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At the White House Convening on food marketing to children a couple of weeks ago, representatives of food companies repeatedly stated that advocates are not giving them nearly enough credit for how hard it is for them to make and market healthier products.  They have shareholders to please.  They need positive reinforcement.

Pressures on advocates to applaud food companies’ efforts may explain the furor last week over McDonald’s latest promises to go healthy.  In a deal brokered with the Clinton Foundation’s Alliance for a Healthier Generation, McDonald’s announced its new initiatives in full-page newspaper advertisements (read the text here):

Among other promises, McDonald’s said it would:

Promote and market only water, milk, and juice as the beverage in Happy Meals on menu boards and in-store and external advertising.

I did not participate in any of the press events so I can’t vouch for what was said.  But it must have left the impression that McDonald’s was dropping sodas as the default drink in Happy Meals (if parents wanted a soda for their kids, they would have to order one).

The Center for Science in the Public Interest (CSPI), for example, issued a press release: “Removing Soda from kids’ meals among McDonald’s improvements.”

Ronald McDonald’s slow march toward healthier meals made a major advance today, but a long road lies ahead for the company. Getting soda out of Happy Meals is historic progress that should immediately be adopted by Burger King, Wendy’s, and other chains. Soda and other sugar drinks are leading promoters of obesity and diabetes and one day it will seem crazy that restaurants ever made this junk the default beverage for kids.

USA Today quoted CSPI’s Margo Wootan:

The prospect of being able to easily order a value meal at McDonald’s that’s comprised of a burger, a small salad and bottle of water is a huge step forward, says Margo Wootan, director of nutritional policy at the Center for Science in the Public Interest. “It takes a meal from being a nutritional disaster (burger, fries and soft drink), to something that will fit a healthy diet.

But then folks started looking at the fine print of McDonald’s actual agreement with the Clinton Alliance.

Uh oh.

CSPI issued another press release the next day: “McDonald’s, Alliance for Healthier Generation, misled public and media re: soda and Happy Meals.”

McDonald’s and the Alliance for a Healthier Generation misled the media, CSPI, and families when they stated that the company would not feature, promote, or market soda in connection with Happy Meals. In briefings to health groups and in their press release and full-page newspaper ads, McDonald’s and the Alliance claimed that the company would “promote and market only water, milk, and juice as the beverage in Happy Meals on menu boards and in-store and external advertising.” But small print in McDonald’s formal agreement with the Alliance states that “McDonald’s may list soft drinks as [sic] offering on [sic] Happy Meal section of menu boards.”

In any case, as McDonald’s explains in its press release, don’t hold your breath for any of its promises to happen soon:

Anna Lappé has a new entry in her Food MythBuster film series, this one on marketing to kids.

You can watch the trailer at the website, and also sign up for the  launch event to participate in the live Q&A session online.

Mexico has an overweight-plus-obesity rate of 70%, and 15% of the population has type-2 diabetes. You might think that a key public health message might be “eat less sugar.”

But check this ad on a city bus:

Translation:

• Cane sugar
• It’s natural
• A little happiness each day
• Only 15 calories per tablespoon 

In other (implied) words, “eat more sugar! It’s good for you!”

The American Journal of Hypertension has published a series of point-counterpoint articles on the salt debate: are public health campaigns to reduce sodium intake warranted by the data?  Public health agencies argue yes.Others argue to the contrary.

This debate is not easily resolved, mainly because everyone eats a high-salt diet; most salt is already in processed and restaurant foods and eaters have no choice.

So the issue really becomes one of whether it makes any difference to high blood pressure to reduce high salt intakes and, if so, to what level—questions difficult to answer with current methods.

Introduction

The Salt Discourse in 2013
Theodore A. Kotchen

CDC Response

Sodium Reduction Is a Public Health Priority: Reflections on the Institute of Medicine’s Report,Sodium Intake in Populations: Assessment of Evidence
Janelle P. Gunn, Jessica L. Barron, Barbara A. Bowman, Robert K. Merritt, Mary E. Cogswell, Sonia Y. Angell, Ursula E. Bauer, and Thomas R. Frieden

NYC DOHMH Response

Getting the Message Right: Reducing Sodium Intake Saves Lives
Jenifer E. Clapp, Christine J. Curtis, Susan M. Kansagra, and Thomas A. Farley

Editorial

The IOM Report Fails To Detect Evidence to Support Dietary Sodium Guidelines
Michael H. Alderman and Hillel W. Cohen

Researcher Responses

Physiology, Not Policy, Drives Sodium Intake 
David A. McCarron

Extreme Sodium Reductions for the Entire Population: Zealotry or Evidence Based?
Andrew Mente, Martin J. O’Donnell, and Salim Yusuf

Flawed Evidence Should Not Derail Sound Policy: The Case Remains Strong for Population-Wide Sodium Reduction
Lawrence J. Appel and Paul K. Whelton

Sodium: How and How Not to Set a Nutrient Intake Recommendation
Robert P. Heaney

A reader writes:

Willingboro, NJ School Board has taken action effective for the 2013-2014 school year to discard a school meal rather than feed a student, if their parents cannot, or haven’t arranged to, refill their student’s lunch account.

Take a look at this letter from the school board administrator announcing discontinuation of humanitarian meals:

If a student goes through the food service line and it is discovered that the student does not have the required funds for a meal, the Chartwells Food Service representative has been instructed by the Willingboro Board of Education to withhold the meal from the student, with the understanding that such meal cannot be re-served and must be discarded.

I was appalled by the letter.  Hungry kids need to be fed.  They can’t learn if they are hungry.

But before going on a rant, I consulted my go-to, school-food guru, Kate Adamick of Cook for America.  She explains the fiscal realities of current school-food policies:

The truth is that there are many, many school districts that do not feed kids whose parent will not pay for them.  Some, as seems to be the prior practice of the Willingboro district, offer a “humanitarian” meal (typically, a peanut butter sandwich and a carton of milk), though that is by no means required of them and by no means universal.

Of course, students who qualify for free meals under the USDA regulations cannot be refused free school meals (provided that the proper paperwork has been filled out on their behalf or that they qualify under other regulatory or statutory provisions).

The refusal to feed everyone, regardless of whether they pay, has become a more pressing issue in recent years, both because the number of families who don’t qualify for free meals but can’t afford to pay for them has increased at the same time the school food budgets have become tighter…Many school districts are truly struggling to keep their financial heads above water….

The REAL answer is for the federal government to provide free meals for all kids.  I doubt, however, that will come to pass in our lifetime.

Here’s how this system works:

• Unlike other aspects of school education, the government requires school-meals programs to be self-supporting.  They must at least break even or do better, which is not so easy given current reimbursement rates.
• The government reimburses schools for federally supported school meals based on the number of participants.
• Parents often cannot or do not want to fill out the paperwork.
• This leaves schools with a dilemma.  If they provide free meals, they lose money.

Some school districts, like the one in New York City, do everything they can to make the system work so that hungry kids get fed.   Willingboro’s school board has chosen to follow the rules to the letter, regardless of the effects of this decision on kids in its schools.

Universal school meals would solve many of the problems caused by current school food policies (for evidence, see Janet Poppendieck’s Free for All: Fixing School Food in America).

Ready to join the universal school meals movement, anyone?

As an undergraduate at Berkeley, I majored in Bacteriology.  I haven’t worked in that field for decades, but the training makes me appreciate the terrific job the Centers for Disease Control and Prevention (CDC) does in providing education about food safety microbiology.

The CDC website is always a good place to start (another is food safety lawyer Bill Marler’s blog).

I thought of this as I was trying to find out what’s going on with the latest big outbreak of foodborne illness, this time due to Cyclospora.

The CDC’s Cyclospora website, updated frequently, keeps track of the numbers of cases—in this case, 641 as of September 3, with 41 hospitalizations—from 24 states.

Investigators traced cases in Iowa and Nebraska to a salad mix produced by Taylor Farms de Mexico.  But this mix is not linked to cases in Texas, which complicates the investigations.

As for the biology of Cyclospora: it’s a parasitic protozoa transmitted through feces.  The CDC provides this handy diagram of its life cycle:

What are you supposed to do to prevent getting sick from Cyclospora?  The CDC says unhelpfully: “Consumers should continue to enjoy the health benefits of eating fresh fruits and vegetables as part of a well-balanced diet.”

Everyone, it says, should follow safe produce handling recommendations.

Translation: Wash your veggies!

It’s the first Sunday of the month and time for my monthly Food Matters column in the San Francisco Chronicle.  In this one, I deal with the annoying “natural” on food labels, a term that the FDA prefers not to define.

Q: I am doing legislative research on food policy for one of my state’s senators on the definition of “natural.” As things stand, it’s difficult for consumers to understand what “natural” means on food labels. How should the FDA define this term so it is accurate and not misleading?

A: I was traveling in New England when your question arrived, and it sent me right to the nearest Hannaford supermarket. Hannaford makes this research easy. Sections everywhere in the store are labeled “organic and natural.”

Organic is no problem. Certified organic products must be made with ingredients raised or grown without artificial fertilizers, pesticides, hormones, antibiotics, irradiation, sewage sludge or genetic modification.

But what are we to make of Honey BBQ All Natural Potato Chips containing 20 ingredients, among them monosodium glutamate, yellow food color, and undoubtedly genetically modified corn and soy, but “no hydrogenated fats and gluten free”? Or Healthy Natural Dog Food containing meat by-products and other such things but “no artificial preservatives, colors or fillers”?

The Food and Drug Administration is not much help. Its answer: “From a food science perspective, it is difficult to define a food product that is ‘natural’ because the food has probably been processed and is no longer the product of the earth. That said, FDA … has not objected to the use of the term if the food does not contain added color, artificial flavors or synthetic substances.”

If you have made it through all the not’s in this non-definition, you can begin to understand how the FDA can allow high-fructose corn syrup to be “natural.” Even though enzymes, synthetic or not, are required to convert cornstarch to this mixture of glucose and fructose, it does not contain artificial colors or flavors.

But the products I mentioned do. Yellow No. 5 is an artificial color. You must assume that the corn or soy in any “natural” product is genetically modified unless the label says GMO-free or Certified Organic. You may be someone who has a hard time considering GMO ingredients “natural.”

In the last decade, new products marketed with “natural” claims have proliferated, and it’s easy to understand why. Marketers love the term. “Natural” sells products, not the least because consumers consider it a synonym for healthful and, often, for organic. Anyone would rather buy “100 percent natural seltzer water” – “calorie-free, no sugar, no sodium, gluten-free” (things never found in water) – than plain seltzer.

While “natural” does not necessarily mean “healthy” or even “healthier,” it works splendidly as a marketing term and explains why many junk-food manufacturers are switching from expensive organic ingredients to those they can market as “natural.”

The FDA isn’t fixing this situation because, according to a statement in response to a petition by Center for Science in the Public Interest, it’s “not an enforcement priority.”

Manufacturers of highly processed foods could not be happier with this nondecision.

In the absence of regulation, enter litigation. In recent years, advocacy groups have filed dozens of lawsuits seeking to ban “natural” claims on foods containing ingredients that seem unnatural, especially those genetically modified. Judges tend to say it’s the FDA’s problem and are calling on the agency to define the term.

The U.S. Department of Agriculture, which is responsible for meat and dairy products, has attempted to clarify what it means by “natural.” Its Food Safety and Inspection Service says meat and poultry can be labeled “natural” when they are minimally processed and have no artificial flavorings, colorings or preservatives. USDA’s Agricultural Marketing Service says “naturally raised” means the meat must come from animals produced with no hormone growth promoters, no antibiotics and no animal by-products.

How about all of the above? And if the public really can’t tell the difference between “natural” and “organic,” the closer the definition of “natural” is to that of “organic,” the less confused they will be.

Perhaps you could advise the senator to begin with the organic standards. And then toss in working definitions that exclude anything synthetic, artificial and more than minimally processed.

You should expect food industry lobbying against this idea to be fierce. But the public will be better served if the compromises in defining “natural” come at the end of the negotiations rather than at the beginning.

Marion Nestle is the author of “Why Calories Count: From Science to Politics,” “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at www.foodpolitics.com. E-mail:food@sfchronicle.com