Search results: children's nutrition

I was interested to see this article in The Lancet: Mexico’s bold new law on adequate and sustainable nutrition.  

Mexico’s new General Law on Adequate and Sustainable Nutrition (Ley general de Alimentación Adecuada y Sostenible) is a substantial step towards transforming food systems to address NCDs and promote environmental sustainability… It enshrines the human right to food…It prioritises health, environmental stewardship, water access, children’s health, enhanced food supply and distribution, the promotion of nutritious food, reduced food loss and waste, food provision in crisis situations, and social participation in food strategies…>It includes specific goals such as the prevention of diet-related non-communicable diseases (NCDs) and the mitigation of global warming….

Can something like this be nutritionally revolutionary?

Kellogg has just launched this cereal with just 6 grams of sugars per serving—half of what’s in most other cereals aimed at kids.

It’s also lower in sodium, but everything else about it looks pretty much the same:

Will Kellogg put money behind this cereal and market it with the millions it spends to market Froot Loops?   Will it reduce the sugars in its other cereals?  Will other cereal companies do the same?

Or will Scooby Doo suffer the fate of Post’s no-added-sugar and otherwise unsweetened Alpha Bits introduced in around 2005?

Post put no money into marketing the cereal and dropped it after just a few months (Alpha Bits now has 6 grams of sugars per serving).

Let’s give Kellogg some credit for giving this a try.   I’ve looked for Scooby Doo in grocery stores but haven’t been able to find it.

I will watch its fate with great interest.

Update: Thanks to Cara for pointing out that with Scooby Doo, Kellogg adds a cereal to its portfolio that meets requirements of the WIC (USDA’s Women, Infants, and Children’s nutritional support program).  As Jessica, a Kellogg rep explains, “The benefit of this cereal is that it’s WIC eligible and boosts several vitamins and minerals, is low in fat, is a good source of fiber and vitamin D and an excellent source of iron.”

And thanks to an anonymous writer for pointing out that Scooby Doo is directly competing with General Mills’ Dora Explorer cereal for the lucrative WIC market, one that should amount to nearly $7 billion in 2013.  WIC specifies what the benefits can be used to buy.  Cereal companies want to be sure they are in that market.

Reports are coming in on the House hearings on the IWG report recommendations.  The IWG, recall from the previous post, is an Interagency Working Group of four federal agencies attempting to set nutrition standards for foods allowed to be marketed to kids.

This first report comes from Broadcasting & Cable:

The first panel of a joint hearing Wednesday on government-proposed food marketing guidelines featured government officials explaining that the principles, announced last April, are only voluntary recommendations to Congress that industry can ignore if they chose, while legislators, primarily Republicans, countering that they represent Big Brother government intruding into meal planning for families and a focus on marketing, without scientific backing, rather than focusing on more physical activity.

Republican lawmakers, it seems, want more science.  That’s always step one in undermining public health proposals: attack the science.  Subsequent steps, you may recall, include attacking critics, focusing on physical activity, and blaming personal responsibility for obesity and its consequences.

According to Healthwatch, Representative Henry Waxman (Dem-Calif)

Compared Republican defenders of unbridled food marketing to children to past champions of the tobacco industry. [He]  drew parallels between Wednesday’s hearing on proposed voluntary marketing restrictions and a 2003 hearing during which some Republicans promoted the safety of smokeless tobacco.

“I just find this an amazing hearing,” Waxman said. “The only thing I can analogize it to is after all the tobacco issues we discussed for many years, Republicans took charge and we never heard anything more about tobacco. Then, suddenly we had a hearing about tobacco.

And the hearing was about how smokeless tobacco should be encouraged as a way for smokers to give up smoking. It was geared to promoting an industry that no doubt supported financially many of the members. I wonder if this hearing is about the same subject.”

What I find most disturbing is the FTC’s backing down on the recommendations which were agreed upon by four federal agencies and voluntary.  CNN reports that David Vladeck, director of the FTC Bureau of Consumer Protection, said:

The coalition of government agencies is “in the midst of making significant revisions” to the original proposal.

Among the changes he suggested are narrowing the age group targeted and focusing on children aged 2 to 11 instead of up to age 17 and allowing marketing of the unhealthier foods at fundraisers and sporting events.

Vladeck also said that his agency would not recommend that companies change packaging or remove brand characters from food products that don’t qualify, as was originally suggested in the guidelines.

“Those elements of packaging, though appealing to children, are also elements of marketing to a broader audience and are inextricably linked to the food’s brand identity,” Vladeck said at the hearing.

This, as I keep pointing out, is about protecting corporate health at the expense of children’s health.

Sad.

I keep hearing rumors that food industry opposition is what is holding up release of the FTC’s position paper on nutrition standards for marketing foods to kids.

I titled my previous post on this report “Standards for marketing foods to kids: tentative, proposed, weak,” because I thought they left far too much wiggle room for companies to market products that I would not exactly call health foods.

Now, Melanie Warner points out that even so, the proposed standards will exclude a great many highly profitable food products.  Hence: food company opposition.

Susan Linn of the Campaign for a Commercial-Free Childhood quotes an executive of the food industry’s Children’s Food and Beverage Advertising Initiative: “There are very few products, period, that meet these standards, whether they’re primarily consumed by adults or children.”

The food industry has consistently opposed giving the FTC more authority over marketing of foods and supplements.  Here is another reason why this agency needs it.

Update, July 24: The missing FTC report is front-page news!  William Neuman is on the front page of the New York Times with a detailed account of the Federal Trade Commission’s lack of action on food company advertising practices.  The FTC standards were expected last week but nobody seems to know when, if ever, they will be released.

Update, July 30: Here is Colbert’s take on the delaying of FTC standards.

Readers have filed corrections to previous postings on industry-funded studies (see here and here).  I am most grateful for their sharp eyes.  No excuses, but I’m having a hard time keeping them straight because there are so many, some are published first online and then again in print, and sometimes I just get them wrong.  Apologies.

The corrections reduce the count to 132/12.  But here are three more to bring it back up to 135/12.

Management of obesity.  George A Bray, Gema Frühbeck, Donna H Ryan, John P H Wilding.  The Lancet.  Published online February 8, 2016 http://dx.doi.org/10.1016/S0140-6736(16)00271-3.

• Conclusion: For patients who struggle with weight loss and who would receive health benefit from weight loss, management of medications that are contributing to weight gain and use of approved medications for chronic weight management along with lifestyle changes are appropriate. Medications approved in the USA or European Union are orlistat, naltrexone/bupropion, and liraglutide; in the USA, lorcaserin and phentermine/topiramate are also available. Surgical management (gastric banding, sleeve gastrectomy, and Roux-en Y gastric bypass) can produce remarkable health improvement and reduce mortality for patients with severe obesity.
• Declaration of interests GAB is a consultant to Herbalife International and Medifast; a member of the Speakers Bureau for Novo Nordisk Pharmaceuticals and Takeda Pharmaceuticals; and receives royalties from Up-to-Date and Handbook of Obesity. GF is a consultant to Novo Nordisk Pharmaceuticals. DHR is a consultant to Novo Nordisk Pharmaceuticals, Takeda Pharmaceuticals, Eisai Pharmaceuticals, Vivus Pharmaceuticals, Janssen Pharmaceuticals, Amgen Pharmaceuticals, Real Appeal, Gila Therapeutics, Tulip Medical, and Scientific Intake; is on the speakers’ bureau for Novo Nordisk Pharmaceuticals, Takeda Pharmaceuticals, Eisai Pharmaceuticals, and Vivus Pharmaceuticals; and has equity ownership in Scientifi c Intake. JPHW received grant funding from Novo Nordisk and AstraZeneca, and is a consultant to Novo Nordisk, Janssen Pharmaceuticals, AstraZeneca Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, and Pfi zer Pharmaceuticals.

The effects of potatoes and other carbohydrate side dishes consumed with meat on food intake, glycemia and satiety response in children.  R Akilen, N Deljoomanesh, S Hunschede, CE Smith, MU Arshad, R Kubant and GH Anderson.  Nutrition & Diabetes (2016) 6, e195; doi:10.1038/nutd.2016.1

• Conclusions: The physiological functions of CHO foods consumed ad libitum at meal time on food intake, appetite, BG, insulin and gut hormone responses in children is not predicted by the GI [glycemic index].
• Acknowledgements: This study was supported by the Alliance for Potato Research and Education (APRE).
• Comment: David Ludwig, M.D., PhD says: “Potatoes are at the top of the list for weight gain according to the best epidemiological research studies. A small new study claimed that potatoes actually had beneficial effects on appetite. There’s just one thing: The study was fully funded by the Alliance for Potato Research and Education, whose mission is to ‘recognize the role of all forms of the potato in promoting health for all age groups.’”  Here’s the press release from the Alliance for Potato Research & Education.

Nutrient Intakes and Vegetable and White Potato Consumption by Children Aged 1 to 3 Years.  Maureen L Storey and Patricia A Anderson.  doi: 10.3945/​an.115.008656.  Adv Nutr January 2016 Adv Nutr vol. 7: 241S-246S, 2016.

• Conclusion: The consumption of all vegetables, particularly those that are excellent sources of potassium and DF, such as potatoes, should be encouraged.
• Funding: Presented at the Roundtable on Science and Policy: Adopting a Fruitful Vegetable Encounter for Our Children. The roundtable was sponsored by the USDA/Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, and was held in Chicago, IL, 10–11 November 2014. The roundtable and supplement publication were supported by an unrestricted grant from the Alliance for Potato Research and Education. The roundtable speakers received travel funding and an honorarium for participation in the meeting and manuscript preparation. Author disclosures: ML Storey is a paid employee of the Alliance for Potato Research and Education; PA Anderson is a paid consultant for the Alliance for Potato Research and Education.
• Comment: Potato trade associations must be really worried about views like those of Dr. Ludwig.  Personally, I love potatoes and think they are delicious but should be eaten in moderation of course, and not in the form of French fries.  Speculation: I wonder if frequent consumption of French fries could be a marker of unhealthful diets in general?

The MAHA Commission released its report last week: The MAHA Report: Make Our Children Healthy Again.  Assessment.

This is one impressive report, forcefully written and tightly documented (it cites my work, among that of many others).

Overall, it paints a devastating portrait of how our society has failed our children.

It begins by stating that “The health of American children is in crisis” due to:

• Poor diet
• Aggregation of environmental chemicals
• Lack of physical activity and chronic stress
• Overmedicalization

The result: high rates of obesity, type 2 diabetes, neurodevelopmental disorders, cancer, allergies  and mental health problems among kids.

Here are some selected items I particularly appreciated in the report.  The bullet points are direct quotes.

On poor diet

• Most American children’s diets are dominated by ultra – processed foods (UPFs ) high in added sugars , chemical additives , and saturated fats, while lacking sufficient intakes of fruits and vegetables.
• Pesticides , microplastics , and dioxins are commonly found in the blood and urine of American children and pregnant women— some at alarming levels.
• Children are exposed to numerous chemicals , such as heavy metals , PFAS , pesticides , and phthalates, via their diet, textiles, indoor air pollutants, and consumer products.
• To get into schools , many food companies have reformulated their products with minor ingredient adjustments to qualify for the federal Smart Snack program by meeting the school nutrition standards, which children can purchase separate from school meals.

The driving factors for poor diets

• Consolidation of the food system
• Distorted nutrition research and marketing
• Compromised dietary guidelines

On the dietary guidelines  

They maintain problematic reductionist recommendations, such as:

• Advising people to “reduce saturated fat” or “limit sodium” instead of focusing on minimizing ultra-processed foods.
• Treating all calories similarly, rather than distinguishing between nutrient-dense foods and ultra-processed products.
• Remain largely agnostic to how foods are produced or processed: There is little distinction between industrially processed foods and home-cooked or whole foods if their nutrient profiles look similar.
• Added sugars, saturated fats and sodium are treated as proxies for ultra-processed foods. For instance, a cup of whole-grain ready to eat fortified breakfast cereal and a cup of oatmeal with fruit might both count as “whole grain servings,” and the guidelines do not weigh in on differences in processing.

They also,

• Do not explicitly address UPFs.
• Have a history of being unduly influenced by corporate interests .

On food systems

• The greatest step the United States can take to reverse childhood chronic disease is to put whole foods produced by American farmers and ranchers at the center of healthcare.
• Traditional Field Crops vs. Specialty Crops : Historically, federal crop insurance programs have primarily covered traditional field crops like wheat , corn , and soybeans, while providing much less support for specialty crops such as fruits, vegetables, tree nuts, and nursery plants.

On Corporate Capture 

• Although the U.S. health system has produced remarkable breakthroughs, we must face the troubling reality that the threats to American childhood have been exacerbated by perverse incentives that have captured the regulatory bodies and federal agencies tasked with overseeing them .
• Limited comparisons between industry-funded research versus non- industry studies have raised concerns over potential biases in industry-funded research…Additionally, some industry leaders have engaged in promoting ghostwriting and sponsored reviews to influence the scientific literature.
• Notably, this ghostwriting strategy mirrors tactics used by the tobacco industry to distort scientific consensus is largely propelled by “corporate capture,” in which industry interests dominate and distort scientific literature, legislative actions, academic institutions, regulatory agencies, medical journals, physician organizations, clinical guidelines, and the news media.
• The pharmaceutical industry, with its vast resources and influence, is a primary driver of this capture, though similar dynamics pervade the food and chemical industries.

Research recommendations

• GRAS Oversight Reform: Fund independent studies evaluating the health impact of self-affirmed GRAS food ingredients, prioritizing risks to children and informing transparent FDA rulemaking.
• Nutrition Trials: NIH should fund long-term trials comparing whole-food, reduced-carb, and low-UPF diets in children to assess effects on obesity and insulin resistance.
• Large-scale Lifestyle Interventions: Launch a coordinated national lifestyle-medicine initiative that embeds real-world randomized trials-covering integrated interventions in movement, diet, light exposure, and sleep timing-within existing cohorts and EHR networks.

Comment

The report has been criticized for not getting some of the science right.  The agriculture industry is particularly concerned about the attack on the chemicals it uses.  It is said to be outraged by the report.  The report did throw Big Ag this bone: “Today, American farmers feed the world, American companies lead the world, and American energy powers the world.”

But the report raises one Big Question:  What policies will this administration come up with to deal with these problems?  These, presumably, will be in the next report, due in about 80 days.

This is an extraordinary report, a breath of fresh air in many ways, and I would love to know who wrote it.

But to fix the problems it raises will require taking on not only Big Ag, but also Big Food, Big Pharma, Big Chemical, and other industries affected by these and its other recommendations (the report also says a lot about drugs and mental health).  Big Ag has already weighed in.  Others are sure to follow.

Oh.  And it’s hard to know how policies can be implemented, given the destructive cuts to FDA, CDC, and NIH personnel and budget.

I will be watching this one.  Stay tuned.

Resources

• The press release: MAHA Commission Unveils Landmark Report Exposing Root Causes of Childhood Chronic Disease Crisis
• The Executive Order establishing the MAHA Commission
• The Commission report: Make Our Children Healthy Again Assessment

Additional resource

• Errol Schweizer sent me his analysis on Medium, well worth reading.

The FDA is an agency within the Department of Health and Human Services, now headed by Robert F. Kennedy, Jr.  It is getting busy on carrying out Secretary Kennedy’s stated agenda.  It took four actions of interest last week.  Check out #3; it requires action.

I.  Approved Three Food Colors from Natural Sources

Since the HHS and FDA announcement last month during a press conference at HHS on petroleum-based food dyes, more U.S. food manufacturers have committed to removing them within the FDA’s set time frame of the end of next year.

“On April 22, I said the FDA would soon approve several new color additives and would accelerate our review of others. I’m pleased to report that promises made, have been promises kept,” said FDA Commissioner Martin A. Makary, M.D., M.P.H. “FDA staff have been moving quickly to expedite the publication of these decisions, underscoring our serious intent to transition away from petroleum-based dyes in the food supply and provide new colors from natural sources.”

FDA approved color additive petitions for:

• Galdieria extract blue, a blue color derived from the unicellular red algae Galdieria sulphuraria (by petition from Fermentalg).
• Butterfly pea flower extract, a blue color that can be used to achieve a range of shades including bright blues, intense purple, and natural greens (Sensient Colors LLC)
• Calcium phosphate, a white color approved for use in ready-to-eat chicken products, white candy melts, doughnut sugar, and sugar for coated candies (Innophos Inc).

II.  Announced top priorities for the Human Foods Program

FoodNavigator-USA report that Mark Hartman, who directs the new Office of Food Chemical Safety, Dietary Supplements, and Innovation, says the FDA soon will:

• Reveal how it will deal with the safety of chemicals in the food supply
• Create a new Office of Post Market Review to conduct risk reviews of chemical additives
• Increase transparency and stakeholder engagement in the review process
• Work through 70,000 comments on the FDA’s proposal for reviewing the safety of chemical additives
• Partner with the NIH to research how food additives affect children’s health
• Work with the food industry to phase out synthetic color additives
• Work through comments on sodium guidance
• Think about ways of addressing added sugars
• Identify ultra-processed foods as an “area of emerging study”

III.  Extended the comment period for front-of-package labeling until July 15

We are taking this action in response to requests to extend the comment period to allow interested parties additional time to submit comments. Comments should be submitted to Regulations.gov and identified with the docket number FDA-2024-N-2910.

Recall: This is what the Biden FDA proposed.  Here’s what I said about it (basically, we need something better).

Here’s a real opportunity.  If you want a front-of-package warning label like those in Latin America, here’s your chance to weigh in.

RFK Jr says he wants to Make America Healthy Again.  One way to do that is to discourage sales of food products high in saturated fat, sodium, and added sugars, but also discourage sales of ultra-processed foods.  Identifying foods as ultra-processed, on the basis of their chemical additives as well as their fat, sugar, and salt, would be an excellent step forward.

If you like the warning labels used in Latin American countries, send a note to the FDA Docket.  You have until July 15 to do that.

IV.  Announced a joint research initiative with NIH to address, among other unspecified questions,

• How and why can ultra-processed foods harm people’s health?
• How might certain food additives affect metabolic health and possibly contribute to chronic disease?
• What is the role of maternal and infant dietary exposures on health outcomes across the lifespan, including autoimmune diseases?

Comment

OK.  This represents action or proposed action.  My question: What will the FDA actually do?  I’m particularly interested in the joint NIH research initiative on ultra-processed foods.  Will NIH reverse its stance on Kevin Hall, whose research aimed to answer precisely that question?  I will be watching all this with much curiosity.

A few weeks ago,  the FDA announced  volunary recalls of  3 brands of baby pouches containing apple sauce with cinnamon, because they contained excess lead.

Lead is poisonous to children’s nervous systems and brain development; there is no safe level of lead intake.

DO NOT LET YOUR KIDS EAT THESE PRODUCTS!

The FDA inspected the plant in Ecuador where cinnamon apple sauce is made; the amounts of lead were shockingly high.  Food Safety News reports:

The applesauce, sold in pouches packaged for children, has been found to have a lead content of 5110 parts per million (ppm) and 2270 ppm. The international Codex body is considering adopting a maximum level of 2.5 ppm for lead in bark spices, including cinnamon.

What is even more shocking about this situation is how the FDA found out about the lead—not by testing but because

…a developing investigation by the North Carolina Department of Health and Human Services and the North Carolina Department of Agriculture & Consumer Services [found] about four children with elevated blood lead levels, indicating potential acute lead toxicity.

The state investigation identified WanaBana apple cinnamon fruit puree pouches as a potential shared source of exposure. As part of their investigation, the department of health and human services analyzed multiple lots of WanaBana apple cinnamon fruit puree, detecting extremely high concentrations of lead.

The FDA then announced it was investigating cinnamon as a source of the lead.

It traced the cinnamon to a supplier in Ecuador.

The FDA suspects that somewhere along the supply chain, someone deliberately added lead to the cinnamon to maintain its color and increase its weight.

This reminds me of the addition of Chinese melamine to pet food and infant formula in 2006 and 2007 (I wrote about the pet food scandal in Pet Food Politics: The Chihuahua in the Coal Mine).

This also points to the need for strengthening the FDA.  It is not required to test products for lead and neither are manufacturers.

The FDA has proposed action levels for lead in foods, but these are neither final nor implemented.

The New York Times quoted Tom Neltner, safety expert at the Environmental Defense Fund:

That the levels of lead in children’s blood tends to be the first line of detection for lead in food is “effectively using kids as canaries…What this shows is a breakdown in the agency, and an industry that needs to be fixed.”

By industry, I’m assuming he means baby food and I could not agree more.

Pouches may be convenient for parents, but they promote sweet tastes and don’t teach kids how to eat real foods.  One study concluded:

Squeeze pouch products available in Australia are nutritionally poor, high in sugars, not fortified with iron, and there is a clear risk of harm tothe health of infant and young children if these products are fed regularly. The marketing messages and labelling on squeeze pouches are misleading and do not support WHO or Australian NHMRC recommendations for breastfeeding or appropriate introduction of complementary foods and labelling of products. There is an urgent need for improved regulation of product composition, serving sizes and labelling to protect infants and young children aged 0–36 months and better inform parents.

That goes for U.S. products too.

Caveat emptor.