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The USDA has made some changes to food packages for participants in the Special Supplemental Food Program for Women, Infants, and Children (WIC).

In a Q and A, the USDA explains the changes and why it made them.

What are the WIC food packages?

The WIC food packages provide supplemental foods designed to address the specific nutritional needs of income-eligible pregnant, breastfeeding, and non-breastfeeding postpartum individuals, infants, and children up to five years of age who are at nutritional risk.

WIC participants receive a monthly benefit from one of seven science-based food packages, according to their life stage nutritional needs. Participants then use their WIC electronic benefit transfer (EBT) card to buy the food and beverages in their package.

If you want to know what’s actually in the package, it’s a lot easier to go to state sites; the USDA site does not help much.

Try New York State’s WIC site. Women with children can use their EBT benefits to buy these foods (women with infants can also get formula and baby food):

• Low fat (1%) or nonfat (skim) milk for women and children two years of age or older
• Whole milk for children one to two years of age
• Cheese, yogurt, evaporated milk, evaporated goat’s milk, or dry milk as milk substitutions
• Soy beverage and tofu as milk alternatives
• Dry beans, canned beans or peanut butter options
• Whole wheat bread or other whole grain options (whole wheat tortillas, brown rice, whole wheat pasta) for children and pregnant and mostly or fully breastfeeding women
• Cash value benefit for fresh, frozen or canned vegetables and fruits
  • Women receive $11.00-$16.50 depending on breastfeeding status
  • Children receive $9.00
• Eggs
• Whole grain cereals
• 100% unsweetened fruit juice
• Canned fish for fully breastfeeding women

Going back to the USDA site. I looked at the changes, lots of them excellent. 

One is expanded benefits in general, and for fruits and vegetables in particular.

Another is improved benefits for women who are breastfeeding.

But for Breakfast Cereals, here’s what the USDA proposed.And here’s what it got, post lobbying.

The bottom line: less whole grain, and more sugar.

Does this make any difference?

In principle, yes. The USDA should not make decisions based on the food companies’ demands to make their products qualify more easily for WIC purchases.

It would be good to keep as much ultra-processed junk food as possible out of the WIC package.

These cave-ins are unlikely to make any noticable difference to health, but set a bad precedent.

Here’s what happened with the rest of the package, mostly to the good.

• Fruits and Vegetables
• Juice
• Milk and Milk Substitutions
• Infant Foods
• Add Infant Formula Flexibilities and Create a Separate Food Package for Partially (Mostly) Breastfeeding Participants
• Whole Wheat Bread,
• Whole Grain Bread, and Whole Grain Options
• Canned Fish
• Legumes and Eggs
• Maximum Monthly Allowances

Nina Guilbeault.  The Good Eater: A Vegan’s Search for the Future of Food.  Bloomsbury, 2024.

I did a back-cover blurb for this book:

The Good Eater is a vegan sociologist’s remarkably open-minded exploration of the historical, ethical, health, environmental, and social justice implications of not eating meat.  Guilbeault’s extensive research and interviews get right into the tough questions about this movement, leaving us free to choose for ourselves whether to eat this way.

Guilbeault has followed vegan dietary practices (no animal products) for a long time but was troubled by the self-righteousness and proselytizing of many vegans.  As a trained sociologist, she set out to investigate the origins, practices, and effects of vegan diets, through reading but also through interviews with what seems like everyone having anything to do with animal welfare and plant-forward diets.  The result is an exceptionally broad look at the who’s who of veganism, from historical figures to contemporary entrepreneurs and chefs.  The book is well written, rational, and not at all uncritical.

Here’s are a couple of excerpts:

Projections show that to avert environmental disaster by 2050 we need to reduce our meat consumption by at least a third, and by half in North America and Europe…But many people still eat eggs for breakfast and yogurt as a snack, put dairy milk in their coffee, add a slice of ham to their sandwich for lunch, and choose a piece of meat or fish for dinner, all in one day.  A reduction from that daily menu to a couple of eggs and a small piece of meat or fish once a week seems like a hefty drop, yet that is how humanity has eaten for most of our natural history.  (pp 284-285)

I can understand why, for many people, a vegan lifestyle seems unappealing, overwhelming, or even downright offensive.  As we know, meat has played a key part in our cultural and evolutionary history, and habits are notoriously difficult to break.  Veganism requires a shift in identity as well as the embrace of a social category still on the fringe….This is partly because being vegan in a non-vegan world is hard, but also because the vegan movement places an emphasis on moral perfection.  Yet…long-lasting, sustainable change doesn’t come from a place of shame, judgment, and guilt.  It comes from a place of joy and a sense of belonging.  (p 290)

 

Fruit juices were not a problem when I was growing up.

Ancient history: Juice was so expensive—it was freshly squeezed from several oranges—that we couldn’t afford to drink much of it,  Juice glasses were 6 ounces.

This was long before cheap concentrated juice appeared in supermarkets, let alone canned and bottled juices and juice drinks.

Because juice is squeezed from several fruits, the sugars add up but the fiber disappears.

The USDA says more than half of apples available for U.S. consumption are used in juices.

All that juice may not be as healthy as you might think.  Two reasons: calories and toxic metals.

CALORIES: Consumption of 100% Fruit Juice and Body Weight in Children and AdultsA Systematic Review and Meta-Analysis.

in this systematic review and meta-analysis, 1 serving per day of 100% fruit juice was associated with BMI gain among children. Findings in adults found a significant association among studies unadjusted for total energy, suggesting potential mediation by calories…Our findings support guidance to limit consumption of fruit juice to prevent intake of excess calories and weight gain.

TOXIC METALS: Toxic metals and essential elements contents in commercially available fruit juices and other non-alcoholic beverages from the United States. Journal of Food Composition and Analysis, Volume 119, June 2023, 105230.

The results showed that the concentrations of Ni, Mn, B, Cd, Sr, As, and Se exceeded the recommended drinking water standards, whereas the remaining elements were found below the drinking water standards….consumption of metals either below or above the drinking water standards can increase the cumulative metals exposure from combined sources and may lead to adverse health outcomes…The study found seven of the 25 elements measured exceeded drinking water standards, especially in the mixed fruit juices. While toxicity is unlikely, more attention should be paid toward moderate beverage consumption, especially to protect the health of infants and young children.

The fruit juice industry—yes, there is such a thing—is fighting back by funding its own research (thanks to Jim Krieger of Healthy Food America for sending this one).

The study:  Health effects of 100% fruit and vegetable juices: evidence from human intervention studies. September 2023.  Nutrition Research Reviews.  DOI: 10.1017/S095442242300015X.

Purpose: The review aimed to shed light on the potential impact of 100% FVJ on human subject health, comprehensively assessing the role each type of juice may have in specific health outcomes for a particular target population, as reported in dietary interventions.

Findings: Some juices demonstrated their ability to exert potential preventive effects on some outcomes while others on other health outcomes, emphasising how the differential composition in bioactive compounds defines juice effects.

Conclusion: Although 100% FVJ appear to have beneficial effects on some cardiometabolic health outcomes, cognition and exercise performance, or neutral effects on anthropometric parameters and body composition, further efforts are needed to better understand the impact of 100% FVJ on human subject health.

Funding: This work was partially funded by the International Fruit and Vegetable Juice Association (IFU). The funder of the study had no input on the design, implementation, analysis or interpretation of the data. P.M. received a research grant from IFU to conduct this review. The authors have no other conflicts of interest to declare.

Comment: This is the usual result from industry-funded articles.  Fruit is better, but juices are fine in small amounts—bring back 6-ounce glasses!

And while we are on the topic, this just in: Are all sugars equal? Role of the food source in physiological responses to sugars with an emphasis on fruit and fruit juice.

Of the currently available data on direct comparisons of whole fruit versus fruit juice, there is no clear evidence for meaningful differences in glycaemic control, inflammation, or blood pressure. There is, however, consistent evidence that whole apples can lower plasma low-density lipoprotein cholesterol concentrations compared with fruit juice.

The headline caught my eye: 5 dead and over 100 hospitalized from recalled Japanese health supplements

The supplement is benikoji.

Kobayashi Pharmaceutical had been selling benikoji products for years, with a million packages sold over the past three fiscal years, but a problem crept up with the supplements produced in 2023. Kobayashi Pharmaceutical said it produced 18.5 tons of benikoji last year.

Apparently, the company knew there was a problem but delayed the recall.

What, you may well ask, is benikoji?   The answer: Red yeast rice.

Red yeast rice is a well known dietary supplement.  it contains lovastatin.  Like other statins, it lowers blood cholesterol levels.

Consumer Lab, which tests and evaluates dietary supplements, says,

Red yeast rice can be very effective in lowering elevated levels of cholesterol, as shown in several clinical trials (see What It Does). However, not all red yeast rice supplements contain the amount of lovastatin needed to lower cholesterol, and products normally do not list the amount of lovastatin they contain on their labels.

Of additional concern is that CL found a potential kidney toxin, citrinin, in 30% of products, one of which contained citrinin at a level 65 times the limit allowed in Europe (there is no established limit in the U.S.).

Like other dietary supplements, nobody is minding the store.  Nobody makes sure the contents of a supplement reflect what is on the label or that labels are accurate.  The FDA says adding lovastatin to red yeast rice, which some manufacturors do, apparently, is illegal in the U.S.  But how would you know?

ProPublica has issued a major and highly importantt investigative report: The U.S. Government Defended the Overseas Business Interests of Baby Formula Makers. Kids Paid the Price.

The report documents how the U.S. has opposed marketing restrictions on infant formula throughout the world.

It refers specifically to what happened in Thailand over attempts to restrict the marketing of toddler formula (an unneccesary product).

In 2017, Thai health experts tried to stop aggressive advertising for all formula — including that made for toddlers. Officials feared company promotions could mislead parents and even persuade mothers to forgo breastfeeding, depriving their children of the vital health benefits that come with it. At the time, Thailand’s breastfeeding rate was already among the lowest in the world.

But the $47 billion formula industry fought back, enlisting the help of a rich and powerful ally: the United States government…U.S. officials delivered a letter to Bangkok asking pointed questions, including whether the legislation was “more trade restrictive than necessary.” They also lodged criticisms in a bilateral trade meeting with Thai authorities and on the floor of the World Trade Organization, where such complaints can lead to costly legal battles…In the end, though, the Thai government backed down. It banned advertising for infant formula but allowed companies to market formula for toddlers like Gustun — one of the industry’s most profitable and dubious products. The final law also slashed penalties for violators.

ProPublica also obtained documents detailing the arguments between trade and health officials over these policies.  See: Documents Show Internal Clash Before U.S. Officials Pushed to Weaken Toddler Formula Rules.

In this case, trade won over health.

The US government role in infant formula marketing goes way back to its opposition to the international code of marketing of breastmilk substitutes.  It is not a nice history and distressing that it continues.

More on infant formula tomorrow…

Jim Krieger, of Healthy Food America forwarded this request for research proposals (RFP) from the National Cattlemen’s Beef Association’s Senior Director of Human Nutrition Research.,

On behalf of The Beef Checkoff, the National Cattlemen’s Beef Association (NCBA) is conducting a request for proposals (RFP) in Human Nutrition, to further understand beef’s nutritional qualities and define beef’s role in a healthy diet to nourish and optimize health at every life stage including research topics related to growth and development, healthy aging, and reduced risk of chronic disease… As part of their long-standing commitment to further scientific discovery, beef farmers and ranchers are invested in funding high quality, rigorous research — from observational epidemiological and clinical intervention trials to modeling and substitution analyses. As nutrition science continues to evolve, broadening and deepening the beef nutrition evidence base is essential to ensure that consumers have the most up-to-date information to make informed choices about the foods they eat

The Human Nutrition Research Program follows a two-part application process, beginning with the submission of a preproposal. Pre-proposals are intended to be a brief overview of the proposed project. Pre-proposals must meet the submission deadline and follow the guidelines in the RFP to be considered. Principal Investigators may submit more than one pre-proposal. Please share this RFP with interested colleagues

PRE-PROPOSALS MUST BE SUBMITTED BY Wednesday April 3, 2024 at 11:59pm MT.

Submit a Pre-Proposal here to join our RFP email list and get information about new research funding opportunities.

Comment: This is how industry funded research begins.  The RFP is not open-ended; it is not asking you to find out whether beef has benefits.  If you want this funding, you had best come up with a research plan highly likely to demonstrate the benefits of beef in nourishing and optimizing health—otherwise, it won’t be funded. This is the USDA-sponsored Beef Checkoff at work.

Here’s your chance!

At the insistence of Jerry Mande, I watched the meeting of the President’s Council of Advisors on Science and Technology (PCAST) to learn about the Federal Vision for Advancing Nutrition Science in the United States.

This Vision derives from last year’s White House Conference on Hunger, Nutrition, and Health and its pillar on enhancing nutrition research.

Cathie Woteki, who introduced the report, made a forceful case for the importance of chronic disease prevention.  Her committee was shocked  that the majority of Americans are overweight or obese, and at a cost of $500 billion annually.  She pointed out the lack of focus and coordination of 200 existing programs that ought to be addressing this issue.

The conclusion: not enough research on chronic disease and more funding needed.

No question about that.  Yes, we need more nutrition research and more funding for it.  A lot more.

But the White House request for the Office of Nutrition Research is only $1.3 million (see p. 26).  Surely this  is some kind of joke?  It’s hardly even a rounding error in federal terms.

As for the PCAST report’s efforts needed:  That’s all?

Yes we can use more data and research on personal eating habits and individual behavior, but what about the food environment?

Maybe PCAST is under political constrainsts but this sure does feel like a lost opportunity.

The report —as yet unpublished—appears to say nothing about:

• The effects of ultra-processed foods on individual food choices and weight. (the word “ultra-processed” was not mentioned)
• The need to change the food environment to make it easier and less expensive for individuals to make healthier food choices.
• Policies to requirie food companies to produce healthier foods and reduce serving sizes.
• Policies to stop the food industry from marketing ultra-processed foods to kids.
• Programs to achieve the existing 2030 health objectives to prevent obesity and chronic disease (these were not mentioned).

The committee said it consulted widely to produce this report.  Not widely enough, I’d say.

Compare this to what the UK House of Lords is doing in its hearings on  Food, Diet and Obesity.  Take a look at who they are listening to.

If the PCAST committee talked to any of these people, their comments are not showing up.

PCAST has a real opportunity here to push for a strong research and policy agenda to address obesity and its related chronic diseases.

What kind? Here are my suggestions.

Today I’m participating on a panel discussion on Ozempic at 12:30 EDT.  See announcement to the right; register for it here. 

I watched the Oprah special on the obesity drugs.

Its messages:

• Obesity is a disease, requiring treatment.
• These drugs offer treatment.
• The drugs are effective; side effects are minimal.
• Yes they are expensive and therefore, promote inequality; therefore, the government should pay for them.

The program was a one-hour, prime-time commercial for the drugs.

The physicians who testified on their behalf consult for the drug companies.

The program has already had an effect.  cause the FDA says semaglutide helps prevent heart attacks, strokes, and deaths in overweigth people, the government will now authorize payment through Medicare Part D.

Here’s what was not discussed.

• The fortunes the drug companies spent on getting doctors, health professionals, and influencers to promote the drugs and minimize their side effects.  See Reuters for US doctors and The Guardian for European influencers.
• The sharp rise in obesity prevalence between 1980 and 2000 and the environmental and commercial reasons for it.
• Anything about prevention. and changing that food environment.
• Anything serious about the down side of taking the drugs (lifetime treatment, cost, side effects, loss of joy in eating).

An editorial in The Lancet says:

A simple pill or injection will undoubtedly help some patients, but it cannot be the sole basis for addressing the complexities of obesity. Obesity is a product of not only an individual’s circumstances and behaviour, but also society at large, shaped by global food markets and trade agreements. Multidimensional approaches are needed to curb the effects of the obesogenic environment, particularly against an international industry that promotes overproduction of cheap food and drinks. Physical activity needs to increase; walking and cycling for journeys to work or school should be normalised and made easier and safer. Sugar taxes and curbs on marketing of high-energy, high-fat, ultra-processed foods need to be implemented. Prevention must be the foundation upon which everything else follows.

Other comments

• The New York Times account focuses on stigma.
• USA Today says people are suing the drug companies over side effects.

Much to be said about all this.  Stay tuned.