Food Politics

by Marion Nestle
Sep 28 2015

Never a dull moment: the BMJ’s attack on the Dietary Guidelines Advisory Committee report

Really, the Dietary Guidelines Advisory Committee’s (DGAC) report shouldn’t be this controversial and shouldn’t be controversial at all (as I’ve said before).  But lots of people—the food industry, of course, but also some scientists and journalists—seem to have exceptionally intense opinions about the fat recommendations [Recall:  The DGAC report does not constitute the Dietary Guidelines; these are written by USDA and HHS and are not due out until the end of this year].

Now, we have the journalist Nina Teicholz, author of The Big Fat Surprise, repeating the themes of her book in the BMJ: The scientific report guiding the US dietary guidelines: is it scientific?.

The BMJ has also found that the committee’s report used weak scientific standards, reversing recent efforts by the government to strengthen the scientific review process. This backsliding seems to have made the report vulnerable to internal bias as well as outside agendas.

Teicholz’s interpretation of the science relating dietary fat to health has been thoroughly critiqued (see end of post).   The way I see it, these arguments are difficult to resolve outside the context of dietary patterns as a whole.

My hypothesis (note: hypothesis) is that for people who balance calorie intake with expenditure, the type of fat—or carbohydrate—matters much less than it does for people who overeat calories.  This hypothesis needs testing to confirm it.

What troubles me about Teicholz’s work is the certainty with which she presents her ideas.  She comes across as utterly convinced she is right, even in the face of substantial and substantive criticism of her statements and interpretations.

At least one error

Here, for example, is one statement in the BMJ article that I know from personal experience cannot be correct.

Much has been written about how industries try to influence nutrition policy, so it is surprising that unlike authors in most major medical journals, guideline committee members are not required to list their potential conflicts of interest.

I was a member of the 1995 DGAC and I was required to declare conflicts of interest.  So were members of the committees in 2000, 2005, and 2010, as shown in this excellent short video.

Later, discussing conflicts of interest among DGAC members, Teicholz says:

Still, it’s important to note that in a field where public research dollars are scarce, nearly all nutrition scientists accept funding from industry. [Nearly all?  I don’t, and I doubt this is correct].  Of far greater influence is likely to be bias in favor of an institutionalized hypothesis as well as a “white hat” bias to distort information for what is perceived as righteous ends.

The “white hat bias” comment refers to a paper by authors who themselves report food-industry funding:

Competing Interests. Drs. Allison and Cope have received grants, honoraria, donations, and consulting fees from numerous food, beverage, dietary supplement, pharmaceutical companies, litigators, and other commercial, government, and nonprofit entities with interests in obesity and nutrition including in interests in breastfeeding and NSBs. Dr. Cope has recently accepted a position with The Solae Company (St Louis, MO.).

Responses to the BMJ article

The DGAC wrote a rebuttal to Teicholz.  It is published on the BMJ website.

HHS also published a statement, reproduced by Mother Jones.

The British Medical Journal’s decision to publish this article is unfortunate given the prevalence of factual errors. HHS and USDA required the 2015 Dietary Guidelines Advisory Committee to conduct a rigorous, systematic and transparent review of the current body of nutrition science. Following an 19-month open process, documented for the public on DietaryGuidelines.gov, the external expert committee submitted its report to the Secretaries of HHS and USDA. HHS and USDA are considering the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, along with comments from the public and input from federal agencies, as we develop the 2015 Dietary Guidelines for Americans to be released later this year.

Yoni Freedhoff’s Weighty Matters blog provides a handy summary of additional responses to the BMJ article.

Scientific analysis of The Big Fat Surprise

Many of the scientific claims in this book seemed so far-fetched that they induced a nutritionist, Seth Yoder, to go over it line by line, read the references, and point out discrepancies.   These are posted on his website in two parts.

A summary quote from Part 1:

What makes this particular book interesting is not so much that it is bad (which it is) or that it is extravagantly biased (which it also is). No, what really fascinates me about this book is that the author excessively and shamelessly lifts other people’s material.

And a quote from Part 2

The Big Fat Surprise (BFS) by Nina Teicholz is yet another book in a long line of books that informs the reader that everything you thought you knew about nutrition is wrong: saturated fat from animals is actually quite good for you, cholesterol isn’t really important, the government lied to you, nutritionists and dietitians lied to you, the American Heart Association lied to you, etc… Leaving aside that the concept of that kind of a conspiracy actually existing is really absurd, what I’m surprised about is that publishers can keep churning out books like this and people are gullible enough to keep buying them.

Caveat emptor.

Additions: 

Sep 25 2015

Soda Politics: Taking on Big Soda (and Winning): Delicious!

Here’s a sweet conclusion to this week’s sugar theme (#5):

Capture

 

 

 

 

 

 

 

 

 

How do bakeries do this?  I have no idea.

But this particular bakery at first refused to make the cake.

It worried about potential copyright violation (I’m not kidding).

Well, it’s too late to sue.  The evidence has been consumed.

Sep 24 2015

Sugar politics: A roundup of items

This week’s post about sugars #4:

Sugar politics is in the news and I’ve been collecting items about it.

  • U.K. consumers say sugar is their #1 food issue, beating out waste and salt.
  • The Florida sugar industry is giving generously to Republican presidential candidates.
  • Australian sugar growers are pushing for greater access to the U.S. sugar market through the Trans Pacific Partnership agreement, and are in part responsible for the impasse in signing it (this is not necessarily a bad thing).
  • U.S. candy makers are not happy about the suspension agreements brought against Mexican sugar imports.  These, they say, have raised the price of sugar.  Ordinarily, under NAFTA, Mexico is allowed to ship as much sugar to the U.S. as it likes, with no tariffs.  But Mexico agreed to new trade caps in return for not having to deal with antidumping investigations (isn’t trade fun?).
  • The Washington Post has a good summary of where we are on putting Added Sugars on food labels.
  • The FDA will take comments specifically on its Nutrition Facts panel studies, including controversial research on how well consumers would understand an added sugars label, the agency announced in a Federal Register notice.  The comment period is extended to October 15.
  • The FDA’s move follows a letter from law firm Olsson Frank Weeda Terman Matz that criticized the agency for not taking comments on its consumer research.
Sep 23 2015

The benefits of eating candy. Who knew?

This week’s sugar item #3

John Downs, the president of the National Confectioners Association has an editorial (note: sponsored) in Politico announcing the NCA’s new campaign to convince Americans of the benefits of eating candy.

Candy is a special treat that has played an important role in cultural traditions, seasonal celebrations and family occasions here in the U.S. and around the world. But some consumers might not know that there is much more that goes into this honest, affordable, fun and transparent treat.

What more?  The economic benefits, of course.  Here’s the Infographic:

The press release highlights the benefits.

The confectionery industry directly employs 55,000 people in the United States, and more than 400,000 jobs in agriculture, retail, transportation and other industries rely in part on the sale of confections for their livelihood.  For every job that is created in confectionery another seven are supported in related industries, which means that candy drives a multiplier effect of 1:7 or an impact of 700 percent.

Sugar?  Calories?  Tooth decay?  Obesity?

Never mind.

Sep 22 2015

Coca-Cola’s transparency initiative

Sugars item #2 for this week (about half of the sugars in US diets come from sugar-sweetened beverages)

As promised in his op-ed in the Wall Street Journal in August, Muhtar Kent, the CEO of Coca-Cola, is making its funding transparent.  He said he “directed Sandy Douglas, president of Coca-Cola North America, to”

Publish on our website a list of our efforts to reduce calories and market responsibly, along with a list of health and well-being partnerships and research activities we have funded in the past five years, which we will continue to update every six months.

True to his word, here is Coca-Cola’s commitment to transparency:

This makes interesting reading, to say the least.  Enjoy!

 

Sep 21 2015

Sugars for toddlers: an invitational roundtable from The Sugar Association

This week, I’m going to be posting items about sugar politics.

Item on sugars #1:

Funny thing.  I was not invited to this event, but someone who was invited passed along the invitation.  You too will be sad you weren’t invited.

I am contacting you at the request of Dr. Courtney Gaine, VP of Scientific Affairs from The Sugar Association, regarding an invitational roundtable on The Role of Sugars in Supporting a Nutrient-dense Diet for Toddlers, 12 to 24 Months.  It will be sponsored by the University of Colorado, Anschutz Medical Campus, Department of Pediatrics, chaired by Dr. Ronald Kleinman from Harvard Medical School, co-chaired by Dr. Frank Greer from the University of Wisconsin School of Medicine, and facilitated by Sylvia Rowe.  The roundtable is supported by an unrestricted educational grant from the Association….

Roundtable Objectives

  • Provide a forum to discuss the science and research voids on the role of sugars as a strategy that may help parents successfully transition their older infants and toddlers (12 to 24 months) from complementary infant foods to consuming a variety of nutrient-dense foods from the family table.
  • Generate potential research ideas and questions on this topic for future guidance on the feeding of young children, including birth to 24 months, which is scheduled for integration into the 2020 Dietary Guidelines for Americans.
  • Create the impetus to extend this research to public-private partnerships with industry, academy and the government.

Proposed Topic Areas 

  • The roundtable has been tentatively divided into these 5 topic areas: 1) transitional toddler feeding and nutrition policy; 2) physiology; 3) sugars in toddler feeding practices; 4) parent-feeding strategies: emerging science; and 5) the research path forward….

Honorarium 

The Sugar Association will reimburse you for all reasonable travel expenses, plus a $2,000 honorarium for your review of abstracts and presentations, which you will receive in mid-October, and your participation in the 1 ½ day roundtable.

This requires some translation.  I may be over-interpreting here, but as I see it, the Sugar Association is paying academics $2000 to implicitly endorse:

  • Promoting the use of sugar as a way to get toddlers to eat healthier foods.
  • Making sure the 2020 dietary guidelines say nothing about the need for kids to eat less sugar (we don’t even have the guidelines for 2015 yet).
  • Making sure that government agencies don’t advise or set policies to encourage eating less sugar.

Sigh.

Sep 18 2015

Weekend reading: the politics of organic foods

Lisa F. Clark. The Changing Politics of Organic Food in North America. Edward Elgar Publishing, 2015.

I did a blurb for this one.  It’s right up my alley.

Lisa Clark’s scholarly account of the development of the organic movement in the United States and Canada beautifully explains the decades-long transition from understanding organic production as inextricably tied to healthy soils, communities, and social justice (“process-based”) to views of organics as meeting certain standards for marketing purposes (“product-based”). Read this book and you will care deeply about the difference in these views as well as understand current debates about the future of organics.

In case you want to know why I favor organics, I do so from a process-based perspective.  I like what organics do for soils, communities, and social justice.  This book does a great job of explaining the basis of the debates over these issues.

Sep 17 2015

Another five industry-funded nutrition studies with industry-favorable results. Score: 60:3

Nutrition research studies funded by food companies are pouring in and here’s another set of five with expected results.  The first one is notable for its extensive revelations, a case of TMI (too much information) if I’ve ever seen one.  As usual, if you run across more of these—and especially industry-funded studies that do not favor the sponsor’s interest, please send.  The roundup since mid-March: 60 with favorable results, 3 without.

Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta‐Analysis of Controlled Feeding Trials.  Laura Chiavaroli, Russell J. de Souza, Vanessa Ha, Adrian I. Cozma, Arash Mirrahimi, David D. Wang, Matthew Yu, Amanda J. Carleton, Marco Di Buono, Alexandra L. Jenkins, Lawrence A. Leiter, Thomas M. S. Wolever, Joseph Beyene, Cyril W. C. Kendall, David J. A. Jenkins, and John L. Sievenpiper.  J Am Heart Assoc. 2015;4: originally published September 10, 2015, doi:10.1161/JAHA.114.001700.

  • Conclusion: Pooled analyses showed that fructose only had an adverse effect on established lipid targets when added to existing diets so as to provide excess calories (+21% to 35% energy). When isocalorically exchanged for other carbohydrates, fructose had no adverse effects on blood lipids.
  • Conflicts:  The disclosures cover two full pages in the journal.  These authors report every source of income—honoraria, prizes, travel funds—including those of their spouses.  They apparently work for every food company imaginable, including any number with interests in minimizing a harmful role of fructose in health.
  • Comment:  I do not know why the editors of this journal decided that the conflict-of-interest statement was worth two pages of journal space.  Perhaps they don’t think such statements necessary and were being ironic?  Or perhaps they wanted to make sure that these highly conflicted authors were fully exposed?  Yoni Freedhoff of Weighty Matters consulted an ethicist about this question but did not get a clear answer.  I wrote the journal editor and asked what this was about, but have not received a response.

Beneficial effects of oral chromium picolinate supplementation on glycemic control in patients with type 2 diabetes: A randomized clinical study. Ana N. Paiva, Josivan G. de Lima, Anna C.Q. de Medeiros, Heverton A.O. Figueiredo, Raiana L. de Andrade, Marcela A.G. Ururahye, Adriana A. Rezende, José Brandão-Neto, Maria das G. Almeida.   Journal of Trace Elements in Medicine and Biology 32 (2015) 66–72.

  • Conclusions: CrPic supplementation had a beneficial effect on glycemic control in patients with poorly controlled T2DM, without affecting the lipid profile.
  • Conflict: Manipulation Pharmacy Companhia da Fórmula donated the chromium picolinate supplement.
  • Comment: Without knowing more about this situation, it’s not possible to say whether donation of a supplement is enough to raise concerns.  This study raises questions because most independently funded studies of chromium and diabetes have shown minimal or no benefits (see, for example this one).

Oat consumption reduced intestinal fat deposition and improved health span in Caenorhabditis elegans model. Chenfei Gao, Zhanguo Gao, Frank L. Greenway, Jeffrey H. Burton, William D. Johnson, Michael J. Keenan, Frederick M. Enright, Roy J. Martin, YiFang Chu, Jolene Zheng.  Nutrition Research September 2015 Volume 35, Issue 9, Pages 834–843.

  • Conclusion: Oat consumption may be a beneficial dietary intervention for reducing fat accumulation, augmenting health span, and improving hyperglycemia-impaired lipid metabolism [in nematodes].
  • Conflict: This research was supported by a nonrestricted donation from PepsiCo Inc. Oats used in this study were a gift of PepsiCo Inc. Y. Chu is an employee of PepsiCo, Inc, which manufactures oatmeal products under the brand name Quaker Oats.

A pilot study examining the effects of consuming a high-protein vs normal-protein breakfast on free-living glycemic control in overweight/obese ‘breakfast skipping’ adolescents. L B Bauer, L J Reynolds, S M Douglas, M L Kearney, H A Hoertel, R S Shafer, J P Thyfault and H J Leidy.  International Journal of Obesity (2015) 39, 1421–1424; doi:10.1038/ijo.2015.101; published online 7 July 2015

  • Conclusion: These data suggest that the daily addition of a HP breakfast, containing 35 g of high-quality protein, has better efficacy at improving free-living glycemic control compared with a NP breakfast in overweight/obese, but otherwise healthy, ‘breakfast skipping’ adolescents.
  • Disclosure: The authors declare no conflict of interest, but the study was funded by the Pork Checkoff.

Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat Breakfast.  Arpita Basu, Nancy M Betts, Misti J Leyva, Dongxu Fu, Christopher E Aston, and Timothy J Lyons.  J Nutr September 2, 2015, doi: 10.3945/​jn.115.215772

  • Conclusions: Acute cocoa supplementation showed no clear overall benefit in T2D patients after a high-fat fast-food–style meal challenge. Although HDL cholesterol and insulin remained higher throughout the 6-h postprandial period, an overall decrease in large artery elasticity was found after cocoa consumption.
  • Funding: Among other sources, the lead author receiveda grant from The Hershey Company.
  • Comment: This is a negative study (no benefit) with a positive spin (higher HDL, decrease in large artery elasticity).

 

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