consider the overall network effect created when hundreds of these articles are published throughout many years and decades.
Finally, while this article focuses on the systematic way that Big Formula companies aggregate power, including by funding scientific research, I am not suggesting that formula should never be used. There are many important reasons why a mother might choose formula feeding for their baby at various points during their baby’s life, including from birth. To learn more about infant and childhood nutrition, check out these resources:
Additionally, if you enjoyed this post, I highly suggest reading the full article by Baker et al. It is very readable, interesting, and open access!
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