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Yesterday, the FDA announced a delay in implementation of menu labeling until December 1, 2016.

Since the FDA issued the menu labeling final rule on December 1, 2014, the agency has had extensive dialogue with chain restaurants, covered grocery stores and other covered businesses, and answered numerous questions on how the rule can be implemented in specific situations. Industry, trade and other associations, including the grocery industry, have asked for an additional year to comply with the menu labeling final rule, beyond the original December 2015 compliance date. The FDA agrees additional time is necessary for the agency to provide further clarifying guidance to help facilitate efficient compliance across all covered businesses and for covered establishments to come into compliance with the final rule. The FDA is extending the compliance date for the menu labeling rule to December 1, 2016, for those covered by the rule.

Here are the relevant Federal Register notices:

• Federal Register Notice for the Compliance Date Extension
• Menu and Vending Machines Labeling Requirements

Let’s be clear about what’s going on here.  New York City, where I live, has had menu labeling since 2008.  The world has not come to an end.

The Affordable Care Act made menu labeling go national in 2010.  The Supreme Court affirmed that law in 2012.

The seemingly endless delays look like successful lobbying at the expense of consumers and public health.

The New York Times account quotes me on this point:

This is a huge victory for the restaurant lobbyists,” said Marion Nestle, a professor in the department of nutrition, food studies and public health at New York University. “Food companies must be hoping that if they can delay menu labeling long enough, it will just go away.

The pizza industry, one of the chief lobbying groups on this issue, is pleased by the decision.  Lynn Liddle, Chair of the American Pizza Community sent out this statement yesterday:

FDA’s delay confirms both the serious deficiencies in the final rules and the urgent need for enactment of the bipartisan Common Sense Nutrition Disclosure Act (H.R. 2017).  Unfortunately, FDA proceeded with an approach to final rules that impose significant compliance costs without achieving any meaningful improvements in consumer education.  After years of uncertainty, FDA still has not addressed basic questions regarding implementation.  The American Pizza Community looks forward to continuing to work with Members of Congress to secure timely passage of the Common Sense Nutrition Disclosure Act.

If you can’t get federal agencies to back off on public health, go right to Congress.

The pizza industry had already succeeded in getting this provision in the House Agricultural Appropriations bill:

SEC. 744. None of the funds made available by this Act may be used to implement, administer, or enforce the final rule entitled ‘‘Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments’’ published by the Food and Drug Administration in the Federal Register on December 1, 24 2014 (79 Fed. Reg. 71156 et seq.) until the later of— (1) December 1, 2016; or (2) the date that is one year after the date on which the Secretary of Health and Human Services publishes Level 1 guidance with respect to nutrition labeling of standard menu items in restaurants and similar retail food establishments.

Although this act is not yet passed and it’s not clear whether this provision would have survived, the FDA got the message (or maybe the White House made sure that it did?).

Menu labels inform the public about the number of calories in the foods they are buying.

The ferocity of lobbying on this idea suggests that restaurant companies would rather you did not have this information.

The FDA, alas, is not helping much on this one.

The nutrition transition is the term used to describe a population’s rapid shift from widespread undernutrition to even more widespread overnutrition and its health consequences.

Here is an example of how that happens.

Thanks to Catherine Normile, currently working in Myanmar, for this report.

The first KFC, and the first major American fast food chain for that matter, opened in Yangon yesterday. I didn’t go inside but I scoped it out, I thought you may be interested to see the incredible crowd outside, and how unfortunate a contribution this is to Yangon’s downtown. It’s on a main road directly across the street from Bogyoke Market, the busiest market in Yangon. My favorite quote comes from this Jakarta Post article: “It is internationally famous, so I think it must be healthy.” Said by a man who queued for 3 hours to get chicken.

Note the waiting crowd.

There were long lines to get in.

The Burmese diet is changing.  Catherine’s previous report was on the influx of Coca-Cola.

I’ll ask again: is anyone tracking changes in health statistics in that country?

Sadie Barr, who writes about school food problems in Washington, DC, wants me and readers to know about the recent $19.4 million settlement paid to the DC school district by its food service provider, Chartwells.

For what?  Overcharging the schools for its meals.

In an e-mail to me, she writes:

The issue of school food fraud isn’t new, and isn’t unique to DC. It happened in New York in 2010 and in 2012, and is probably occurring within the quarter of school districts nationwide that outsource their food service. It was written about in the New York Times in 2011 and in an investigative report published in 2009. This fraud represents millions (if not billions) of public funds going toward a company’s profits, instead of education.

How does this work?  Food service companies buy foods from manufacturers who give them kickbacks, but do not pass the savings along to the schools.

She points out that this scam affects quality of school food, posing a special burden to the more than 50% of students nationwide (it’s more than 70% in DC) who qualify for free and reduced priced meals.

The lawyers negotiating the settlement were from Phillips & Cohen LLP, a firm that specializes in representing whistleblowers.  In this case, the whistleblower was Jeffrey Mills, director of food services for the DC public schools from 2010 to 2013.

The Phillips & Cohen press release quotes Mills as complaining that Chartwells overcharged the school district and also caused circumstances when “food was delivered late, the number of meals was insufficient or the food was of poor quality or spoiled.”

Mills said that his goal had always been to improve food programs for DC’s school children: “District funds should be used to feed students the best quality food at the lowest cost.”

This is not the first time Chartwells got caught doing something like this.

In 2012, Chartwells’ parent company, Compass Group USA, paid $18 million to settle allegations by the New York Office of the Attorney General that the company wrongfully retained rebates on purchases of food and non-food commodities made under contracts with 39 school districts in that state.

Phillips & Cohen also say:

The allegations made in the District’s complaint and Mr. Mills’ complaints are allegations only.   The allegations against Chartwells have not been adjudicated.  Chartwells denies liability for the allegations.

Maybe so, but the company agreed to the $19.4 million of the DC case.

If you are having trouble understanding the fights over the USDA’s school nutrition standards, the Chartwells’ case should help.

For food service companies and the companies that supply food products, there is lots of money to be made on school meals.

Addition, July 9: DC, it seems, is renewing its contract with Chartwells, according to the Washington City paper’s story on Jeff Mills.

Addition, July 10:  The Washington City paper explains the politics of Chartwells in DC.

Because transportation from rural areas is expensive and trucks are few and far between (one result of the U.S. embargo), the Cuban government is promoting urban agriculture.  Our Food First tour group went to a small organic farm and store (Organopónico) in Havana:

The farm grows a wide variety of vegetable crops, some outdoors but some under mesh.  The sun is hot.

The farm sells produce to local residents.  I watched a steady procession of people coming to shop, only to be disappointed at the scarcity of items available.  It’s too hot to grow much this time of year.

The board lists prices in pesos (indicated by $)—$4 to $10 a pound.

Another of the many Cuban contradictions: Cuba has two currencies, pesos and CUCs (Cuban Convertables).  A CUC is roughly equivalent to one dollar, or 24 pesos.  Salaries are paid in pesos.  Markets sell in CUCs or, recently, both.  This system, designed to take advantage of tourist dollars, is slated to end soon.

To put vegetable prices in context: the average Cuban salary is about 470 pesos a month, or $20 (but note that Cubans are given free food rations, education, and health care).

We also visited the much larger 25-acre farm in Havana’s Alamar neighborhood.

You can see the surrounding apartments in this photo, but not the next one.

With no money for gas or tractors, plowing gets done with oxen.

This farm also has a store.

I waited on a long line to buy a glass of freshly squeezed sugar cane juice.

This was incredibly delicious and totally worth the wait.

How much sugar is in this?  I searched for, but cannot find reliable Nutrition Facts for fresh cane juice.  If you happen to know where to find this, please send.*

On Monday, I’ll file the last of these Cuba posts, this one on food availability.

Note: the resumption of diplomatic relations and agreement to reopen embassies yesterday should make travel much easier.

*Answer to query: Thanks to Andy Bellatti and Cara Wilking for sending this link to a Nutrition Facts label for cane juice.  No wonder it was so good: 30 grams of sugar in 8 ounces!

I’m still catching up on what happened during the week I was offline in Cuba (more on that later this week).

One big event was the FDA’s announcement that it no longer considers artificial trans fat as generally recognized as safe (GRAS) for human consumption, meaning that processed food manufacturers need to get rid of it.  They get three years to do so.

Here are the relevant documents:

• Federal Register Notice: Final Determination Regarding Partially Hydrogenated Oils June 2015
• Federal Register Notice: Tentative Determination Regarding Partially Hydrogenated Oils; Request for Comments and for Scientific Data and Information; Extension of Comment Period December 2013
• Final Determination Regarding Partially Hydrogenated Oils (Removing Trans Fat)
• FDA Blog: Protecting Consumers from Trans Fat
• Press Release: The FDA takes step to remove artificial trans fats in processed foods

Center for Science in the Public Interest, which has petitioned the FDA to get rid of trans fats for decades, describes this move as a “huge advance.”

As for complications:

• The Environmental Working Group (EWG) is worried about the half-gram loophole:  “FDA memos show…80 percent of these uses [of partially hydrogenated oils containing trans fat] don’t require disclosure of the presence of trans fat because of the half-gram loophole.”
• Politico Pro reports that “food industry lawyers are already scouring the document in hopes of finding some way to shield them from legal action” and that a ban on trans fat will increase demand for palm oil causing widespread deforestation across Indonesia and Malaysia.
• Politico Pro also reports on a lawsuit filed immediately against Heinz for using trans fat in its frozen microwave french fries and tater tots while marketing its products as trans fat free.

I vote for the FDA’s move as a long-awaited step in the right direction.  Progress!

Addition, July 5:  The Wall Street Journal’s editorial board has a somewhat different view.  Trans fats are already gone, thanks to consumers, and all the FDA has done is to set up a basis for class-action suits.

This is a roundup of recent items on the effects of bird flu on egg producers: (1) the toll of the epidemic, (2) the politics, (3) the effects on restaurants, (4) the potential for a vaccine, and (5) a Food-Navigator-USA special edition.

1.  The toll: According to the USDA’s Chicken and Eggs report, the number of chickens laying table eggs declined by 33.5 million since April 1, a loss of 11%, and the number of eggs is down by 5%.  In May alone, 31.4 million layers were “rendered, died, destroyed, composted or disappeared,” four times the usual mortality rate.  No surprise, but egg prices went up by 46 cents in the last couple of weeks and now average $2.05 a dozen for Large white eggs Grade A or better (see USDA’s National Retail Report).  Since December, USDA says there have been 223 outbreaks of bird flu that have affected 48.1 million chickens and turkeys.

2.  The politics: According to an article in Fortune magazine, the flu epidemic is a consequence of industrial egg production, in which many thousands of birds are packed together.

But perhaps the most troubling aspect of the crisis is its implications for the viability of industrial-scale farming. The egg industry’s huge “layer operations”…are designed to protect birds from contamination, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota at the University of Minnesota. The animals’ environment is tightly controlled…But when a virus pierces such defenses, or when defenses lapse, having all of one’s eggs in one basket (so to speak) can make the impact more devastating.

3.  Restaurants: The Des Moines Register reports that restaurants will be raising prices as a result of the egg shortage.

4.  Bird Flu Vaccine: According to PoliticoPro Morning Agriculture, a small company in Iowa says it’s got a vaccine that needs USDA approval before it can be used.  But people in the poultry industry think it might be “a non-starter for foreign buyers of U.S. poultry products.”

5.  Food Navigator-USA’s Special Edition is called Avian flu in focus: Navigating the egg shortage crisis.  As Food Navigator explains, “manufacturers that rely on egg products face some big challenges in the weeks and months ahead.”

• United Egg Producers: It could be 1-2 years before US egg industry recovers from avian flu: It could be one to two years before the US egg industry is firing on all cylinders again following the latest avian flu outbreak, says United Egg Producers, a co-op which owns 95% of the nation’s egg-laying hens… Read
• Post Holdings lowers avian flu egg impact forecast after tests confirm false positive for Nebraska flock: Post Holdings says the impact of the avian flu outbreak on its egg volume commitments is not quite as bad as it had warned last month, as tests suggesting a company-owned chicken flock in Nebraska had the deadly virus had proved inaccurate… Read
• Avian flu outbreak has not dented consumer confidence in eggs, reveals American Egg Board survey: Devastating though the latest outbreak of Avian flu has been to the US egg industry, it does not appear to have dented consumer confidence in eggs, says the American Egg Board… Read
• Egg replacement ingredients help manufacturers reformulate in avian flu wake: The spread of avian flu among hens in the U.S. may be slowing, but the resulting egg shortage could take up to two years to rebound. In response, ingredient suppliers are stepping up to the plate and offering a variety of solutions that can replace anywhere from 25% to 100% of eggs in products ranging from baked goods to sauces to noodles… Display
• Avian flu prompting strategic rethink at US food companies, claims Hampton Creek boss: ‘It’s not just about price’: The latest outbreak of avian flu has, predictably, prompted a surge in demand for egg replacers. But some industrial egg users are now considering making permanent changes to recipes and menus rather than just making tactical substitutions whenever egg prices spike, claim suppliers… Read
• Bakers hail new egg supplies from The Netherlands, but warn that avian flu crisis is ‘far from over’: The arrival of egg products from The Netherlands “may make up for about 10% of the supply that’s been lost due to the impact of the avian influenza” in the US, says the American Bakers Association. .. Read
• Egg supplies decreasing at ‘alarming rate’ due to avian flu, warn bakers: Bakers and other big users of eggs could face major supply shortages if the government does not act quickly to allow temporary imports from more egg-producing countries, claims the American Bakers Association (ABA), which says “25% of industrial egg product production, including liquid, frozen, and powdered eggs, is now offline due to avian influenza”…Read
• Consumers increasingly value animal welfare and seek out retailers, CPGs that do, too: Consumer concern about animal welfare is rising to a level that retailers – and by extension CPG manufacturers and suppliers – can no longer ignore, according to new research by the Food Marketing Institute… Read

While I was visiting Cuba, formerly the largest supplier of sugar to the United States and now blocked from selling anything to us, I missed several stories about sugar.  It’s time to catch up with them.

• The Mexican Nutritional Health Alliance announces a 6% reduction in purchase of sugary beverages since implementation of the peso-per-liter tax.
• Johns Hopkins issued a case study on Mexico’s soda tax, explaining why it worked.
• The New York City Department of Health and Mental Hygiene has a new advertising campaign on the health risks of sugary drinks for children.  You can view the ads here.
• Canada has decided against requiring labeling of added sugars, but instead plans to institute a Daily Value for total sugars of 100 grams and to group all sugars on the ingredient list.  Note: 100 grams is 20% of total calories for people on 2000-calorie diets, and is twice what is recommended by most health authorities these days.
• The Washington Post says it’s great to get rid of trans fats, but what about sugars?
• The Washington Post also discusses the war between the Corn Refiners (makers of high fructose corn syrup) and sugar trade associations, this time over federal protections of the sugar industry.  I’ve discussed sugar policy in previous posts (see this one, for example).

On this last item the Post explains:

While other crop subsidies have withered, Washington’s taste for sugar has been constant. The sugar program, which has existed in various forms since the 1930s, uses an elaborate system of import quotas, price floors and taxpayer-backed loans to prop up domestic growers, which number fewer than 4,500.

Sugar’s protected status is largely explained by the sophistication and clout of a small but wealthy interest group that includes beet farmers in the Upper Midwest, cane growers in the South and the politically connected Fanjul family of Florida, who control a substantial part of the world sugar market.

Attempts to get rid of the sugar program have been constant, at least since the 1970s when I first started teaching about it, but to no avail.  Why not?  Because outrageous as the program is, it only costs the average American $10 per year—not enough to generate widespread opposition, apparently.

The bottom line on all this: eating less sugar is always a good idea.

I’ve been posting summaries of studies funded by food companies or trade groups, all of which come up with results that the sponsor can use for marketing purposes.

In each of these posts, I ask for examples of industry-funded studies that produce results contrary to the interests of the funder.

In response, I received this comment from Mickey Rubin, Vice President for Nutrition Research, National Dairy Council.

He gave me permission to reproduce his letter: 

Dear Marion,

By way of introduction, my name is Mickey Rubin and I am a scientist at the National Dairy Council. I understand that you know Greg Miller, and I asked him for your contact information so I could write to you directly after reading with great interest your most recent post on industry-funded nutrition research, in which you selected a sample of 5 studies/papers sponsored by industry all showing favorable outcomes. Although none of the papers you selected were sponsored by the organization I represent (although there is one dairy industry sponsored review paper in the list), what struck me is your focus on the favorable vs. unfavorable dichotomy, rather than the reality of what much nutrition science research results in: null findings.

It seems that there are fewer and fewer nutrition studies published that report the null, or find no effect. I agree with you that the reason we don’t see more of these studies in the literature has to do with bias, but I suspect that it is publication bias as much as any other bias. From my interactions with nutrition researchers, I gather it is quite difficult and sometimes impossible to get a study with no significant effects published regardless of funding source, to say nothing of allegiance bias by some researchers hesitant to publish findings that may go against their own hypotheses. Dr. Dennis Bier of Baylor College of Medicine and editor in chief of the American Journal of Clinical Nutrition has presented eloquently on this issue previously. You may also be aware of David Allison’s papers on other types of bias. So I think it is important to discuss all types of bias, and not just industry bias. You of course wouldn’t want your discussion on bias to be biased to just one type.

At National Dairy Council we have an extensive program of nutrition research that we sponsor at universities both nationally and internationally. While I can’t speak for all of industry, we strongly encourage the investigators of all of our sponsored studies to publish the findings, no matter the results. Thus, we would expect our sponsored studies to have a similar “success” rate as those sponsored by the National Institutes of Health. In fact, that is exactly what one recent analysis – not sponsored by the dairy industry – found, reporting that there was no evidence that dairy industry funded projects were more likely to support an obesity prevention benefit from dairy consumption than studies sponsored by NIH.

We feel this transparency is not only critical to the credibility of the research we sponsor, but we also feel it is important that our research contributes to nutrition science knowledge as a whole. We hope that other scientists take the findings from studies we sponsor and build upon them, and if it is by using research dollars from other sources, even better! I’ll be the first to stand up and say that one favorable study on milk, as an example, does not close the books on the subject. We need many studies in many different labs sponsored by multiple agencies in order to produce a portfolio of knowledge. I suspect that is certainly an example of where you and I are in agreement.

That all said, please allow me to provide some examples of studies the National Dairy Council has sponsored that are published and, rather than showing a clear benefit, do not refute the null hypothesis. These are all studies published within the last 4 years. It’s not meant to be comprehensive, but rather just a sample similar to what you provided. I could also provide you a list of studies we have sponsored that have shown favorable results for dairy, but you seem to have that covered, and I’ll instead wait until one of our sponsored studies appears in a subsequent blog post J.

Thanks for taking the time to read. I appreciate the dialogue.

Here’s his list of papers:

Studies with null finding:

Bendtsen et al. 2014: http://www.ncbi.nlm.nih.gov/pubmed/24168904

• No unique benefit of dairy protein over other proteins for weight maintenance

Maki et al. 2013: http://www.ncbi.nlm.nih.gov/pubmed/23901280

• No effect of three servings of dairy on blood pressure

Chale et al. 2013: http://www.ncbi.nlm.nih.gov/pubmed/23114462

• Whey protein supplementation offered no additional benefit over resistance training alone in older individuals

Lambourne et al. 2013: http://www.ncbi.nlm.nih.gov/pubmed/23239680

• No change in body weight or composition in adolescents performing resistance training and supplemented with milk, juice, or control

Van Loan et al. 2011: http://www.ncbi.nlm.nih.gov/pubmed/21941636

• Recommended dairy servings offered no additional weight loss benefit over calorie restriction without dairy servings 

Studies with mixed findings (some outcomes changed, others null):

Maki et al. 2015: http://www.ncbi.nlm.nih.gov/pubmed/25733460

• The main finding from the study was that dairy intake had no effect on glucose control whereas sugar sweetened product consumption contributed to a worsening of glucose control in at-risk adults.

Dugan et al. 2014: http://www.ncbi.nlm.nih.gov/pubmed/24236646

• Waist circumference and BMI were lower in women after consuming the dairy diet as compared to the control diet. Fasting glucose was lower in men following the dairy diet as compared to the control diet. There were no differences in blood pressure, serum lipids, fasting insulin, or insulin resistance between the treatments.

Here’s what I wrote in response:

I am familiar with charges of bias against independently funded researchers (“White-hat Bias”), which equates industry biases with biases that result from career objectives and other goals.  I do not view the biases as equivalent.  Industry-sponsored research has only one purpose: to be used in marketing to sell products.   As I have said repeatedly, it is easy to design studies that produce desired answers.

When I was in graduate school in molecular biology, we were taught—no, had beaten into us—to do everything we could to control for biases introduced by wishful thinking.  I don’t see that level of critical thinking in most studies funded by food companies.

You may be correct about the influence of publication bias with respect to dairy studies, but how do you explain the situation with sugar-sweetened beverages?  Studies funded by government and foundations typically indicate strong correlations between habitual consumption of sugary beverages and metabolic problems, whereas studies funded by the soda industry most definitely do not.   The percentages are too high to be due to chance: 90% of independently funded studies show health effects of soda consumption whereas 90% of studies funded by soda companies do not.  This is troubling.

We’ve seen the results of studies funded by tobacco and drug companies.  Are food-industry studies different?  I don’t think so.   What seems clear is that industry-induced biases are not recognized by funding recipients, a problem in itself.

That’s why I’m posting these studies as they come in and begging for examples of industry-funded studies that do not favor the interests of the donor.

Thanks to Mickey Rubin for writing and for permission to reproduce his letter.

Let the discussion continue!