by Marion Nestle

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Nov 24 2013

How come no San Francisco Chronicle column today?

It’s the first Sunday in December and normally I would be posting my San Francisco Chronicle Food Matters column.  But I am leaving the Chronicle—after five and a half years and nearly 70 columns.  I will write one more for the end of the year, but that will be the last.

My timing turned out to be prescient.  My column appeared in the Chronicle’s free-standing, prize-winning food section.  The Chronicle is now ending that separate section.

I have no information about why this is happening other than what’s been speculated and what the paper’s editor says.

I started writing the column in the spring of 2008 at the invitation of Michael Bauer.  I thought it would be a splendid opportunity—a public platform for my ideas about food and nutrition—and the chance to work with writers whose work I respected.

Indeed it was.

But I also knew that the paper was having financial difficulties and did not expect it to survive for much longer.  I agreed to take on the column under the assumption that the paper would not last more than a year or so.  

Wrong.

At first I wrote a column every three weeks.  When that proved too much—I do have a full-time job at NYU, after all—I asked to have the schedule reduced to once a month.  Even that proved difficult. 

My editor at the Chronicle has always been the terrific Miriam Morgan, who convincingly discouraged my occasional attempts to give up the column.

But now I’m working on a demanding book manuscript and the column is too much of an interruption.

I will miss having the column, but I won’t miss the deadlines.

My column’s time has come.  But when Miriam Morgan told me that the paper would be making some changes in the food section, I had no idea that this meant the end of the food section as well.

Alas.

But all may not be lost.  Want to help save the Chronicle food section?  Click here

Nov 20 2013

Conflicts of interest in nutrition societies: American Society of Nutrition

I am a member of the American Society for Nutrition (ASN), the organization that publishes the American Journal of Clinical Nutrition (AJCN) and the Journal of Nutrition.

I’ve become increasingly worried about food company influence on ASN.  Food companies fund sessions at ASN annual meetings.

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But I’m even more concerned about food company sponsorship of scientific studies published in AJCN.

The results of sponsored studies almost invariably benefit the sponsor.  Exceptions are scarce.

The conflicts are so blatant that I can often guess from reading an abstract who the study’s sponsor must be.

A look at the conflicts of interest disclosed by the editorial board of AJCN suggests why this problem is occurring.

Of the 12 members of the editorial board, only 3 disclose no corporate conflicts of interest, and 2 others disclose minor conflicts.

But the majority—7 of the 12—list major corporate affiliations.  The list of food companies for which they consult or advise is too long to reproduce but it includes Coca-Cola, PepsiCo, The Sugar Association, The National Restaurant Association, ConAgra, McDonald’s, Kellogg, Mars, and many others.

This raises uncomfortable questions: How does this editorial board deal with papers suggesting harm to health from consuming products from these companies?  How does it deal with sponsored papers suggesting benefits of the products?

Affiliations with food companies may or may not lead to publication bias, but at the very least they give the appearance of serious conflicted interest.  This affects opinion not only of sponsored studies, but also of the overall credibility of research published in the journal.

For the results of papers published in the AJCN to be considered credible, the editorial board should:

  • List the editor responsible for review of published papers in the conflict disclosures.
  • Recuse individual members with conflicts from reviewing papers in their area of conflict.
  • Phase out conflicted editors as quickly as possible.
  • Appoint editors who have minimal or no conflicts.
  • Give special editorial scrutiny to papers sponsored by food and beverage companies.

ASN is not the only nutrition society raising doubts about its conflicts of interest with food company sponsorship.  The Academy of Nutrition and Dietetics (AND) is the subject of two recent reports analyzing its conflicts of interest.

I will say more about these reports tomorrow, but it looks like a similar report could be written about ASN, alas.

Nov 19 2013

FoodNavigator-USA.com on “Tackling Diabetes”

FoodNavigator-USA.com has a special edition on “Tackling Diabetes: Formulating for Healthy Blood Sugar.”

We’ve been telling people to lose weight, eat more complex carbs and do more exercise for years to get their blood sugar under control, but the number of Americans with type two diabetes continues to rise at an alarming rate. So how can the food industry help? In this FoodNavigator-USA special edition we explore the growing number of tools in the formulator’s toolbox to help promote healthy blood sugar. We also look at what messages resonate with consumers, from the glycemic index to healthy blood sugar, plus what you can, and can’t, say about diabetes on a food label.

Here are the articles in this series:

It’s always interesting to look at such issues from the food industry’s perspective.  And FoodNavigator reporters do an especially good job of putting the issues in context.

 

Nov 18 2013

What’s up with the new cholesterol/statin guidelines?

Last week, a Feedback comment from a reader, Judith Rice-Jones, inspired me to try to understand what’s going on with the new heart disease prevention guidelines (I can’t say I’m succeeding very well).

Looking forward to your response to the recent recommendations for more people to take statins. Don’t see anything in the new recommendations about changing lifestyle or diet to reduce risks of stroke or heart attack.

Yes, there are lifestyle recommendations.   But lifestyle changes do not make money for drug companies, and they don’t get press attention.

The American College of Cardiology (ACC) and American Heart Association (AHA) issued four sets of guidelines:

  1. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
  2. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
  3. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk
  4. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk

These organizations say:

AHA and ACC are pleased to announce a series of new cardiovascular prevention guidelines for the assessment of cardiovascular risk, lifestyle modifications that reduce risk, management of elevated blood cholesterol, and management of increased body weight in adults. These guidelines are based on rigorous, comprehensive, systematic evidence reviews originally sponsored by the NHLBI. The ACC and AHA collaborated with professional organizations to finalize these AHA/ACC cardiovascular prevention guidelines, and stakeholder organizations were invited to review and endorse the final documents.

So these guidelines are a major big deal.  The New York Times said you need to know three things about them:

  • You don’t need to know your cholesterol number (unless it is very high).
  • You do need to know your risk (for this you need to use the risk calculator and, therefore, to know your LDL and HDL levels and blood pressure).
  • If you are at risk, take a statin (most, at least, are generics).

But wait!

As the New York Times also suggested, the new guidelines have taken many by surprise.

This is an understatement.

Problem #1: Authoritative clinicians say more patients should not be taking statins

This announcement is not a result of a sudden epidemic of heart disease, nor is it based on new data showing the benefits of lower cholesterol. Instead, it is a consequence of simply expanding the definition of who should take the drugs — a decision that will benefit the pharmaceutical industry more than anyone else.

This opinion piece points out that members of the group writing the recommendations have financial ties to drug makers, as do both the AHA and ACC.

The guidelines might make sense, they say, if statins

actually offered meaningful protection from our No. 1 killer, heart disease; if they helped people live longer or better; and if they had minimal adverse side effects. However, none of these are the case…as shown in a recent BMJ article co-written by one of us.

Perhaps more dangerous, statins provide false reassurances that may discourage patients from taking the steps that actually reduce cardiovascular disease…80 percent of cardiovascular disease is caused by smoking, lack of exercise, an unhealthy diet, and other lifestyle factors. Statins give the illusion of protection to many people, who would be much better served, for example, by simply walking an extra 10 minutes per day.

Problem #2: The risk calculator greatly overestimates risk

The lead article in today’s Times summarizes studies to be published in The Lancet tomorrow concluding that the risk calculator makes the risks seem greater than they really are.

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It will lead many doctors to prescribe statin drugs to people who do not need to take them (from the standpoint of drug companies, that’s the point).

The calculator overpredicted risk by 75 to 150 percent, depending on the population. A man whose risk was 4 percent, for example, might show up as having an 8 percent risk. With a 4 percent risk, he would not warrant treatment — the guidelines that say treatment is advised for those with at least a 7.5 percent risk and that treatment can be considered for those whose risk is 5 percent.

What to do?

  • Best to discuss this one with your doctor.
  • For sure, eat your veggies and be active.
  • If you still smoke cigarettes, stop.
  • Stay tuned for further developments.

Just for fun

Let’s let Brian McFadden (Sunday’s New York Times Week in Review) have the last word for today.

Nov 13 2013

Healthy foods can carry toxic bacteria, alas

As always, I am indebted to Bill Marler for keeping me up to date on the latest outbreaks of foodborne illness.

The most recent—26 illnesses, 6 hospitalizations—seems caused by E. coli 0157:H7 contaminating grilled chicken salads sold by Trader Joe’s in California, Washington and Arizona.  According to the CDC:

Epidemiologic and traceback investigations conducted by local, state, and federal officials indicate that consumption of two ready-to-eat salads, Field Fresh Chopped Salad with Grilled Chicken and Mexicali Salad with Chili Lime Chicken, produced by Glass Onion Catering and sold at Trader Joe’s grocery store locations, are one likely source of this outbreak of STEC O157:H7 infections.

These are multiple ingredient products.  What could be the source of the toxic E. coli?

Marler provides some labels:

The contaminated ingredient could be Israeli couscous, something I can’t read (currents?), asiago cheese & toasted pecans with sweet basil dressing (first label), or white chicken meat, mixed greens, corn, peppers, sun-dried tomatoes, pepitas and asiago cheese with a jalapeno Caesar dressing (second label).

This will be hard to figure out.  There are lots of possibilities.  Likely candidates are mixed greens and jalapenos—this would not be the first time—but others could also have gotten contaminated along the way.

Marler also took the trouble to go to the website of Glass Onion Catering.  You will be happy to learn that this company’s “ salads, sandwiches, wraps and treats are crafted to the client’s specific recommendation. We only use the freshest, most natural ingredients to promote a healthy lifestyle,” and that the products are

  • Trans fat free
  • No artificial colors or flavorings
  • No preservatives or additives
  • No genetically modified ingredients
  • Locally grown produce used (when possible)

Too bad they aren’t also free of this nasty form of E. coli.

Everyone who prepares or produces food needs to know how to follow standard food safety procedures.

You should not have to worry about buying foods at Trader Joe’s that make you sick.

To keep up with this is not so easy.  Because the products have meat (chicken) and vegetables (mixed greens, etc), they are regulated by two agencies: FDA and USDA.  This means three agencies are involved:

Wouldn’t it make more sense to have one food safety agency?  Just asking.

Nov 12 2013

Annals of marketing: Got Milk?–Lady Gaga style

This gem comes courtesy of DairyReporter.com.

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It got my attention, for sure.

Recall that Got Milk! ads are funded by a USDA-sponsored research and promotion (a.k.a “checkoff”) program, this one, appropriately, for fluid milk.

Will this ad help reverse the long-term trend in declining milk sales let alone consumption?

Um.  Why don’t I think so.

Nov 6 2013

In food politics too, money talks

Can money buy elections?  Apparently so.

Yesterday’s election results indicate that the GMO-labeling initiative in Washington state and the soda tax initiative in Telluride, CO both failed.

Washington’s I-522

According to USA Today, the defeat cost opponents $22 million.  All of that—except $550—came from out of state.

The top five contributors were the Grocery Manufacturers Association, Monsanto, DuPont Pioneer, Dow AgroSciences and Bayer CropScience.

But the Grocery Manufacturers Association was required to list its contributors.  The top five?  PepsiCo, Nestlé (no relation), Coca-Cola, General Mills, ConAgra  at about a million each when you add it all up.

USA Today reports:

Food industry ads claimed that the initiative would raise food prices. Labels would mislead consumers into thinking that products that contain genetically engineered ingredients are “somehow different, unsafe or unhealthy,” said Brian Kennedy of the Grocery Manufacturers Association, a food industry group based in Washington, D.C.

The Yes on 522 campaigns emphasized consumers right to know what’s in their food.

But PoliticoPro points out that because votes are mailed in, more than 600,000 votes may still be left to count.

The food and biotech industries used their considerable war chest to make ad buys across the state, pointing out all of the products that would not be covered under the measure — such as cheese, beer, restaurant food and even, they claimed, pet food — and pushing the message that the bill is misleading and would considerably raise food prices. They said the law would hurt Washington’s farm families.

As I told USA Today, sooner or later, one of these is going to pass. At some point the industry is going to get tired of pouring this kind of money into these campaigns and will beg for labeling, which is what should have happened in the first place.

The Telluride soda tax

Telluride is a small town, so the amounts are much smaller.

According to ProPolitico, the Colorado Beverage Association installed an onsite lobbyist to generate opposition to the measure through meetings and an Internet site.

The largest donors to the opposition campaign were a Texas billionaire who owns a second home in Telluride ($55,000), and the the local and national beverage associations. were the largest contributors to the anti-tax campaign, giving $20,000 and $55,000 respectively.

Taxes, of course, are never popular even when intended for public health purposes, as this one was.

Soda taxes too, will pass eventually.

Patience and fortitude.

Addition: Here’s the Washington State vote as of this morning.

Oct 30 2013

Let’s Move!’s latest: Sesame Street characters free to produce marketers

Coming soon to a supermarket near you: Sesame Street characters on packages of vegetables.

The Let’s Move! press release begins:

Washington, DC – As part of First Lady Michelle Obama’s Let’s Move! initiative, Mrs. Obama today joined Sesame Street’s Elmo and Rosita to announce that Sesame Workshop and the Produce Marketing Association (PMA) joined the Partnership for a Healthier America (PHA) in a two-year agreement to help promote fresh fruit and vegetable consumption to kids, making those healthy choices a little easier for busy parents and families to make.

The agreement allows PMA’s community of growers, suppliers and retailers to utilize the strength and influence of the Sesame Street brand without a licensing fee, using characters like Big Bird, Elmo, Rosita and Abby Cadabby to help deliver messages about fresh fruits and vegetables. Sesame Street characters may be on produce in stores as early as mid-2014.

This is big news.  Let’s Move! is attempting to level the marketing playing field and give fruits and vegetables a competitive edge.

I, of course, have mixed feelings.  I’ve long been on record as opposed to marketing anything to kids, whether good, bad, or indifferent.

Marketing is not education. Education is about imparting knowledge and promoting wisdom and critical thinking.

Marketing is about creating demand for a product.

Children are demonstrably unable to tell the difference or, for that matter, to distinguish marketing from entertainment.  That is why marketing to children crosses an ethical line.

But if the foods are healthy, don’t the ends justify the means?  Isn’t anything that gets kids to eat healthy foods worth doing?  After all, kids live in a marketing environment, so marketing might as well be used to do good rather than harm.

This is the rationale behind the marketing of baby carrots with “eat ‘em like junk food” ads.  Reportedly, these ads increased sales of baby carrots.

But perhaps this campaign also reinforced the idea that kids are only supposed to eat foods that come with cartoons or toys?

I’d like to see the data on the long-term effects of the campaign on sales, whether sales dropped when the commercials stopped, and whether they affected kids’ attitudes toward eating vegetables in general.

In the meantime, this will be an interesting experiment.  I’m hoping researchers are ready to go, have their evaluation methods in place, and are already collecting baseline data.

Also in the meantime, ProPolitico writers Byran Tau and Helena Bottemiller Evich point out that “Michelle Obama policy initiatives are a big deal for big business.”   Their article begins:

The latest Let’s Move! event is brought to you by the letter K. As in K Street.”

It explains how:

corporate America’s biggest players…stand to benefit from exposure, public goodwill generated from being involved in a public health or charitable effort or the policy itself.  Big lobbying forces and major industry groups like the American Beverage Association, the International Bottled Water Association, the Food Marketing Institute, the Grocery Manufacturers Association, the National Restaurant Association, the U.S. Chamber of Commerce and many others have all worked closely with the East Wing on those initiatives, both of which heavily focus on private sector contributions.

If kids eat more healthfully for the next couple of years as a result of this campaign, it will be hard to do anything but applaud it.

Although the questions raised by this campaign are uncomfortable, I’m going to try to keep an open mind and wish it the very best of success.

Addition, October 31: Obamafoodorama’s eyewitness account includes the First Lady’s press release.

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