I did a bunch of interviews about the sugar industry’s funding and manipulation of research this week (see the list at the bottom of the post).

I tried to point out that in the fuss over sugars vs. saturated fat, calories get forgotten.  They shouldn’t be.

The balance between fat and carbohydrate matters much less when calorie intake is balanced by physical activity.

The Atlantic notes that Americans eat and waste vast amounts of food, using USDA data on the amount of calories made available by the food supply.

I love the USDA’s “Food Availability (Per Capita) Data System.”  Here’s how to use it:

• Scroll all the way down to the bottom of the page to Nutrient Availability.
• Click on Nutrients.
• Download Excel Spreadsheet.
• Click on the worksheet, “Nutrients and other components of the US food supply.”  Have fun checking out the trends from 1909 to 2010.  We have available to us 4000 calories per day per capita.
• Click on the second worksheet, “US Food supply: Nutrients contributed from major food groups.”  Now you can see where the calories come from:  Grain products and fats and oils together account for more than 1800 of the 4000 calories in the food supply.  Add in sugars and sweeteners and you are up to 2500.  Meat, poultry, and fish brings it over 3000.

Hmmm.

This is why I co-authored a book on the topic: Why Calories Count: From Science to Politics.

Chase Purdy writing in Quartz says “The system for catching dangerous pathogens in America’s food supply is finally working.”

Here’s the best evidence: the remarkable decline in cases of STEC (Shigella Toxin E. Coli).

Quartz quotes food safety lawyer Bill Marler: “You look back over time and, from 1993-2003, about 90% of my firm’s revenue was from E. coli cases connected to hamburger.”

What changed?  Regulation.

The USDA now considers STEC to be an adulterant and does not permit meat and poultry contaminated with it to be sold.

But then there’s Salmonella.  It is not considered an adulterant.  Why not?  Because it occurs so frequently that USDA considers it normal.  Cases of Salmonella have not declined as much as they should.

In the meantime, the FDA is diligently following through on its food safety rulemaking.  On August 24, it opened three more sets of draft guidance documents for public comment.

• Draft Guidance for Industry #235 – Current Good Manufacturing Practice Requirements for Food for Animals: helps producers of animal feed comply with Good Manufacturing Practice requirements.  And see .  Federal Register Notice for the Draft Guidance for Industry on Current Good Manufacturing Practice Requirements for Food for Animals
• Draft Guidance for Industry #239 – Human Food By-Products for Use as Animal Food: helps providers of byproducts of human food production with how to use them safely in animal feed.  And see Federal Register Notice for the Draft Guidance for Industry on Human Food By-Products for Use as Animal Food
• Draft Guidance for Industry for Classification of Activities as Harvesting, Packing, Holding, or Manufacturing/Processing for Farms and Facilities: helps food companies decide if and how FSMA rules apply to their operations.  And see Federal Register Notice for the Draft Guidance for Industry for Classification of Activities as Harvesting, Packing, Holding, or Manufacturing/Processing for Farms and Facilities

FDA officials explain:

When we were drafting and seeking public comment on the rules that will implement theFDA Food Safety Modernization Act (FSMA), we promised that we would do whatever we could to help the regulated industry understand and meet the new requirements….Meeting the FSMA mandate involves cooperation between the FDA and the food industry. From the smallest food operation to the largest company, we want to be sure that we’re all on the same page and these draft guidances will help get us there.

Onward and upward.  This is progress.  It would be nice if it went faster but it’s real progress—even if Bill Marler still has plenty of work to stay busy.

I wrote a commentary for a study published this morning in JAMA Internal Medicine: “Food industry funding of nutrition research: The relevance of history for current debates.”

The study, by UCSF investigators Cristin Kearns, Laura Schmidt and Stanton Glantz, is based on their archival research.  They found documentary evidence of shocking manipulation by the sugar industry of a Harvard review of studies on dietary factors and heart disease published in the New England Journal of Medicine in 1967.

Kearns et al. discovered that the sugar industry trade association paid investigators at Harvard an impressive amount of money ($48,000 in today’s dollars) to produce research demonstrating that saturated fat—not sugar—raises the risk of heart disease.

In my commentary, I reproduced a figure from the sugar-funded 1967 reviews.  This summarizes the epidemiology showing that both sugar and saturated fat intake were then indistinguishably associated with increased mortality in 14 countries.

Nevertheless, the reviews exonerated sugars and blamed saturated fat.

Yes, I know that association does not necessarily mean causation, but I’m guessing that the epidemiology still shows that both sugars and saturated fats are associated with increased heart disease risk.

My interpretation: We would all be healthier eating less of sugary foods and fatty meats.

Here are the relevant documents for your reading pleasure:

• The press release from JAMA Internal Medicine
• The press release from UCSF
• The article by Kearns et al.
• Kearns et al.’s online tables analyzing the studies (look for Supplement in their paper)
• The New England Journal of Medicine articles from 1967: Part 1 and Part 2
• My commentary on Kearns et al.’s paper
• NYU’s blog post about my commentary
• JAMA Internal Medicine’s podcast interview with me and Stan Glantz (find it under Related Multimedia on the right side of the page)

The Sugar Association issued a response to today’s article by Kearns et al.:

We acknowledge that the Sugar Research Foundation should have exercised greater transparency in all of its research activities…Generally speaking, it is not only unfortunate but a disservice that industry-funded research is branded as tainted…We question this author’s continued attempts to reframe historical occurrences to conveniently align with the currently trending anti-sugar narrative, particularly when the last several decades of research have concluded that sugar does not have a unique role in heart disease.  Most concerning is the growing use of headline-baiting articles to trump quality scientific research—we’re disappointed to see a journal of JAMA’s stature being drawn into this trend.

I will post press accounts as they appear (I’m quoted in most of these):

•  Vox 
• New York Times
• STAT (a particularly detailed account)
• CSPI’s comment on Kearns et al.
• Reuters 
• Live Science
• Bloomberg News 
• Healthy Food America comment
• Business Insider
• Associated Press 
• NBC
• Time
• Quartz
• CNN
• Forbes
• United Press International
• Good Food
• Fortune
• Daily Mail
• Helio
• The Guardian
• US News
• CBS News
• Glamour
• Smithsonian
• Huffington Post
• Union of Concerned Scientists

Sandor Ellix Katz.  Wild Fermentation: The Flavor, Nutrition, and Craft of Live-Culture Foods.  Chelsea Green, 2016.

This is the updated and revised edition of Katz’s wildly popular and influential book—a how to on the theory and practice of preparing, eating, and enjoying fermented foods.

Katz describes himself as a fermentation evangelist, and so he is.

By eating a variety of live fermented foods, you promote microbial diversity in your body.  The live bacteria in those ferments…help to digest food and assimilate nutrients, as well as stimulate immune responses.  There is no one strain that is uniquely beneficial; rather the greatest benefit of eating bacteria lies in biodiversity.

With the microbiome the hot new thing in biology, this book could not be better timed.

And besides.  Fermented foods are delicious.  Ginger champagne, anyone?

The USDA has just released its annual summary of statistics on national food insecurity, with these encouraging results.

Both total and very low food security have declined since 2014 and are heading back to the lower levels observed in the early 2000s.

The USDA defines food insecurity as not having enough resources to provide food for family members.

The new data show:

• Households considered food insecure = 12.7%
• Households considered severely food insecure = 5%
• Households with children who are food insecure = 7.8%
• Food insecurity is higher in households headed by single parents, especially those who are Black or Hispanic
• Food insecurity is higher in some states (e.g., Mississippi = 20.8%) than others (e.g., North Dakota = 8.5%)
• Food-insecure households participating in federal food assistance programs = 59%

These figures are better than last year’s, but still need improving.

The bottom line: federal food assistance programs do not do enough to alleviate food insecurity, even among households enrolled in them.

The much delayed UK government’s plan for dealing with childhood obesity has finally been released to virtually universal dismay over the missed opportunity.

The strategy is now a Plan, and says it is “the start of a conversation.” It reconfirms the government’s intentions to implement a soft drink tax, subject to consultation, but does not include a range of measures recommended by its own Public Health England and by last year’s House of Commons Health Committee, such as reduce food marketing and controls on retail promotions. It relies on voluntary sugar reduction by the food industry and encouraging parents to help increase children’s physical activity to meet the recommended 1 hour per day.

It’s fun to read the criticisms: nobody minces words.

An editorial in The Lancet

The UK Government’s long-anticipated response to the childhood obesity crisis disappointed everyone. From doctors, health charities, and celebrities to the very industry it seeks to propitiate, the Childhood Obesity Plan, published with as little noise as possible in the summer recess, has met with resounding criticism. As a Comment in today’s Lancet highlights, the strategy has been delayed for a year, and in that time it has been watered down to a vague Plan with no teeth.  Reading the report from start to finish gives the impression that its authors haven’t.

The Lancet editorial continues

The absence of curbs on industry practices that contribute to childhood obesity—promotions of unhealthy food in supermarkets and restaurants; advertising of junk food through family TV programmes and social media—seems like a gift to industry.

The Lancet is especially miffed because it ran a series on obesity last year that made it clear what kinds of policies needed to be enacted.

Also in The Lancet, World Obesity’s Tim Lobstein and Klim McPherson say

What we read in the government’s Plan is nothing particularly new, nothing bold, and very little that can actually be measured to assess the Plan’s success. It is a document that is not only a disappointment to public health professionals, but also evidence of a government walking away from its moral duty to protect the health of children, and its fiscal duty to protect the NHS from the consequent costs.

The Association for the Study of Obesity (ASO) issued a statement:

the plan is a lost opportunity to provide leadership and commitment in tackling childhood obesity as part of a whole systems approach. It lacks bold actions that are needed to reverse the current high levels of child obesity such as: a ban on junk food advertising before the 9pm watershed; reduction in portion sizes; reformulation targets for industry that address high energy density foods; curbing the promotion of unhealthy foods in supermarket; investment to increase and extend evidence-based child weight management services. All of these would be robust, evidence-based actions and would start to tackle the root causes of obesity in this country.

Again in The Lancet, Yoni Freedhoff and Kevin Hall point out the need for more sensible weight loss studies:

Over the past several decades, dozens of randomised controlled trials have compared various diets for the treatment of obesity. Ideally, such studies should have provided strong evidence for clear clinical recommendations and also put a stop to society’s endless parade of fad diets. Unfortunately, the evidence base remains contested and the “diet wars” continue unabated…What is especially striking is the similarity of the long-term pattern of mean bodyweight change, irrespective of diet prescription.⁵ …Fewer resources should be invested in studying whether or not a low-carbohydrate diet is marginally better than a low-fat diet, or whether intermittent fasting provides marginally better short-term outcomes than a so-called Paleo diet.

Their study provides further evidence why we need stronger policies for preventing obesity.  It’s too bad the UK couldn’t do better.

And if you think things are any better in New Zealand…

The food industry has hit out at claims in a leading journal that New Zealand’s childhood obesity plan was flawed and that the government valued corporate profit over public good. The Food and Grocery Council said that an editorial in the New Zealand Medical Journal, which claimed that the government’s strategy did not address excess sugar intake, was “flawed on many fronts.  Moreover, the FGC complained that its response to the article, solicited by Fairfax Media, was not run.

Addition, September 14

• Jamie Oliver weighs in—The Guardian

My daughter, Rebecca Nestle, sends these from Valencia Street, San Francisco, August 2016.

There was this booth.

And this unidentified person wearing a great tee shirt:

Michael Ableman.  Street Farm: Growing Food, Jobs, and Hope on the Urban Frontier.  Chelsea Green, 2016.

Chelsea Green publishes books on “the politics and practice of sustainable living,” and its catalog gets better all the time.

Michael Ableman’s latest book is beautifully designed, packed with wonderful color photographs, and a must have for anyone even remotely curious about whether urban farming is worth a try.

Ableman was asked to start urban farms in the toughest areas of downtown Vancouver.  His book is a series of thoughtful, personal, and remarkably frank essays about how he turned vacant lots and parking lots into vegetables while engaging with the locals, coping with the city bureaucracy, dealing with landlords desperate for more parking space, and managing the hazards of trying to make this work among people beset by poverty, alcohol, and drugs.

But he did make it work and this book explains how you too can do this.

Street Farm is an elegant how-to manual on using farming to do real community work with populations classically “hard to reach” but thriving on such initiatives.