Food Politics

by Marion Nestle
Aug 8 2010

Why public health matters

I received a couple of requests to define “public health” last week from readers Anthro and MA.  As MA puts it,

Maybe…we need a definition of “public health.”  I view my health as a private matter, my food choices as a private matter, and an expression of my freedom.  To me, public health is not an individual concern, it’s a corporate (group) concern – government, schools, companies, farms, etc.  Public health includes things like properly working sewer systems, sanitation, water quality, and air quality.   Marion – can we get a definition of ‘public health’ from you, as Anthro suggested?

My definition of public health isn’t much different from mainstream definitions.  But to me, public health is a critically important expression of democracy, and the antithesis of  a “corporate” concern.  Public health approaches promote good health for everyone, not just those who can afford it or are educated enough to make appropriate choices.

A standard definition such as the one given in Wikipedia, says that public health is about promoting health and preventing disease through societal choices and efforts.   Public health deals with health at the population level, rather than at the level of individual personal responsibility, and it emphasizes prevention rather than treatment.

In my experience teaching public health nutrition, the concept of public health is sometimes hard for people to grasp, especially since populations are made up of individuals. I like to explain it this way: public health makes it easier for individuals to make healthful food choices for themselves and their families. Or to put it another way, public health makes better food choices the default.

The classic example of a public health intervention is water chlorination.  As individuals, we could all boil our own drinking water to kill harmful organisms but this requires us to have stoves, pots, and fuel, and to know how to boil water.  For many people, having to do this would be an intolerable burden and responsibility.  Instead, some societies choose to take public health measures to ensure that drinking water is safe at the tap for everyone.

Other food examples: milk Pasteurization, banning of trans fats, food labeling.

The particular example that elicited the question has to do with food safety.   We, as a society, could insist that food producers take measures to ensure that their products are free of harmful microorganisms (public health), or we could teach individuals how to manage food safety in the home or restaurants and cook foods properly (personal responsibility).

Preventing obesity is another example: We could, as a society, take measures to make it easier for people to eat more healthfully and be more active (public health) or leave it up to individuals to do this for themselves (personal responsibility). Many of the arguments about suggested public health measures to prevent obesity are about how best to balance society’s needs with individual rights.  But as I see it, the proposals aim to tweak societal choices that have already been made: which crops receive farm subsidies, for example.

An exceptionally clear example is how to avoid toxic levels of methylmercury in fish.   We can teach pregnant women to recognize which fish are high in methylmercury and hope this works well enough so they will avoid buying such fish (personal responsibility) or we could–as a society–require coal-burning power plants to scrub their emissions so mercury doesn’t get into ocean or lake waters in the first place (public health).

Obviously, both public health and individual approaches are necessary, but the overall objective of public health is to make it much, much easier for individuals to make better health choices without having to think about them.

Because public health applies to everyone, it is essentially democratic.   And that’s one of the reasons why I think it matters so much.

Aug 6 2010

International food politics: Save Russia’s fruit seed bank!

The Global Crop Diversity Trust is writing to warn readers about the impending destruction of Russia’s historic fruit-and-seed collection in order to make way for commercial development.  Its press release begins:

As the fate of Europe’s largest collection of fruit and berries hangs in the balance of a Russian court decision, the Global Crop Diversity Trust issued an urgent appeal for the Russian government to embrace its heroic tradition as protector of the world’s crop diversity and halt the planned destruction of an incredibly valuable crop collection near St. Petersburg.

Pavlovsk Experiment Station is the largest European field genebank for fruits and berries, and is part of the N.I. Vavilov Research Institute of Plant Industry, where Russian scientists famously starved to death rather than eat the seeds under their protection during the 900-day siege of Leningrad during World War II.

At issue is an effort by residential real estate developers to build houses on land occupied by Pavlovsk Station. The take-over would involve bulldozing Pavlovsk’s field collections amassed over the last century—collections that contain thousands of varieties of apples, strawberries, cherries, raspberries, currants and other crops—90 percent of which are not found anywhere else in the world.

Want to know more?  Read the Vavilov Research Institute’s discussion of the history and significance of this collection, its press release, and articles about this situation from the Independent and New Scientist.

Change.org is encouraging people to write to the president of Russia to save the collection. Want to add your signature?  Here’ s how.

Aug 5 2010

John Dewey on school farms. Reauthorize child nutrition!

Thanks to Daniel Bowman Simon who knows that I love old materials on American food politics.  He just sent me this 1917 World War I pamphlet—written by the distinguished educator, John Dewey—urging schools to teach kids how to farm.  Dewey was thinking of the war effort, of course, but also for kids’ health and character development.

What, then, is the duty of the school? In the fight for food, and it will be a fight, school children can  help…With some intelligent direction, these school children and older boys and girls and men and women might easily produce on the available land an average of $75 each in vegetables and fruits for their own tables or for sale in their immediate neighborhood; fresh and crisp through all the growing months and wholesomely canned and preserved for use in winter.

This would add $750,000,000 to the best form of food supply of the country without cost of transportation or storage and without profits of middlemen…In addition to the economic profits, there would be for the children health and strength, removal from temptation to vice, and education of the best type; and for older persons, rest and recreation in the open air and the joy of watching things grow.

What a good idea.

Dewey’s ideas remind me of the child nutrition reauthorization bills now languishing in Congress.    The bills fund school meals, WIC, and other programs in this country’s safety net for kids from poor families.  The bills have plenty of support from anti-hunger, health, and nutrition advocacy groups.  They even have bipartisan support says Senator Richard Lugar (Rep-Indiana).  The First Lady has called on Congress to pass them without delay.

What’s holding them up?  The same thing that is holding up the food safety bill: a dysfunctional Congress.

One can dream that the bills will help schools promote gardening along with everything else they are supposed to do.  But it sure seems like the time to push Congress to get busy and start doing its job.  Now!

Addition: The Senate passed the bill this afternoon!

Aug 4 2010

We need S. 510 to pass, despite tea bagging

My policy is to ignore snippy comments on this site but I recently received one that raises an issue worth attention.  In response to my most recent post about the endless—and to my mind, appalling—delays in passing S. 510, a bill that will give the FDA authority to require safe food production, a critical reader, Harry Hamil, writes:

Dr. Nestle, your statement, “What’s holding up this bill? Nothing but politics of the worst kind,” is absolutely false and you know it.  As you well know, there is broad, deep and large opposition to the industrial-size-only approach to food safety that S 510/HR 2749 will make the law of the land….And, once again, I challenge you to a debate of the actual provisions of the bill. Your previous blogs demonstrate a remarkable ignorance of the actual provisions and little understanding of the real world consequences.

As readers of this blog know, I believe that all food, no exceptions, from large producers and small, should be produced safely, meaning that producers should follow food safety plans that involve preventive controls.  But this comment raises another issue: the unhelpful tone of this debate.

Bill Marler, the Seattle lawyer who represents the victims of food poisonings, gets such comments all the time.  In a post on FoodSafetyNews.com, he deals with the tone issue in response to rather nasty comment about his views of raw milk.  Marler says:

Actually, I get more than a few emails like this.  Most do a bit better at spelling and punctuation, but nearly all are from raw milk proponents, producers, or consumers (although there are a few from the anti-S. 510 cabal).  Some, but not all, have a level of passion that borders on violence.  Perhaps not directed at me, but generally in the “do not tread on me”–“tea party” shouting that we have been subjected to over the last year.

Frankly, I was perplexed at the “yell fest” that passed for discussion of whether we should expand health care to the 40 million of our fellow citizens without health insurance.  I am shocked at how we scream at each other via email or blog comments about raw milk or honest differences about how food safety legislation should be modeled.  It is like screaming at and belittling each other at the dinner table–albeit, a very large table.

What is with all this anger over food?  I mean, honestly, it seems like there are bigger fish to fry.  What about the wars?  Global warming?  Energy policy?

But, folks are angry about their view of food–especially the proponents of raw milk (affectionately, “raw milkies”) and the anti-S. 510 folks (affectionately, “organic tea baggers”).  Both groups view themselves as victims of big government and big business bent on reducing them to servitude or extinction.  They cannot see that perhaps, just perhaps, people who see the dangers of raw milk or the value of S. 510, might simply have an honest disagreement with those that see raw milk as the nectar of the gods or S. 510 as more than a method of lining the pockets of Monsanto.  But, hey, that is just me.

So, do the yelling, threats and belittling of the anti raw milk/pro S. 510 crowd actually work?  Are some convinced that those that yell the loudest have the best arguments?  Or, do some simply shy away from their positions after being the target of a nasty blog post or scathing email or comment?  I think some do.  I know I have been tempted to simply focus on other pressing issues surrounding food safety–there are many–and let folks guzzle raw milk to their heart’s content and let S. 510 die a lingering death.

But, that is not my style.  Even as a child when told to do A I usually did B.  When the raw milk party calls me a tool of big dairy or an ambulance chaser, I come back with reasoned pros and cons of raw milk consumption, videos of raw milk consumers sickened, and a website–Real Raw Milk Facts–dedicated to having a reasoned discussion about raw milk.  I am also beginning to work on a raw milk retail sampling project to test its safety.

As for S. 510, the nastier the emails from small producers who want little or no food safety regulation, the more money I donate to political campaigns, the more trips I take to DC, and the more often I fund victim visits to their favorite senator.

And, to do the above, I hardly raise my voice.  Well, once in awhile I do.

Me too.  Thanks Bill.
Aug 3 2010

I’m shocked, shocked. Cattlemen misuse checkoff funds.

The National Cattlemen’s Beef Association, which got $51 million in checkoff funds last year, is improperly allowing some of this money to be spent on lobbying activities, according to William Neuman in today’s New York Times.

Checkoff programs are administered by the USDA.  They tax commodity producers to fund generic marketing campaigns (think: Milk Mustache).  As I explained in my book, Food Politics:

Although the check-off legislation specifically prohibits use of the funds for lobbying, the distinction between promoting a product to consumers as opposed to promoting it to lawmakers can be subtle. Some of the boards are so closely affiliated with lobbying groups that they share office space.

For many years, the Cattlemen’s Beef Promotion and Research Board (check-off organization) shared an address with the National Cattleman’s Association (trade association lobbying group), and the National Pork Board (check-off) shared offices, staff, and telephone services with the National Pork Producers Council (lobbying).

Even cozier, the legislation specifies that a certain percentage of the funds must be allocated to the commodity groups responsible for nominating the board members who run the programs; these members are officially appointed by USDA.

Check-off funds are supposed to be used for research as well as advertising, but only a small fraction is used for that purpose. In the mid-1990s, 8% of the beef check-off’s $80 million or so went to research, and the rest for promotion and “information;” research percentages for dairy, egg, potato, and soybean checkoff programs were slightly higher.

Regardless of level, nearly all of the research is designed to promote the commodity. Beef check-off research is designed to “dispel negative perceptions about beef,” and to develop a factual basis for viewing beef products as “part of a varied, convenient, and healthful diet”….The great majority of the funds are spent to convince consumers to choose one type of food product over another.

The Meat and Beef Boards, for example, design campaigns to build demand for red meats and meat products; encourage consumers to view beef as wholesome, versatile, and lower in cholesterol; and educate doctors, nurses, dietitians, teachers, and the media about the nutritional benefits of beef.

Checkoff programs reek of conflicts of interest.  What makes this particular audit so interesting is that it was done by an outside accounting firm.  Usually, these things are done internally and remain private.  Chalk one up for this administration’s attempt to be transparent.

Aug 2 2010

Why the FDA must act on health claims

On July 30, Center for Science in the Public Interest (CSPI)—in collaboration with representatives of a long list of distinguished health and consumer organizations (see below)–wrote Martha Coven of the Domestic Policy Council and Ezekiel Emanuel of the Office of Management and Budget urging them to encourage the FDA to take more vigorous enforcement action against misleading health claims on food packages.

Their petition responds to comments by the FDA’s Michael Taylor (discussed in a previous post) in a July 19 article for the Atlantic Food Channel, titled “How the FDA is picking its food battles.”   In explaining why the FDA is backing off from doing anything about unsubstantiated health claims on food products, Taylor said:

FDA must pick its battles—and set its priorities—in a way that will best benefit the public health….We have no pre-market review authority over such claims, and, under prevailing legal doctrines concerning “commercial free speech,” the evidentiary requirements placed on FDA to prove that such claims are misleading are significant and costly to meet. Moreover, meeting them requires tapping the same team of nutritionists, labeling experts, and lawyers who are working on our other nutrition initiatives.

We’re also conscious of the cleverness of marketing folks, who, once we prove today’s claim is misleading, can readily come up with another one tomorrow. Going after them one-by-one with the legal and resource restraints we work under is a little like playing Whac-a-Mole, with one hand tied behind your back.

So, we must make choices….especially considering the other high-priority nutrition and food safety initiatives that compete for FDA’s finite resources. We’ll consider all possibilities, but, in the meantime, we call on the food industry to exercise restraint, and we welcome the scrutiny CSPI and the media give to this issue.

Clearly, I was not the only one dismayed by this statement, which appears to be an open invitation to food companies to do whatever they like with health claims.  Indeed, Taylor’s statement reminded me of the Bush Administration’s FDA which, in 2003, announced that it had lost so many first amendment  health claims cases in court that it no longer intended to fight them.

But Taylor’s statement is also an open invitation to food advocates to get busy, as CSPI and the other signers of this letter have now done. The letter, dated July 30, 2010, is a follow up to a June 11 meeting on FDA/USDA Food Labeling Reform Efforts:

At Zeke’s suggestion, we are attaching a Priority List/Timetable Chart that provides an overview of the recommendations we made at our meeting and delineates how those recommendations intersect. As we discussed:

• We commend the Food and Drug Administration (FDA) for increasing the number of enforcement actions it has taken against misleading food labeling, and we urge the agency to increase those efforts. We also commend the FDA’s initiative to develop a system for disclosing key nutrition information on the fronts of food labels. However, we emphasize that the existing Nutrition Facts panel must also be modernized. In particular, nutrition information must be based on up-to-date serving sizes, a Daily Value for added sugars must be established and added to the existing Nutrition Facts panel, and “Calories per serving” must be displayed more prominently. Revisions to the Nutrition Facts panel and the development of a front-of-pack disclosure system are closely intertwined and should be developed concurrently.

• We urge the Domestic Policy Council to ask the FDA to ensure that any front-of-pack labeling scheme is not undercut by deceptive health-related claims on the fronts of food packages. Such claims, if unabated, will divert attention from any front-of-pack scheme the FDA develops. Since our meeting, the Federal Trade Commission (FTC) issued a consent order prohibiting claims that a food product could strengthen immunity because the claim lacked sufficient clinical evidence. Such claims are called “structure/function” claims by the FDA. The FDA should take a consistent position regarding the use of those claims. In addition, the FDA should address claims exaggerating the presence of healthy ingredients stressed in the U.S. Dietary Guidelines such as whole grains, fruits, and vegetables. For example, failure to remedy claims such as “Made with real fruit” on products that contain little fruit will detract from a declaration of sugar content that the FDA may specify in a front-of-pack labeling scheme, thus frustrating the Administration’s attempts to reduce childhood obesity.

• One way to remedy exaggerated claims for healthy ingredients (other than prohibiting them completely) is for the FDA to revise the ingredient list to require that the percentage of key ingredients such as fruit be disclosed in a clear, easily readable manner. FDA could also require that ingredient lists group all sources of added sugars to provide consumers with a clearer indication of the amount of added sugar in a product. The First Lady has recognized that ingredient labeling reform is an integral part of the Administration’s broader efforts to combat childhood obesity. The U.S. Department of Agriculture (USDA) is already working on new formats for ingredient labeling. We support those efforts and request the Council to encourage the FDA to follow USDA’s approach.

• In regard to a timetable, the recommendations we have made are closely intertwined with efforts already ongoing at the FDA. In some cases, they are necessary to ensure that those ongoing efforts by FDA succeed. We, therefore, urge the Council to recommend that the FDA expand its food labeling reform initiatives to include these additional issues and address them concurrently. Additional efforts that complement existing FDA labeling reform initiatives should commence as soon as the first set of initiatives is published in the Federal Register. All initiatives should be finalized by October 2012. This request is based on the fact that the FDA implemented the Nutrition Labeling and Education Act of 1990 in two years. The reform efforts we request are more limited than the requirements of the 1990 Act, and the FDA should be able to accomplish them by 2012 based on the agency’s previous performance on such matters.

• Rep. DeLauro, Chair of the House Agriculture Appropriations Subcommittee, asked the FDA how many FTEs the agency would need to issue regulations to revise the Nutrition Facts panel, increase the prominence of calories per serving, require caffeine labeling, and establish a daily value for added sugars, as well as other issues. The FDA stated that approximately “10-12” additional FTE’s would be necessary to address such concerns. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations for 2005: Hearings Before a Subcomm. of the House Comm. on Appropriations, 108th Cong. 2d Sess. 323 (2004). While the FDA’s response at the time involved some issues not covered by our current requests, we believe that the FDA’s estimate is still reasonable, and we urge the Council and the Office of Management and Budget to work with the FDA to ensure that the FDA devotes additional resources to this effort.

We welcome the opportunity to assist the Administration and look forward to continuing our dialogue.

The letter is signed by Bruce Silverglade, Director of Legal Affairs, CSPI and representatives of Consumers Union, American Public Health Association, American Medical Association,  American Cancer Society Cancer Action Network, American Heart Association,  American Society of Bariatric Physicians, American Diabetes Association,  American Dietetic Association, Alliance for Retired Americans, Society for Nutrition Education, American Institute for Cancer Research, and Directors of Health Promotion and Education.

Let’s hope the FDA pays attention and gets busy on these issues.

Aug 1 2010

Self-promotion alert: books just published

It’s been a busy summer with three books just out, all three in paperback or Kindle editions.  Click on Books above or the covers in the upper right-hand corner of the site to get information about them, or the ones below to see what Amazon has to say about them.
To be published August 4: the University of California Press paperback edition of Pet Food Politics: The Chihuahua in the Coal Mine.

In June, University of California Press issued the revised edition of Safe Food: The Politics of Food Safety, with a new introduction and concluding chapter that bring everything up to date since the book first came out in 2003.  I can’t help commenting that at the time the book went to press in December, the Senate had not yet passed the food safety bill.  Guess what?  It still hasn’t.

And in May, Free Press/Simon & Schuster issued Feed Your Pet Right: The Authoritative Guide to Feeding Your Dog and Cat.

Enjoy!

Jul 31 2010

Food Matters column: water and sports drinks

My monthly Food Matters Q and A column in the San Francisco Chronicle appears this weekend:

Are 8 glasses of water a day really necessary?

Q: It’s such a hot summer and I’m sweating all the time, but I don’t feel thirsty. Do I have to force myself to drink eight glasses of water a day?

A: San Franciscans: Please, no complaints about summer fog. Where I live, it’s hot and humid, and staying hydrated takes work.

Everybody needs water to replace the amounts lost through breath, sweating and excretions. In comfortable temperatures, the amounts lost conveniently come out to about a quart of water for every thousand calories consumed. If you eat 2,000 calories a day, you need about 2 quarts of water.

But water equivalents – juice, coffee, tea, soda and anything else with water in it, including food – work just as well. Watermelon is called watermelon for a reason. It is mostly water and perfect for hot summer days.

Mostly, you don’t have to keep track of how much liquid you drink. Thirst takes care of it. If you need water, you feel thirsty and you get something to eat or drink. Problem solved.

But thirst doesn’t work very well at times when it is most needed – in very hot weather, at high altitudes or during heavy exercise. People in hot climates, mountain climbers and athletes have to force themselves to drink.

How can you tell when you need water? This is easy. Look at your urine. If you are dehydrated, your urine is bright yellow and smelly. If you are getting enough water, your urine is pale and practically odorless.

Except for these exceptions, hardly anyone needs to worry about how much water to drink. That “hardly anyone,” however, also includes children and the elderly, who tend not to regulate water balance very well. Beyond these exceptions – as you shivering San Franciscans can attest – thirst works well as a guide to how much to drink.

Q: A young woman I know got a nasty combination of altitude sickness and electrolyte imbalance when she was hiking in the Sierra Nevada. She sipped water constantly, ended up drinking too much, and got so sick from lack of salt that she had to be airlifted out. Are those Gatorade-like drinks that replenish electrolytes any better than plain water when you are hiking or exercising hard?

A: Those drinks might help, but your friend also must not have been eating much on that hike. Foods are excellent sources of electrolytes.

Electrolytes are minerals like sodium, potassium and chloride that help balance blood acidity. They are lost in sweat, which is why sweat tastes salty. Our bodies have plenty of electrolytes. Salt, for example, is usually eaten in great excess. Normal sweat losses don’t matter much, unless we are vigorously exercising or sweating profusely.

But sweating is easy to miss at high altitudes because it evaporates so quickly. The higher the altitude, the easier it is to overlook fluid and electrolyte losses.

High altitude also disrupts normal appetite, so climbers don’t feel hungry or thirsty. Elite climbers know to pack lightweight foods and supplements made especially for that purpose, and to force themselves to eat and drink frequently.

Drinks advertised as electrolyte supplements do indeed contain electrolytes. Gatorade Orange Sports Drink, for example, contains water as the first ingredient, followed by sugars (sucrose syrup, high-fructose corn syrup), flavors and three sources of electrolytes – salt (sodium chloride), sodium citrate and monopotassium phosphate – along with color additives and thickeners.

If you are an athlete working out for an hour or more, Gatorade might replenish your sodium, potassium and chloride more quickly than food can, but not by much. An 8-ounce Gatorade serving provides just 1 percent of the daily value for potassium (30 milligrams) and 5 percent of the daily value for sodium (110 milligrams).

Gatorade is a sweetened drink supplemented with a few salts, but with less sugar and fewer calories than a regular soft drink. On the basis of electrolytes, PepsiCo, its parent company, markets Gatorade as a better choice than any other drink, including water. Nothing, says PepsiCo, rehydrates, replenishes and refuels athletes better. According to Advertising Age, the company backs up that contention with a hefty advertising budget – $118 million in 2009.

Studies do show that replenishing electrolytes is a good thing to do at high altitude or during any other extreme activity. But hikers can do this with food or supplements without having to carry additive-laden sugary drinks in a backpack.

An average carrot, for example, provides 230 milligrams of potassium and 50 milligrams of sodium. Many other vegetables have similar electrolyte profiles. Nobody wants to carry heavy foods up a mountain, which is why sports shops sell dehydrated foods and special supplements for high-altitude climbers.

It’s a good idea to drink water at high altitude, but also to eat plenty of good food at regular intervals.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/07/30/FDD51EK7K0.DTL

This article appeared on page K – 5 of the San Francisco Chronicle

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