Posts dated: January2012

A new diet study just out from the American Journal of Clinical Nutrition went to a lot of trouble to prove the obvious.  When it comes to weight loss, how much you eat matters more than the proportion of fat, carbohydrate, and protein in your foods.

Researchers at the Pennington Biomedical Research Center got volunteers to eat diets that were supposed to differ in proportions of fat (40% vs 20%), carbohydrates (35% vs. 65%), and protein (25% vs. 15%).

The results of the study are consistent with the findings from many previous studies:

• The major predictor for weight loss was adherence to the diet.
• People on all of the diets lost weight by six months, but regained some of it by two years.
• The study had a high drop-out rate (hence the importance of adherence).
• It was hard for people to stick to the diets, especially those at the extremes of one dietary component or another.

In my book with Malden Nesheim coming out on April 1, Why Calories Count: From Science to Politics, we review the previous studies of whether what you eat matters more to weight loss than how much you eat.

Some people find it easier to stick to diets that are higher in protein and fat.  I’m guessing that proponents of low-carbohydrate diets will argue that none of the diets in this particular study was really low in carbohydrate.

But studies show that people have a hard time adhering to diets that are very low in carbohydrate.  The low range in this study—35%—is at the lower end of acceptability for many people.

The bottom line: all diets work if you stick to them.

I was fascinated to read Cookson Beecher’s Food Safety News’ analysis of current campaigns to label genetically modified foods (GMOs).

It brought back memories of the time I served as an obviously ignored consumer representative on the FDA’s Food Advisory Committee.  Back in the early 1990s, the FDA formed this committee to get advice on issues that might be controversial.  It asked us for advice about whether to approve GM foods and, if so, whether they should be labeled.

We learned later that the FDA was using the committee to give it a heads up on decisions that were already made.  The FDA had every intention of approving GMOs (I wrote about this in my book Safe Food: The Politics of Food Safety).

I and the other three consumer representatives argued as strongly as we could that labeling was essential:

• Consumers have a right to know
• Consumers want to know (polls showed this overwhelmingly, even in 1994)
• Not-labeling will induce distrust of biotech foods and the biotech industry
• Not-labeling will end up hurting the biotech industry (in Europe, definitely.  Monsanto is no longer selling GM corn in France and BASF has moved its biotech operations to the U.S.)
• Not-labeling will stimulate the organic industry (it did!)
• The FDA allows plenty of process labeling (e.g., made from concentrate, irradiated)
• Not-labeling will make the FDA look as if it was in bed with the biotech industry
• Transparency is always the right thing to do

Too bad our arguments failed.  Eighteen years later, not-labeling has caused no end of problems for the biotech industry.  This issue is not going away.

The FDA has approved many GM fruits and vegetables but it is impossible to know whether they are offered for sale in supermarkets (as I discussed in Safe Food, Hawaiian papayas are the most likely candidates).

But most corn, soybeans, and cotton grown in America are GM.  So are sugar beets.

Campaigns to require labeling of GM foods are heating up.

• Washington state is considering legislation
• California may have a ballot initiative
• 14 states, among them Oregon, New York, Maryland and Vermont, considered bills last year
• Alaska passed a law requiring GMO labeling of fish and shellfish in 2005
• 50 countries require disclosure of GM ingredients

The “Just Label It!” campaign is collecting signatures.  If this is an issue you care about, signing on is easy.

A study published online in the American Journal of Public Health fiddled around with red (avoid) and green (eat me) labels on items in a hospital cafeteria.

The investigators measured sales before the start of the intervention.  About a quarter of items sold were in the red category and 42% were green—these hospital workers were already making healthy choices.

The intervention took place in two 3-month phases.  The first phase just involved traffic light labels.  In the second phase, the investigators moved the items around to make the green-labeled products more visible and accessible.

The results: labels alone led to decreases in sales of red-labeled items and increases in sales of those with green labels.

For example, sales of red-labeled drinks decreased by 16.5%.  When the drinks were made less accessible, sales declined by an additional 11.4% (sales of bottled water increased).

No wonder the food industry in Great Britain fought so hard against traffic light front-of-package labeling.  No wonder the Grocery Manufacturers Association and Food Marketing Institute much prefer their own guaranteed-not-to-work system.

And data like these surely explain why the FDA is taking so long to do anything with the Institute of Medicine’s proposed labeling system—not exactly traffic lights, but pretty close.

This study provides further evidence for the value of such schemes for helping people make healthier choices.

FDA: get busy!

Michelle Obama and Tom Vilsack announced new nutrition standards for school meals yesterday, to what seems to be near-universal applause (the potato growers are still miffed, according to the New York Times).

The new standards are best understood in comparison to current standards (see chart).  They call for:

• More fruits and vegetables
• A greater range of vegetables
• A requirement for whole grains
• All milk to be 1% or less
• Only non-fat milk to be permitted to be flavored

This may not sound like much.  But given what it has taken USDA to get to this point, the new standards must be seen as a major step forward.

See, for example, the comparison of an old and new weekly menu (this has not changed since USDA’s original proposal in January last year).

The new one looks so much better.   Now it’s up to schools to make the new standards work, make the foods taste yummy, and get kids to be willing to try new foods.

To review the history: This all started when the USDA asked the Institute of Medicine to design nutrition standards that would:

• Increase the amount and variety of fruits, vegetables, and whole grains
• Set a minimum and maximum level of calories
• Focus more on reducing saturated fat and sodium

The new standards come pretty close to what the IOM recommended (see the earlier chart), with some now-famous exceptions.  The IOM proposed limits on starchy vegetables.  USDA then proposed to limit starchy vegetables to two servings a week.  It also set a minimum for the amount of tomato sauce on pizza that could count toward vegetable servings.

Under pressure from potato growers and suppliers of school pizza, Congress weighed in and overruled the USDA on both counts.

The result: pizza now counts as a vegetable.

To give some idea of the extent of lobbying on all sides of this issue, USDA’s January proposal elicited 132,000 public comments (these are someplace at www.regulations.gov and are addressed in the Federal Register notice).

I asked in a previous post whether this kind of congressional micromanagement made sense (absolutely not, in my view).  I also wrote previously about the intense lobbying efforts to make sure these standards would never be released.

Despite congressional and industry opposition, the standards are out.

Applause is very much in order for Mrs. Obama’s leadership on this issue.

Good work.  Now let’s get busy on the next challenges:

• Set nutrition standards for competitive foods in schools—those sold outside of the lunch program as snacks and meal replacements.
• Teach kids where food comes from
• Teach kids to cook

For the record:

The initial press release: It is headlined “First Lady to Announce New Nutrition Standards for Meals Served in America’s Schools: Public-Private Partnership Aims to Connect More Kids to Nutrition Programs.”  I’m not sure where the Public-Private Partnership comes into this.

USDA’s actual press announcement provides links to the Nutrition Standards home page and other relevant documents.

Additions: Dana Woldrow sends this link to shed some light on the curious business of private-public partnerships.  Here’s one where Goya foods is giving out teaching materials in schools.

I’m at the Emma Willard school in Troy, NY today and will miss the noon USDA conference call announcing new school nutrition standards.  I will post on them tomorrow.  In the meantime…

Sarah Wu (aka Mrs. Q), Fed Up With Lunch: How One Anonymous Teacher Revealed the Truth About School Lunches–and How We Can Change Them!  Chronicle Books, 2011.

I did a blurb on this one:

Only someone who has actually eaten what our kids are fed in school—every day for an entire school year—could write so convincing an expose.  Mrs. Q did not set out to be an activist, but her book is a compelling case study of what’s wrong with our school food system and what all of us need to do to fix it.  Her account of what one person can do should inspire every parent to advocate for better food for kids in school as well as out.

Novella Carpenter and Willow Rosenthal.  The Essential Urban Farmer.  Penguin, 2011. 

This book is a must for anyone interested in growing food plants in urban environments.  Carpenter wrote Farm City about her own inner city farm in Oakland, CA and teams up with the founder of City Slicker Farms, also in Oakland.  They cover everything you can think of, from dealing with contaminated soil to growing enough food to start your own business. 

They illustrate the how-to with photos, diagrams, and line drawings that make it all look easy.  Urban farming IS easy, at least in miniature (tomatoes, lettuce, herbs, and blueberries flourish on my Manhattan terrace).  It doesn’t have to be a big deal.  Go for it!

Food Safety News is always an invaluable source of information about the science and politics of food safety, but today’s items are more than enough reason to subscribe immediately.

Start with Dan Flynn’s astonishing account of his repeated attempts to discover the name of the restaurant chain responsible for Salmonella outbreaks in Southern states last winter.

After calling health officials in several states where cases occurred, he says:

The surprise is not so much that public health officials do not want to name the restaurant chain involved, but that no one wants to talk about the outbreak at all…As we search for more information about this outbreak, we will do our best to follow the CDC’s own advice and provide timely and accurate information for the public.

The CDC’s report on this outbreak—and on similar ones that occurred previously—simply identify the source as “Mexican-style fast food Restaurant Chain A.”

Don’t we have the right to know the source of the outbreak so we can choose not to go there?

Food safety lawyer Bill Marler illustrates the importance of this question with an analogy:

I wonder if public health officials would have identified the actual restaurant (McDonalds) in the 1982 E. coli O157:H7 outbreak if the 1993 Jack in the Box E. coli O157:H7 outbreak would have happened?

So what’s going on here with CDC?   Again, Food Safety News comes through with an insightful explanation by Ray Costa, who works with companies on food safety issues:

When public health officials make mistakes in foodborne outbreaks, the industry suffers and the political fallout is extreme…We should not forget that local officials are closely tied to their communities in many ways.

Local health departments rely on revenue generated from the local food service industry. After many years, bonds form between local public health agencies and industry, naturally, and out of necessity.

But, he says:

In the end, honesty is the best policy during any outbreak of disease. When the investigator is guided by a careful analysis of data, an honest presentation of the facts and truthful explanation is all we can ask for…The public understands and forgives a mistake when it occurs out an abundance of caution to protect them, but there is no forgiveness for a failure to inform them and they suffer as a result.

The failure of CDC to name names is preventing the redress that victims rightfully have for damages and also reflects the power industry has to keep our investigators silent.

Food Safety News has promised to stay on this.  Its reporters are performing a great public service.

I’ve been saving up items about beverages, mostly having to do with marketing:

Soda companies vs. civic public health campaigns: In strategies reminiscent of those used by tobacco companies, soda companies are filing suit to obtain documents from public agencies all over the country.  Digging them up takes staff time and effort and slows down the real work of these agencies—the point of this approach.

Sonic’s marketing campaign, Limeades for Learning (“when you sip, kids learn”) encourages purchasers of its high-calorie drinks (620 for a medium, 950 for a large) to vote for school projects.

Dr Pepper Snapple’s diet—oops, low-calorie—10-calorie Dr Pepper Ten is aimed at men.  Men, it seems, like low-calorie sodas but squirm at the notion of diet sodas.

Coke covers both bases.  Diet Coke targets women and Coke Zero targets men in an “it’s not for women” campaign.   Is this ad offensive?  It not only excludes half the market, says Food Navigator’s Carolyn Scott-Thomas, but is

patronizing to both men and women in its reinforcement of what I had (perhaps naively) hoped were outdated stereotypes….It deliberately picks at the edges of our comfort zones.  Is it OK to be sexist if it’s done with irony?…Provocation is a blunt instrument.  It may prove effective for sales—perhaps as effective as sexually explicit marketing—but it is still crude and obtuse.”

She asks: “Would this ad be offensive if it involved a bunch of redneck clichés and proclaimed ‘it’s not for blacks’?  You bet it would.”

Coca-Cola has launched a global music effort to connect with teens.  Coke CEO Muhtar Kent says:

Our success in growing our sparkling category today depends on our ability to grow and connect with teens, the generation of tomorrow.

Pepsi, not to be outdone, has invented a social marketing vending machine for the digital age.  Buy a drink and you now have the opportunity to send one as a gift to a friend or a random stranger.

The Committee on Nutrition, American Academy of Pediatrics weighs in on sports and energy drinks.  Its tough report begins with the statement that “Sports and energy drinks are being marketed to children and adolescents for a variety of inappropriate uses.”

Sports drinks…may contain carbohydrates, minerals, electrolytes, and flavoring and are intended to replenish water and electrolytes lost through sweating during exercise.

In contrast…energy drinks also contain substances that act as nonnutritive stimulants, such as caffeine, guarana, taurine, ginseng, l-carnitine, creatine, and/or glucuronolactone, with purported ergogenic or performance-enhancing effects.

The report ends with this unambiguous conclusion:

the use of sports drinks in place of water on the sports field or in the school lunchroom is generally unnecessary. Stimulant containing energy drinks have no place in the diets of children or adolescents.

In response, Red Bull says it is not marketing to children.  Instead, it says, the company totally follows the “agreed codes of practice for the marketing and labelling of energy drinks.”

Just for fun I looked up some advertising budgets reported in Advertising Age. For 2010, Coca-Cola spent $267 million just to advertise Coke, Pepsi spent $154 million just to advertise Pepsi and another $113 million for Gatorade, and Dr. Pepper spent a mere $22 million for Snapple.

These expenses are just for those individual products and just for campaigns run through advertising agencies.  Pepsi’s total advertising budget that year was $1.01 billion.

Water, anyone?

The latest obesity statistics from the Centers for Disease Control and Prevention show no change over the last several years in either adults or children.  No change is good news.

For adults in 2009-2010 the prevalence of obesity was 35.5% among men and 35.8% among women.  Obesity, in these surveys is defined as a Body Mass Index (BMI) at or greater than 30.

This represents no significant overall change compared to rates in 2003-2008.  

Going back to 1999, however, obesity rates increased significantly among men in general, and among black (non-Hispanic) and Mexican-American women in particular.  In more recent years, the rates among these groups leveled off.

 For children and adolescents in 2009-2010 the prevalence of obesity was 16.9%.  For this group, obesity is defined as a BMI at or greater than the 95th percentile of weight for height.

This represents no significant change compared to rates in 2007-2008, but with one exception: the rate of obesity among adolescent males aged 12 through 19 increased.

For decades, rates of overweight and obesity in the United States stayed about the same. But in the early 1980s, rates increased sharply and continued to increase through the 1990s.

The increases correlated closely with deregulatory policies that encouraged greater farm production and loosened restrictions on food marketing.  These led to an increase in the number of calories available in the food supply, pressures on food companies to sell those calories, a proliferation of fast food places, and marketing strategies that made it normal to drink sodas all day long, and to eat everywhere, at all times of day, and in larger portions.

Why are obesity rates leveling off now except among boys?  Nobody seems to know.

I can make up several reasons, all speculative (and I have my doubts about most of them).

• People have gained all the weight they can and are in equilibrium
• People are more careful about what they are eating
• The poor economy is encouraging people to eat less
• Junk food marketing is targeted more to boys
• Girls are more careful about their weight
• Boys are particularly susceptible to “eat more” marketing pressures
• Boys are under greater psychological tension and eat to relieve it

Anyone have any better ideas?  It would be good to figure out the reason(s) as a basis for more sensible public policy.