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?

I’m trying to make sense of the ongoing spread of bird flu to chickens, dairy cows, and an occasional person.

Bird flu, avian influenza, is (obviously) a viral disease in wild birds, but highly pathogenic strains can and do infect chickens, animals, and people.

It was considered sporadic and not much of a problem until we started industrial chicken production, crowding tens of thousands of chickens together in on huge barn.  Viruses can spread easily under those conditions.

Once bird flu gets into a chicken flock, the common practice is to—and here is one of my favorite euphemisms—“depopulate” the birds.

Or try another euphemism: The virus has “claimed” 2 million chickens in Texas.

“Culling” (another term) is expensive and cruel.  And taxpayers pay for it.

But now, to further complicate matters, bird flu has spread to at least 13 herds of dairy cows.

This is being attributed to contagion from migratory birds.  But milking and herd transport may also be responsible.

Bird flu has also spread to at least one person who worked with dairy cows.

Oh dear.  This has “spooked” cattle and dairy stock prices.

But there’s more: Scientists suspect bird flu may be responsible for widespread deaths of penguins in Antarctica.

This virus is causing lots of problems and I’d like to know a lot more about what is causing its transmission.

In the meantime, the CDC says the risk to humans is low, but people who work with chickens or susceptible animals should take precautions.

Masks and handwashing?  Always a good idea.

As I pretty much demonstrate every Monday, industry-funded studies almost invariably produce results favoring the sponsor’s interests.

But here we have a rare exception to the rule:

• The study: Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.  The American Journal of Clinical Nutrition,Volume 119, Issue 1, January 2024, Pages 39-48.
• Objective: “To test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y.”
• Conclusions: “Among 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study.”
• Funding: The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging.

Comment: Why anyone would think that cocoa extract would have any efffect at all on cognitive function is beyond me, but I, in sharp contrast to Mars, am not trying to sell cocoa extract or convince anyone that M&Ms are a health food.  But, as seems invariably the case, the investigators did give Mars a small break in favorably finding “possible” cognitive benefits of cocoa extract for people eating terrible diets.  My prediction: further studies will not find benefits of cocoa extract—or M&Ms—on cognitive function even though eating M&Ms can be lots of fun.

I received an emailed announcement from the  Meat Institute and FMI—the Food Industry Association of its annual report, The Power of Meat.

Here is part of its summary infographic.

The press release quotes Meat Institute President and CEO Julie Anna Potts:

When shoppers hear ‘protein,’ they think ‘meat,’ and the Meat Institute is actively working to maintain and grow Americans’ confidence about meat’s role in healthy, balanced diets. Our Protein PACT initiative drives progress and provides transparent information about how meat contributes to the health of people, animals, and the planet – which 83% of consumers are looking for when they make meat purchases.

For summary of key findings, see:

• Power of Meat 2024 infographic here
• The Top 10 Findings of the Power of Meat 2024 here

If you want the full report, you have to contact someone at the Meat Institute or FMI.    It will cost you $350 if you are not a member.

The USDA has released its latest data on sugar production and the 20-year downward trend continues.

The chart is based on data from the USDA Economic Research Service’s (ERS) Food Availability (Per Capita) Data System,

Availability means total amount produced, less exports, plus imports; it is a proxy for consumption (but undoubtedly higher than actual consumption).

In 2021, total caloric sweeteners (meaning all kinds of sugars and syrups) had dropped by 17% since 1999, the peak year for sugars availability.

Almost all of the change is due to the drop in availability of corn sweeteners.

Why the drop in corn sweeteners?  Corn syrup used to be much cheaper than cane and beet sugars.  But now that so much of it is grown to produce ethanol biofuel, its cost is about the same so there is no point in using it except in products where it works better—soft drinks, for example.

The drop in overall sugar availability looks like a healthy trend.  But the prevalence of  overweight and obesity continues to rise in children and adults.

There are still plenty of sugar calories available in the food supply.

The 127.3 pounds available in 2021 works out to a whopping 158 grams per person per day, three times the upper recommended limit and about 5 ounces.

If someone is producing that much sugar, or making sugary products, that person wants to sell it.

You are the target of those sales efforts.

If you try to resist, you are fighting the entire food system on your own.

Courage!

The Federal Trade Commission (FTC) has issued a report on Market Factors Relevant to Infant Formula Supply Disruptions 2022. 

As the report explains:

Widespread supply disruptions for infant formula began shortly after Abbott Nutrition voluntarily recalled several powdered infant formulas manufactured at its facility in Sturgis, Michigan in response to reports of bacterial contamination on February 17, 2022. The FDA advised consumers that same day not to use the recalled formula. In turn, the USDA provided guidance to WIC State agencies and offered program flexibilities to support WIC participants’ access to infant formula.

The infant formula market in the United States is, to say the least, distorted.

• It is highly concentrated; the top 2  manufacturers control 66% of the market; the top 4 control 97%: Mead Johnson/Reckitt (39%), Abbott (27%), Nestle/Gerber (18%), Perrigo/store brands (13%).
• More than half (56%) of infant formula is sold through the WIC program through state-determined single-supplier contracts awarded to companies who offer the largest rebates (sometimes selling formula to the government below cost).
• Why would they do this?  Suppliers who hold state contracts dominate non-WIC sales in that state (the WIC halo or spillover effect).

Obviously, this system is highly vulnerable to disruptions and price inflation.

So what does the FTC conclude?

This Report was written from the perspective of the FTC, which is an agency tasked with promoting fair, competitive markets that deliver high quality, affordable, reliable supplies of products. Pursuant to this mandate, the FTC analyzes high levels of concentration in the infant formula market and explores whether certain policy changes could promote greater competition and resiliency, thereby rendering the market less susceptible to serious supply disruptions. We recognize that concerns about competition and resiliency must be balanced against other policy priorities, and that any attendant tradeoffs will require thoughtful and careful analysis.

Members of Congress asked for the report.  Did they get what they wanted?

The USDA’s recent annual report on WIC, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Background, Trends, and Economic Issues, 2024 Edition, points out that this system doubles the cost of formula for non-WIC families.  Highly consolidated markets pretty much always lead to higher prices.

WIC is an important program for low-income women and children, demonstrably effective in reducing food insecurity.  Nobody wants to criticize it out of fear that Republicans will cut its budget.

But there has to be a better way to do this.

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…