): e1001798. https://doi.org/10.1371/journal.pmed.1001798
Academic Editor: Simon Capewell, University of Liverpool, UNITED KINGDOM
Received: October 30, 2014; Accepted: January 29, 2015; Published: March 10, 2015
Copyright: © 2015 Kearns et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Data Availability: The Roger Adams Papers, 1812–1971, Record Series Number: 15/5/23 are available for research at the University of Illinois Archives at 19 Library, 1408 W. Gregory Drive, Urbana, IL 61801.
Funding: This work was supported by the UCSF Philip R. Lee Institute for Health Policy Studies, a donation by the Hellmann Family Fund to the UCSF Center for Tobacco Control Research and Education, the UCSF School of Dentistry Department of Orofacial Sciences and Global Oral Health Program, National Institute of Dental and Craniofacial Research grant DE-007306 and National Cancer Institute Grant CA-087472. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: FAO, Food and Agriculture Organization; FDA, Food and Drug Administration; ISRF, International Sugar Research Foundation; NCI, National Cancer Institute; NCP, National Caries Program; NIDR, National Institute of Dental Research; NIDCR, National Institute of Dental and Craniofacial Research; NIH, National Institutes of Health; RFC, request for contracts; SA, the Sugar Association; SRF, Sugar Research Foundation; TIRC, Tobacco Industry Research Committee; TWG, Tobacco Working Group; WHO, World Health Organization; WSRO, World Sugar Research Organisation
Despite overwhelming consensus on the causal role of sugars in tooth decay  and recommendations by expert committees [2–4], quantitative targets restricting the intake of sugars to control dental caries have not been widely implemented . In 2003, a joint committee of the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) recommended limiting “free” or added sugars, defined as “monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit concentrates” to 10% of total calories . The World Sugar Research Organisation (WSRO), a trade organization representing more than 30 international members with economic interests in the cane and beet sugar industry, including the Sugar Association (SA) in the US and Coca-Cola , successfully blocked the 2003 WHO/FAO joint committee recommendation from becoming WHO policy . The WHO/FAO joint committee quantitative recommendation to limit free sugars  was replaced with the nonspecific recommendation to “limit the intake of free sugars” . In 2014, based largely on the global burden of dental disease, the WHO Nutrition Guidance Expert Advisory Group issued draft guidelines with strong quantitative recommendations to limit daily consumption of free sugars to 10% of total calories, with a further suggestion to limit free sugars to less than 5% of total calories . As with the 2003 WHO recommendation, WSRO and its members have submitted comments in opposition to the 2014 WHO draft recommendation [9,10] and have signaled willingness to contest the 2014 recommendations with equal force as in 2003 [11,12]. WSRO argued that dental public health interventions should focus on reducing the harm of sugar consumption with methods such as the “regular use of fluoride toothpaste” rather than restricting sugar intake [9,13].
Publications about food industry influence on public health policy are growing [14–21], but analyses of food industry documents are rare . Historical analyses of internal tobacco industry documents have proven key to informing policy and litigation successes in tobacco control [23–27]. There are similar historical internal 