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The World Health Organization (WHO) has finally officially released its recommendations for sugar intake.  I say “officially,” because I posted an earlier version these guidelines late in January.

The new—and official—WHO guideline, “Sugar intake for adult and children,” makes these recommendations for adults and children:

• For general health, Reduce daily intake of free sugars to less than 10% of total energy intake.
• For additional health benefits: Reduce daily intake to below 5% or roughly 25 grams (6 teaspoons) per day.

This recommendation is based on a scientific review as well as comments by groups such as Center for Science in the Public Interest.

The British advocacy group, Action on Sugar, is disappointed in the recommendations, thinks they don’t go far enough, and suspects that heavy food industry lobbying was at work.

There is absolutely NO nutritional requirement for free sugars in our diets, therefore AoS is disappointed that the 5% recommendation is conditional. The WHO used the GRADE[Grading of Recommendations Assessment, Development and Evaluation] system for evaluating the evidence which is useful for drug trials, but is not appropriate for the links between diet and health. This has allowed the food industry to sow the seeds of doubt amongst the WHO, who have failed to come up with the strong recommendation that is so vitally needed, especially for children.

On the other hand, the food industry says the recommendations are misleading and based on weak evidence.

The US Sugar Association [said]…Such a claim is serious, and requires high-quality data, particularly given the potential for consumer confusion and the likelihood that the economic impact to developing countries will be severe. There was a need for extensive debate, especially before the 5% value was included in official recommendations, said the European Committee of Sugar Manufacturers (CEFS). “Especially because the data this value is based on was deemed to be of very low quality by both WHO and the dental health review authors,” it said…. The sugar industry said that sugar in isolation could not be blamed for obesity and asked people to focus on what the WHO defined as the primary cause of obesity: an imbalance between calories and activity.

The WHO recommendations are similar to those issued for decades by national health agencies.  The last time WHO tried to issue the 10% of calories advice in 2003, it got clobbered by lobbyists.

This time, lobbyists didn’t succeed.  This is progress.

Tomorrow: more on sugar lobbying.

Kate Pine, a reader of this blog, sends this winter scene from Cedar Rapids, Iowa:

Her poignant comment:

I thought you might like to see this billboard…Note the snow on the street since I took this photo a couple days ago. This is part of why the public is so ill-informed about where and how food is produced.

Postscript: Daniel Bowman Simon writes: “This appears to be an ad for Bushel Boy, a year-round greenhouse tomato growing operation in MN.”  He also sends this link to a story in Crain’s about how Bushel Boy is financed.

I was invited by CNN to comment on the announcement by Nestlé that it is removing artificial colors from its chocolates.

Here’s what I said:

(CNN) When food giant Nestle USA (to which I am, alas, not related) last month announced plans to remove all artificial flavors and colors from its chocolate candies, it understandably made headlines. According to the company, by the end of 2015, none of a group of 250 chocolate products including Butterfinger and Baby Ruth will contain artificial flavors or colors such as Red #40 or Yellow #5.

With the expectation that these chemicals will also disappear from the company’s other candies, it looks like the end of the use of artificial flavors and colors in anything but the cheapest food products. If that proves to be the case, it will be a welcome shift.

Nestle USA intends to advertise the reformulated products with a “No artificial flavors or colors” claim on package labels. If sales of the “no artificial” candies grow as expected, the company will surely extend the removal to all of its other colored and flavored food products. After all, Nestle’s international parent company — and the company’s competitors — will have to take notice and find ways to remove these chemicals from all their product lines.

Nestle USA has undeniable clout. It accounts for a quarter of the $100 billion in annual revenues of the more than century-old, privately held parent corporation, which itself is the largest food company in the world. This move surely will not only reverberate through the candy industry, but also affect every other major food company.

In substituting natural for artificial flavors and colors, Nestle USA is responding to what its customers are saying. The company’s own research indicates that Americans prefer their beloved candy brands to be free of artificial flavors and colors, while other surveys find majorities of respondents saying that artificial chemical additives negatively influence their buying decisions.

Nestle is also responding to decades of complaints from consumer advocates about the potential health risks of these chemicals, especially the dyes. Studies in experimental animals have linked high doses of food dyes to health problems, among them organ damage, cancer, birth defects, and allergic reactions. In humans, studies link food dyes to hyperactivity and other behavioral problems in young children.

The credibility of these studies and their implications for human health remain hotly debated. In the 1970s, for example, Ben Feingold, a physician in California, suggested that food additives caused children to become hyperactive. Much of the evidence for the “Feingold hypothesis” rested on anecdotal reports by parents, whereas double-blind, controlled clinical trials produced contradictory results.

On the basis of current evidence, some artificial food dyes have been banned, while others remain in use despite suggestions that they too might be harmful. But the makers and users of food dyes argue that the chemicals are safe at current levels of usage. As a result of all this, and in the absence of convincing evidence of their safety, the advocacy group Center for Science in the Public Interest has campaigned since the 1970s to remove food dyes and other chemicals from foods, and has continued to petition the Food and Drug Administration to ban them.

The opposing views complicate the regulatory status of food dyes. But after one clinical trial reported that dyes induce hyperactivity in half the children studied, the British government asked companies to stop using most food colors; the European Union requires a warning notice on many foods made with them.

In the United States, the FDA does not permit artificial food dyes to be used unless the manufacturers can meet safety requirements. But the amounts of these substances in the country’s food supply have greatly increased in recent years — soft drinks, breakfast cereals, frozen desserts and even salad dressings all contain artificial coloring agents. True, the FDA considers a dye to be safe if there is a reasonable certainty that no harm will result from its intended use. But that standard is vague enough to cause concern.

Given the unresolved scientific questions, it is reasonable to ask why artificial colors have to be in foods at all. From the standpoint of manufacturers, such additives are essential for covering up and hiding unattractive colors in processed foods. To the public, red candy seems to taste better than the drab variety. And while natural colors exist, they are less stable or more expensive to produce. But for Nestle to have taken the action that it has, the company must have found substitutes it can live with. And appealing to consumers’ preference for “natural” makes good business sense.

The truth is that whether artificial colors do or do not cause health problems in adults or children, they are there strictly for cosmetic purposes. For that reason alone, getting rid of them is a good idea.

In 2013, Michael Moss wrote a long and highly entertaining piece for the New York Times Magazine about putting the advertising firm Victor & Spoils to work on making up a campaign to sell, of all things—broccoli.

The theory: marketing sells junk food so why not fruits and vegetables?

At last week’s meeting of the Partnership for a Healthier America (the industry support group for Let’s Move!), First Lady Michelle Obama announced that Victor & Spoils had created a for-real campaign to sell fruits and vegetables to moms and teens.

Meet brand FNV.

And don’t miss the video.

Some people who attended the meeting found this on apples in their hotel rooms (thanks to Marie Bragg for sending).

The produce industry considers this campaign to have “monumental implications” for its sales.

In other words, it is expected to work.

I’ve written about such campaigns in 2010 and in 2013.

As I said in 2013:

Marketing is not education.

Education is about imparting knowledge and promoting wisdom and critical thinking.

Marketing is about creating demand for a product.

But such campaigns clearly work.  The 5-A-Day for Better Health campaign in the early 1990s increased F&V consumption—for as long as it lasted.

Although this campaign raises the usual questions about marketing vs. education, and what happens when the funding runs out, it’s not aimed at young children.

I’m wishing it the very best of success.

I gave a talk last week at Hastings College in Hastings, Nebraska.

Before I left, Michael Moss, who wrote the New York Times investigative report about Hasting’s USDA animal research facility, mentioned the Kool-Aid museum.

The Kool-Aid museum?

As it happens, I adore museum exhibits devoted to single food items.  The Hastings Museum houses a permanent collection of Kool-Aid historical materials and artifacts.

A Hastings resident, Edwin Perkins, invented this product in 1927.

Kool-Aid, in case this isn’t on your usual shopping list, is a flavored and colored powder that comes in small packets.  You add the 4.6 gram contents—plus one full cup of sugar—to two quarts of water.

What’s in the packets?  I was given a cherry limeade flavor: contains citric acid, maltodextrin, calcium phosphate, vitamin C, natural and artificial flavor, salt, artificial color, red 40, tocopherol [a form of vitamin E], BHA, and BHT (preservatives).

The less said about nutritional value, the better.

But take a look at its corporate history:

• 1953   General Foods buys Kool-Aid
• 1985  Philip Morris buys General Foods and, therefore, Kool-Aid
• 1988  Philip Morris buys Kraft
• 1989  Philip Morris combines Kraft and General Foods to create Kraft General Foods (Kool-Aid is now owned by a cigarette company)
• 1995  Philip Morris names the combined entity Kraft Foods
• 2003  Philip Morris changes its name to Altria (Kool-Aid is still owned by a cigarette company)
• 2007  Philip Morris splits Kraft—and, therefore, Kool-Aid—off as a separate company
• 2012  Kraft splits into two companies, Kraft Foods Group (with Kool-Aid) and Mondelez International
• 2012  Kraft Foods Group cuts a deal with SodaStream International to use Kool-Aid with SodaStream devices

I loved the exhibit, even though you have to go through rooms full of guns to get to it.

The exhibit didn’t mention the Jonestown massacre, the source of the phrase “drinking the Kool-Aid” because Kool-Aid was not involved.

The uproar caused by the release of the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (DGAC) has been even noisier than I predicted, so noisy that USDA Secretary Vilsack appears to have pulled back on it.  He told Jerry Hagstrom (HagstromReport.com) that:

He wants people to realize that the process of writing the dietary guidelines “is just beginning today,” and that he and [HHS Secretary] Burwell will consider input from federal agencies and the general public. He said he wants to be sure that people “know that I know my responsibility.”

In this, Vilsack was referring to the directive by Congress in the 2015 appropriations bill blocking him from considering sustainability in the guidelines.

As for the DGAC report: It concluded:

…the U.S. population should be encouraged and guided to consume dietary patterns that are rich in vegetables, fruit, whole grains, seafood, legumes, and nuts; moderate in low- and non-fat dairy products and alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and beverages and refined grains.

Predictably, this did not go over well with the meat industry or, for that matter, other industries affected by such advice or groups funded by such industries.

Less predictably, the New York Times published an Op-Ed by Nina Teicholz, the journalist author of “The Big Fat Surprise,” a work based on her own review of the science of fat.  In her view, mainstream nutritionists have badly misinterpreted this science to the great detriment of public health.

Her conclusion:

…we would be wise to return to what worked better for previous generations: a diet that included fewer grains, less sugar and more animal foods like meat, full-fat dairy and eggs.

But Teicholz’ book has been the subject of a line-by-line analysis by Seth Yoder (whom I do not know personally).  Mr. Yoder did what graduate students in science are trained to do: read the references.

He looked up and examined the references Teicholz cites in the book as the basis of her views.  He documents an astonishing number of situations in which the references say something quite different from what Teicholz gets out of them.  At the very least, his analysis raises serious questions about the credibility of her views on the science of fat.

Let’s grant that the science of nutrition is difficult to do and complicated.  The New York Times should know this, which is why I’m surprised that it would give Teicholz so prominent a platform without countering them with point-counterpoint views of a respected nutrition scientist.

It does little to foster the health of the public to make nutrition science appear more controversial than it really is.

The basic advice offered by 2015 Dietary Guidelines Advisory Committee boils down to plain common sense:

• Eat plenty of foods from plant sources
• Eat foods from animal sources in moderation
• Balance calories
• Avoid overeating junk food

Unfortunately, this kind of advice doesn’t make headlines or, apparently, merit op-ed space in the New York Times.

The 2015 Dietary Guidelines Advisory Committee (DGAC) issued its more than 500-page report yesterday.

Before I say anything about it, please note that this report informs, but does not constitute, the Dietary Guidelines. The agencies—USDA and HHS—write the actual Guidelines and are not expected to do so until the end of this year.

Here are what I see as the highlights (these are direct quotes)

• A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.
• A diet higher in plant-based foods…and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet.
• It will take concerted, bold actions…to achieve and maintain the healthy diet patterns, and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative.

Some facts and statements from the report (not direct quotes).

• Half the energy intake in U.S. diets comes from a combination of burgers and sandwiches (~14%), desserts and sweet snacks (8.5%), sugary beverages (6.5%), mixed dished made with rice, pasta, and other grains (5.5%, savory snacks (~5%), pizza (4.3%), and meat, poultry and seafood mixed dishes (~4%).
• Nearly half of total sugar intake comes from beverages other than milk and 100% fruit juice

The report comments on issues under current debate.

• Saturated fat: “replacing SFA with unsaturated fats…significantly reduces total and LDL cholesterol…Strong and consistent evidence…shows that replacing SFA [saturated fatty acids] with PUFA [polyunsaturated fatty acids] reduces the risk of CVD [cardiovascular] events and coronary mortality…For every 1 percent of energy intake from SFA replaced with PUFA, incidence of CHD [coronary heart disease] is reduced by 2 to 3 percent. However, reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD risk.”
• Sugars: “Strong and consistent evidence shows that intake of added sugars from food and/or sugar sweetened beverages are associated with excess body weight in children and adults…Strong evidence shows that higher consumption of added sugars, especially sugar-sweetened beverages, increases the risk of type 2 diabetes among adults and this relationship is not fully explained by body weight.[Theae findings are] compatible with a recommendation to keep added sugars intake below 10 percent of total energy intake.”
• Food labels: “Consumers would benefit from a standardized, easily understood front-of-package (FOP) label on all food and beverage products to give clear guidance about a food’s healthfulness.” [This refers to the recommendations of the Institute of Medicine that I’ve written about previously; they disappeared without a trace.]
• Soda taxes: “Economic and pricing approaches, using incentives and disincentives should be explored to promote the purchase of healthier foods and beverages. For example, higher sugar-sweetened beverage taxes may encourage consumers to reduce sugar-sweetened beverage consumption.”
• SNAP: “Policy changes within the federal Supplemental Nutrition Assistance Program (SNAP), similar to policies in place for the WIC program, should be considered to encourage purchase of healthier options, including foods and beverages low in added sugars. Pilot studies using incentives and restrictions should be tested and evaluated.”

The DGAC recommends (these are direct quotes but not necessarily complete):

• Establish local, state, and Federal policies to make healthy foods accessible and affordable and to limit access to high-calorie, nutrient-poor foods and sugar-sweetened beverages in public buildings and facilities.
• Set nutrition standards for foods and beverages offered in public places.
• Improve retail food environments and make healthy foods accessible and affordable in underserved neighborhoods and communities.
• Implement the comprehensive school meal guidelines (National School Lunch Program) from the USDA that increase intakes of vegetables (without added salt), fruits (without added sugars), and whole grains.
• Limit marketing unhealthy foods to children.
• Make drinking water freely available to students throughout the day.
• Ensure competitive foods meet the national nutrition standards (e.g., Dietary Guidelines for Americans).
• Eliminate sugar-sweetened beverages [from schools].
• Nutrition Facts label should include added sugars (in grams and teaspoons).

And for all federal nutrition programs, the DGAC recommends:

• Align program standards with the Dietary Guidelines for Americans so as to achieve the 2015 DGAC recommendations and promote a “culture of health.”

Congratulations to this committee for its courageous recommendations.

Why courageous?  See my previous comments on the objections to such advice.

The next step: public comment:

The public is encouraged to view the independent advisory group’s report and provide written comments at www.DietaryGuidelines.gov for a period of 45 days after publication in the Federal Register. The public will also have an opportunity to offer oral comments at a public meeting in Bethesda, Maryland, on March 24, 2015. Those interested in providing oral comments at the March 24, 2015, public meeting can register at www.DietaryGuidelines.gov. Capacity is limited, so participants will be accepted on a first-come, first-served basis.

Here’s your chance to support this committee’s excellent ideas and demonstrate public approval for diets that promote the health of people and the planet.

Note: the reactions to the report are pouring in and I will deal with them next week.  Enjoy the weekend!