by Marion Nestle

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Mar 15 2016

Five more industry-positive studies. The score: 150/12

Higher compared with lower dietary protein during an energy deficit combined with intense exercise promotes greater lean mass gain and fat mass loss: a randomized trial.  Thomas M Longland, Sara Y Oikawa, Cameron J Mitchell, Michaela C Devries, and Stuart M Phillips.  Am J Clin Nutr  March 2016  vol. 103 no. 3 738-746. doi: 10.3945/​ajcn.115.119339

  • Conclusion: Our results showed that, during a marked energy deficit, consumption of a diet containing 2.4 g protein · kg−1 · d−1 was more effective than consumption of a diet containing 1.2 g protein · kg−1 · d−1 in promoting increases in LBM [lean body mass] and losses of fat mass when combined with a high volume of resistance and anaerobic exercise.
  • Conflicts of interest: SMP has received research funding, travel allowances, and honoraria from the US National Dairy Council and Dairy Farmers of Canada. None of the other authors reported a conflict of interest related to the study.
  • Comment: Dairy, of course, is a source of protein.

Consumption of dairy foods and diabetes incidence: a dose-response meta-analysis of observational studies. Gijsbers L, Ding EL, Malik VS, de Goede J, Geleijnse JM, Soedamah-Muthu SS. Am J Clin Nutr. 2016 Feb 24. pii: ajcn123216. [Epub ahead of print]

  • Conclusion: This dose-response meta-analysis of observational studies suggests a possible role for dairy foods, particularly yogurt, in the prevention of T2D. Results should be considered in the context of the observed heterogeneity.
  • Funding: This meta-analysis project on dairy products and incident diabetes was funded by Wageningen University.  SSS-M previously received funding from Global Dairy Platform, Dairy Research Institute, and Dairy Australia for projects related to dairy effects on lipoproteins and mortality; JMG previously received funding from the Global Dairy Platform and Dutch Dairy Association for projects related to dairy and cardiovascular diseases; and ELD previously consulted for the Dairy Research Institute. LG, VSM, and JdG reported no conflicts of interest related to the study. Any prior sponsors had no role in the design and conduct of the study, data collection and analysis, interpretation of the data, decision to publish, or preparation of this manuscript. The current funder had no role in design and conduct of the study, data collection and analysis, interpretation of the data, or decision to publish.
  • Comment: The conclusions put a positive spin on results that can also be considered equivocal.

Plenary Lecture 2: Milk and dairy produce and CVD: new perspectives on dairy and cardiovascular health. Julie A. Lovegrove* and Ditte A. Hobbs.  Proceedings of the Nutrition Society, Page 1 of 12 doi:10.1017/S002966511600001X.

  • Conclusion: These apparent benefits of milk and dairy foods have been attributed to their unique nutritional composition, and suggest that the elimination of milk and dairy may not be the optimum strategy for CVD risk reduction.
  • Conflicts of Interest: The authors have previously received funding for research from AHDB Dairy. J. A. L. has acted as an advisor to the Dairy Council. J. A. L. has received funding for research from Volac for BBSRC case studentship and ‘in kind’ foods from Arla for an MRC funded study.

Multivitamin/mineral supplements: rationale and safety – A systematic review. Hans K. Biesalski, Jana Tinz.  Nutrition, in press 2016.  doi:10.1016/j.nut.2016.02.013

  • Conclusion: Taken together, these findings indicate that MVM can be safe for long-term use (more than 10 years).
  • Funding: Editorial support was provided by Peloton Advantage and funded by Pfizer.

The challenges of vitamin and mineral supplementation in children with inherited metabolic disorders: a prospective trial.  A. Daly, S. Evans, S. Chahal, I. Surplice, S. Vijay, S. Santra and A. MacDonald.  J Human Nutrition and Dietetics.  Article first published online: 18 JAN 2016. DOI: 10.1111/jhn.12354 (thanks to Cole Adams for sending).

  • Conclusions: Despite improvements in some nutritional markers, overall use of the vitamin and mineral supplement was less than prescribed. New methods are needed to guarantee delivery of micronutrients in children at risk of deficiencies as a result of an essential manipulation of diet in inborn disorders of metabolism.
  • Funding: Anita MacDonald has received research funding from Merck Serono, Vitaflo Ltd and Nutricia. She is on Advisory Boards for Arla, Merck Serono and Nutricia. Anne Daly and Sharon Evans have received research funding from Vitaflo Ltd, and Nutricia. Research funding was obtained from Vitaflo International for the funding of this project.
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Mar 14 2016

Gaming Australia’s Health Star labeling system

Australia has government-sponsored front-of-package nutrient labeling—the Health Star system—that looks a lot like the U.S. grocery industry’s Facts Up Front, but is even more favorable to manufacturers of processed foods.

As I explained a few years ago, Facts Up Front was a successful scheme by the Grocery Manufacturers and Food Marketing Associations to head off the FDA’s attempts to put traffic-light signals on the front of processed food products (here’s more of the back story).

Like the U.S. system, the Australian system is voluntary.  Unlike it, Health Stars are prominent and convey the impression that the more starts, the better.

A year into the program, Australian newspapers are writing about how companies are “gaming” the system:

SOURCE: CHOICE

Deakin University professor of public health nutrition Mark Lawrence said the health star rating system was being exploited as a marketing tool by junk food manufacturers to make consumers think their food was healthy. He said the scheme for packaged food undermined the public health message that people should eat fresh, unprocessed food.

This article quotes a statement by Kellogg that sales of Nutrigrain cereal went up after the company reformulated the product to raise its rating from 2 to 4 stars.

But isn’t reformulation a good thing?  It could be but just because a processed food is “better-for-you,” does not necessarily make it a good choice.

Professor Mark Lawrence of Deakin and Christina Pollard of Curtin University write:

Its main design limitation is that it simplistically frames the cause of, and solution to, dietary imbalances in terms of nutrients. This is fundamentally at odds with the latest nutrition advice, which uses a food-based approach…So what the health star rating system ends up doing is encouraging marketing of unhealthy or discretionary foods, as healthy options.

Overall, they point out:

Part of the problem is that the campaign’s main message – “the more stars the better” – is misleading…The actual health message is to eat more of these [recommended healthy] foods; it’s not that we should try to eat food with more stars.

Good advice.

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Mar 12 2016

“Superannuated Chardonnay Socialist!” Moi?

The Australian Broadcasting Corporation’s Sarah Whyte of ABC 7:30 interviewed me and others for a 6-minute segment on Coca-Cola’s funding of health researchers.  Here’s an excerpt from the transcript:

TIM OLDS, UNI. OF SOUTH AUSTRALIA: I’ve got about $26 million worth of funding, and of that, probably less than $2 million would have come from industry sources. Most of it comes from government schemes such as the NHMRC and the ARC, a lot from government departments.

SARAH WHYTE: So when you take that funding, do you get other academics saying you shouldn’t be taking funding from that?

TIM OLDS: We get a lot of academics saying that.

SARAH WHYTE: He disagrees with people like Marion Nestle who says his work is compromised.

TIM OLDS: I think frankly this is an example old-style, superannuated chardonnay socialism.

Oh.

Here’s what he’s referring to (the dates are Australian).

February 17  Marcus Strom, a business reporter with the Sydney Morning Herald, invites me to lunch to discuss issues related to Soda Politics.

February 24  Strom publishes an article based on our conversation: “What Coca-Cola isn’t telling you about its health funding in Australia” (the video tells the story).

February 26  The Sydney Morning Herald publishes Strom’s account of our lunch interview.

March 1  I give a lecture on Soda Politics at the University of Sydney.

March 3  In response to my remarks, the director of Coca-Cola Amatil makes this statement: “one can [of soda] a week not unhealthy.”

March 10  Coca-Cola publishes a preliminary version of its “commitment to transparency,” listing some of the community organizations it funds.

March 10  Strom writes an analysis of the transparency list—$1.7 million in support of research over five years—noting several key omissions.

March 10  ABC 7:30 runs its video (and see transcript).

March 10  A blogger publishes a list of individuals funded by Coca-Cola during that period.

March 11  Coca-Cola releases the complete version of its transparency list, including the names of individuals.

March 11  I receive an e-mail message from a Coca-Cola official stating the company’s commitment to transparency.

We are continuing to progress on our commitment to enhance our transparency in markets across the globe. Today, in Australia and New Zealand, we launched country-specific websites listing our health and well-being partnerships, research and health professionals and scientific experts that have received financial support from Coca-Cola from 2010-2015. In December 2015, we launched sites with this information in Great Britain, Germany, France, Ireland, Denmark, Finland, Belgium, Sweden, Norway and the Netherlands.  We will publish the six-month update for the U.S. later this month.

March 11  Strom attempts to interview the 14 health experts on Coca-Cola’s list; most don’t return his calls.

Coca-Cola deserves much praise for following through on its transparency commitments.  The aftermath continues.

Additions: New Zealand transparency and more from Australia

March 3: Coke: One can a week ‘not unhealthy’

March 11:  Coca-Cola cash went to NZ health organisations and research

March 11: Coca-Cola funds research in NZ, NZ Herald

March 13: Three Kiwi health professionals took money from Coca-Cola

March 14:  Gary Moorhead, past CEO of Sports Medicine Australia argues that shaming researchers does no good

March 15: NZ Dominion Post editorial says dentists should not take money from Coca-Cola

March 16: The Press, New Zealand, editorial on whether Coca-Cola should be paying scientists

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Mar 11 2016

Should the East River Pepsi-Cola sign be landmarked?

An editor at the New York Times invited me to write an op-ed on the proposed landmarking of the East River Pepsi-Cola sign, but then said:

We’re not going to use this. People really love that Pepsi sign so much that they don’t want to hear arguments against it.

So I offered it to the Daily News.  I’ve written for it before.  Its editors are highly professional and a pleasure to work with.  And it goes to an audience to which I do not usually have access.   See what you think.

The Long Island City Pepsi-Cola sign: Hazard, not landmark

NEW YORK DAILY NEWS
Thursday, March 10, 2016, 5:00 AM
Looks pretty. Tastes sweet. Has ugly side effects.

Looks pretty. Tastes sweet. Has ugly side effects.

I did not know whether to laugh or cry when I read that the city’s Landmarks Preservation Commission had deemed the Pepsi-Cola sign in Long Island City, Queens, so worthy of permanent preservation that it was considering it for landmark status.

Granted, the neon monument has been part of the East River landscape for the past 80 years. And yes, there is precedent for landmarking a sign rather than a building. Pine Bluff, Ark., chose to landmark a McDonald’s sign, and Cambridge, Mass., preserved a Shell Oil sign.

But the fact is that the Pepsi-Cola sign is a highly visible expression of soda industry marketing. The sign advertises a sugar-sweetened beverage — precisely what the city Health Department has, with good reason, been working hard to discourage New Yorkers from consuming in large quantities.

For the past few years, subway poster campaigns have featured the astonishing amounts of sugar contained in carbonated sodas — close to a teaspoon per ounce. They have also illustrated how this excessive sugar turns to fat in the body, how sugary beverages raise the risk for type 2 diabetes, and how much walking it takes to work off the calories in a single 20-ounce drink — a trek from Union Square to Brooklyn.

And let’s not forget former Mayor Michael Bloomberg’s ultimately unsuccessful though valiant attempt to set a cap of 16 ounces on sugary beverages sold in places under city jurisdiction.

That particular tactic was hugely controversial. But nobody can seriously dispute that sugary drinks contribute to obesity and its consequences.

Pepsi may be the underdog — Americans drink more Coke — but it is a very large runnerup in the sugary drink category. Its revenues in 2015 amounted to $63 billion worldwide.

Pepsi is Big Soda incarnate. It works hard to maintain that position, spending more than $200 million a year advertising Pepsi-Cola alone. It is also Big Food. Altogether it spends about $2 billion a year on worldwide marketing for all of its products, including Frito-Lay snack foods and other brands.

To generate sales, Pepsi relentlessly targets its marketing to teenagers and young adults and, as part of that approach, generously pays sports and music figures to endorse its products.

We’ve all seen the Super Bowl ads. We know about the reported $50 million deal with Beyoncé. And like Coca-Cola, although not quite to the same extent, PepsiCo funds health organizations such as the American heart and cancer associations, and contributes to health programs at universities such as Yale. All of this can buy loyalty from health professionals, and also silence from them about the role of soft drinks in health.

Soda advertising is so much a part of the American landscape that most of us don’t even notice it anymore. It is just there. And that’s how the company intends it. As an industry executive once told me, effective advertising is supposed to slip below the radar of critical thinking.

I’m guessing that’s what’s happening with the Pepsi-Cola sign. Its significance as advertising for a sugary drink — one best consumed infrequently and in small amounts — has become unnoticeable. To the landmarks folks, therefore, this is just a quaint piece of history — not an active, pulsating sign promoting something dangerous to human health.

But landmarking the Pepsi sign, which is visible to millions of New Yorkers and tourists every single day, would engage New Yorkers as formal partners in marketing sugary drinks.

I can’t help but remember the Camel cigarette sign in Times Square, for years blowing smoke rings. Would today’s Landmarks Preservation Commission want that billboard preserved for eternity? Or would it blush at the thought of promoting and sustaining an icon of corporate marketing, and of an unhealthful product at that?

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Mar 10 2016

Food-Navigator USA’s Special Edition on Weight Management

Food-Navigator USA publishes occasional “special editions” with collections of articles on similar topics.  This one is on how food companies are dealing with weight management: “With almost two thirds of Americans overweight or obese, weight management is still a huge market opportunity for food and beverage manufacturers. However, messaging is moving away from diet-based concepts to more positive messages about food quality, satiety, and overall health & wellness.”track

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Mar 5 2016

Three books about eating: 3. A Short History

This is the third book about eating I’ve been posting about.  The first two were here and here.

Graham Dukes & Elisabet Helsing.  A Short History of Eating.  The London Press, 2016.

Dukes and Helsing, married couple, English and Norwegian respectively, and friends of long standing, have produced a light-hearted, entertainingly illustrated romp through the history of the human diet, from breast milk (on which Helsing is expert) to bubble gum, based on their research into a wide range of sources, literary as well as anthropological.   The authors quote poems in appropriate places:

When mighty Roast Beef was the Englishman’s food,

It ennobled our brains and enriched our blood.

Our soldiers were brave and our courtiers were good

Oh! the Roast Beef of old England.

The illustrations display cartoons, ads, portraits, and botanicals.

Here is an excerpt to give you the flavor…

Marie Antoinette, the last Queen of France before the Revolution, is often cited—almost certainly wrongly—as having suggested that since during a famine the starving population lacked bread they should eat cake instead…But if Marie Antoinette truly did propose that the populace eat cake, what sort of cake, familiar in her royal circle, might that have been?  Modern reference sources define a brioche today as a light yeast bread with butter and eggs…A better clue…may be that provided by that infamous rascal of the day, the Marquis de Sade.  In July 1783, from his prison cell in Vincennes…he wrote a letter to his patient wife imploring her to send him: “…four dozen meringues; two dozen sponge cakes (large): four dozen chocolate pastille candies with vanilla….”

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Mar 4 2016

Julia Belluz (Vox) on my collection of studies sponsored by food companies

Julia Belluz of Vox has just done a story on my collection of studies funded by food companies.  Here are a few excerpts.  For the entire article and its excellent illustrations, click on the link):

About a year ago, Marion Nestle finally got sick of the rotten state of nutrition science.

Everywhere she looked, she found glaring conflicts of interest. “Without any trouble, I could identify industry-funded nutrition studies by their titles,” says the New York University professor. “It was so obvious”…But Nestle is not the first to notice this problem. Many nutrition researchers have been complaining about conflict-of-interest problems in their field for some time now. Whereas other fields, like medicine, have been putting in place safeguards to protect against undue industry influence, the field of nutrition has lagged behind in this regard.  And other research backs up Nestle’s findings. Take this review of studies on sugary drinks. Independently funded studies tend to find a correlation between soda consumption and poor health outcomes. Studies funded by soda makers, by contrast, are less likely to find such correlations. Or take this investigation of 206 publications on the health effects of milk, soft drinks, and fruit juices. Studies that were funded by beverage companies were four to eight times more likely to come to favorable conclusions about the health effects of those beverages.

The reporter interviewed researchers who work in food and nutrition about all this.

They all acknowledged that she was tapping into a real problem, one that’s been difficult for their community to address.  So why are conflicts of interest allowed to persist in nutrition research?  One root cause is the need for funding. Right now nutrition science is relatively underfunded by government, leaving lots of space for food companies and industry groups to step in and sponsor research…Tradition also plays a role. “Nutrition science has always been close to producers,” Dutch nutrition researcher Martijn Katan told me. “There’s such a direct interest in the outcomes of research for producers”…And food companies have ample incentive to promote this research. Under Food and Drug Administration rules, any health claims that they want to make on their packaging has to be backed up by scientific research. So the food industry has a keen interest in funding research — and favorable research that their profits may depend on.

She quotes Martijn Katan:

In the long term,” Katan said, “the deepest harm being done is that it undermines the credibility of science. In the short term, it means some people will eat more butter or cheese than is good for them, and that it will take longer to get people off soda.”

Her conclusion:

None of the researchers I spoke to suggested we should abolish industry funding of food and nutrition studies. As Katan has written, these collaborations can lead to fruitful discoveries…Instead, they wanted to see more awareness about the problem, more scrutiny of industry-funded research, and organized efforts to control conflicts of interest. “It’s not the quality of the science that’s at issue,” Nestle explains. “The studies are carried out according to strong scientific principles. But the bias seems to come in around the research question that’s asked, the interpretation of the results, putting a positive spin on findings even when the results are neutral.” That’s not good for science or for public health.

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Mar 3 2016

More industry-funded studies with industry-favorable results. The score 140/12.

A nutrient profiling system for the (re)formulation of a global food and beverage portfolio.  Antonis Vlassopoulos · Gabriel Masset · Veronique Rheiner Charles ·Cassandra Hoover · Caroline Chesneau‑Guillemont · Fabienne Leroy ·Undine Lehmann · Jörg Spieldenner · E‑Siong Tee · Mike Gibney ·Adam Drewnowski.  Eur J Nutr DOI 0.1007/s00394-016-1161-9.

  • Conclusions:  The NNPS sets feasible and yet challenging targets for public health-oriented reformulation of a varied product portfolio; its application was associated with improved nutrient density in eight major food categories in the USA and France.
  • Funding: The research presented herein was funded by Nestec Ltd, which is a wholly owned affiliate of Nestlé S.A.  The first eight authors are employed by Nestlé.
  • Comment: the paper is the basis of a Nestlé infographic.

Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial.  Heather C Stobaugh, Kelsey N Ryan, Julie A Kennedy, Jennifer B Grise, Audrey H Crocker, Chrissie Thakwalakwa, Patricia E Litkowski, Kenneth M Maleta, Mark J Manary, and Indi Trehan.  Am J Clin Nutr  First published February 10, 2016, doi: 10.3945/​ajcn.115.124636.

  • Conclusion: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF [ready-to-use supplemental food], although the whey RUSF supplement provided less total protein and energy than the soy RUSF.
  • Funding for this project was provided by the Danish Dairy Research Foundation, Arla Foods Ingredients Group P/S, and the US Dairy Export Council. IT was supported by the Children’s Discovery Institute of Washington University in St. Louis and St. Louis Children’s Hospital…The funders had no role in the design or implementation of the study and no role in the analysis or interpretation of the data.

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UK.  L. Claxton, M. Taylor & E. Kay.  British Dental Journal 220, 121 – 127 (2016).  Published online: 12 February 2016 | doi:10.1038/sj.bdj.2016.94

  • Conclusion If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year…This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved.
  • Declaration: This study and writing support for the manuscript were funded by Wrigley Oral Healthcare Programme.

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base Richard D. Feinman, Wendy K. Pogozelski , Arne Astrup M.D., Richard K. Bernstein M.D., Eugene J. Fine M.S., M.D. , Eric C. Westman M.D., M.H.S.  , Anthony Accurso M.D. , Lynda Frassetto M.D.  , Barbara A. Gower Ph.D.  , Samy I. McFarlane M.D.  , Jörgen Vesti Nielsen M.D.  , Thure Krarup M.D. , Laura Saslow Ph.D. , Karl S. Roth M.D. , Mary C. Vernon M.D. , Jeff S. Volek R.D., Ph.D. , Gilbert B. Wilshire M.D. , Annika Dahlqvist M.D.r , Ralf Sundberg M.D., Ph.D.  , Ann Childers M.D.  , Katharine Morrison M.R.C.G.P.  , Anssi H. Manninen M.H.S.  , Hussain M. Dashti M.D., Ph.D., F.A.C.S.,  F.I.C.S., Richard J. Wood Ph.D., Jay Wortman M.D. , Nicolai Worm Ph.D.  Nutrition. January 2015 Volume 31, Issue 1, Pages 1–13 DOI: http://dx.doi.org/10.1016/j.nut.2014.06.011

  • Conclusion: Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1.
  • Disclosure: AA is consultant/member of advisory boards for the Dutch Beer Knowledge Institute, NL, Global Dairy Platform, USA, Jenny Craig, USA, McCain Foods Limited, USA, McDonald’s, USA, and Gerson Lehrman Group, USA (ad hoc consultant for clients). He is recipient of honoraria and travel grants as speaker for a wide range of Danish and international concerns. He has conducted research funded by a number of organizations with interests in the food production and marketing sector. RDF writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation. EJF has received grant support from the Veronica and Robert C. Atkins Foundation. TK sits on an advisory board for Eli Lilly and gives lectures for Lilly about the diabetic diet. NW has written popular-audience books on low-carbohydrate diets and is a consultant and promoter for Leberfasten/Hepafast, a specific low-carbohydrate meal replacement program. JW is on the Scientific Advisory Board of Atkins Nutritionals Inc. with paid retainer, honoraria, and travel costs. None of the other authors have anything to declare.
  • Comment: The Atkins Diet is low-carbohydrate.

Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial David G. Marrero, PhD, Kelly N. B. Palmer, MHS, Erin O. Phillips, BA, Karen Miller-Kovach, EBMA, MS, Gary D. Foster, PhD, and Chandan K. Saha, PhD. Am J Public Health. Published online ahead of print February 18, 2016: e1–e8. doi:10.2105/AJPH.2015.303035

  • Conclusions. A large weight-management program is effective for achieving lifestyle changes associated with diabetes prevention. Such programs could significantly increase the availability of diabetes prevention programs worldwide making an immediate and significant public health impact.
  • Funding: This study was funded by Weight Watchers International.

It’s close to a year since I first started collecting these studies.  When the year is up, I will do some analysis.  Until then, the bottom line is that it’s easier to find industry-funded studies with results favorable to the sponsor than it is to find those that are not.

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