This absolutely superb—informative, eminently readable, compelling—book makes the strongest possible case for the benefits of not eating ultra-processed foods.

These, you may recall, are produced by industrial means, loaded with unfamiliar and questionable food additives, unable to be made in home kitchens, and designed deliberately to be irresistibly delicious, if not addictive, so as to make profits for food companies.

They also encourage people to eat more than they realize, and are consistently associated with poor health.

Van Tulleken is a British physician, scientist, and television star with his twin brother Xand.

Although I am thoroughly familiar with just about everything in this book having written extensively about these topics myself, I still found it to be a great read.

Van Tulleken tells stories really well.  I was hooked on page 30 with the description of Lyra, his 3-year-old daughter’s first encounter with a breakfast cereal aimed at kids.  He had decided to do a Morgan Spurlock  (Super Size Me!) experiment on himself and eat mainly ultra-processed foods for as long as he could stand it.  He began with a breakfast of Coco Pops cereal.

I had assumed that, having never tried Coco Pops, she [Lyra] wouldn’t have any interest in them.  But Kellogg’s had got her hooked before she’d had a mouthful.  She knew that here was a product designed with a three-year-old in mind.  Again, I told her no, so she collapsed on the floor crying and screaming with rage…My lingering doubts [about this cereal] were irrelevant ….Lyra had crawled out from under the table, filled her bowl and started to eat great fistfuls of dry Coco Pops, wide-eyed and ecstatic.  Defeated, I poured out the milk, and read the ingredients…Lyra put her ear to the bowl and shut her eyes, entranced. She then began to eat again.

And eat.  And eat.  As I watched her, it seemed she wasn’t fully in control…Lyra had hardly taken a breath.  I normally have to do a little cajoling at mealtimes, but the first bowl of Coco Pops had simply disappeared.  When I tried to suggest that one bowl was enough, the idea was immediately dismissed.  It felt like advising a smoker to stick to one cigarette.  Her eating wasn’t just mindless: it was trancelike.

This is just what ultra-processed foods are supposed to do.

Van Tulleken calls for government policies to be made without food company involvement, and for policies to restrict the marketing of such foods.

Yes!

The book is published today by Norton. I thought it was a great read.

The workshop covered the ways that funding sources (especially corporate funders) influence research quality and outcomes (precisely the topic of my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

The report is a succinct yet thorough summary of the research on the effects of funding on research design, outcome, and interpretation.

Some of the speakers:

• Lisa Bero, PhD, Chief Scientist, Center for Bioethics and Humanities, at the University of Colorado Anschutz Medical Campus, Overview of the Evidence on Sponsor Influence
• David Michaels PhD, MPH, epidemiologist and professor at the George Washington University School of Public Health; former Assistant Secretary of Labor for the OSHA. How to Protect Public Health in the Face of Disinformation.
• Gary Ruskin, Executive Director, U.S. Right to Know,  Where are the points of influence on scientific research?
• Martin McKee, CBE, MD, president of the British Medical Association and Professor of European Public Health at the London School of Hygiene and Tropical Medicine. What You Don’t See That Counts: A Peek Behind the Smokescreen
• Laura A. Schmidt, PhD, Professor Health Policy in the School of Medicine at the University of California at San Francisco. Industry Funding Bias in the Case of Nutrition Science

This report is a great place to begin if the topic is new to you.

And so is this, of course.

Thanks to Bill Marler for keeping us all up to date on the Daily Harvest saga.  He keeps up with the literature and writes, Is the Tara mystery closer to being solved?

My most recent post on this mystery was almost a year ago.

To review: Daily Harvest is a company that makes and ships preprepared vegan frozen meals, one of which, French Lentil + Leek Crumbles, has been recalled after several hundred people who ate it developed serious problems with their livers and gall bladders.

This was no trivial incident.  The FDA reported “As of 10/18/2022, there were 393 adverse illness reports in 39 states with 133 hospitalization and 0 deaths.”  But it could not detrmine the specific cause or route of contamination.

My post had breaking news:

The ingredient that caused the illnesses among people who consumed Daily Harvest’s French Lentil + Leek Crumbles has been identified, sort of.  As suspected, it’s the tara flour.  But what’s the toxin in the tara flour?  That, we still don’t know.

Now we have a new study: Is Baikiain in Tara Flour a Causative Agent for the Adverse Events Associated with the Recalled Frozen French Lentil & Leek Crumbles Food Product? A Working Hypothesis. 

In summary, the results of these initial studies support a working hypothesis that the adverse events reported by individuals consuming the Daily Harvest Crumbles product originate from the tara flour ingredient and are due, at least in part, to high levels of nonprotein amino acids (e.g., baikiain). It is further hypothesized that in vivo metabolism of metabolically unstable baikiain results in a toxic metabolite(s) that depletes glutathione and/or is an irreversible enzyme inhibitor (for L-pipecolate oxidase), resulting in adverse events which are dependent on the dose consumed and potentially exacerbated for individuals that have specific genetic predispositions.

Baikiain, which I had never heard of, is an analog of the amino acid proline.  In bacteria, it catalyzes proline destruction.  If it does this in humans, it also might account for the liver toxicity experienced by people who ate the Daily Harvest frozen meals containing tara.

The authors of the tara flour study identified baikiain in the flour.  They gave baikiain to mice, who did not fare well with it.

The hypothesis here is that some people are more susceptible to the toxic effects of baikiain than others.  The French Lentil + Leek Crumbles were sent to 26,000 customers, of which 400 or so got sick, more than 100 of them badly enough to have to be hospitalized; some required surgery.

The lesson here is that food ingredients need better testing.   Whoever makes tara must consider it GRAS (generally recognized as safe) for human consumption.

As Tom Neltner writes,

Tara flour is yet another example of how FDA’s GRAS program is broken—putting the health of Americans at unnecessary risk. FDA should use its big food reboot to fix the program so that we can have confidence in the safety of our food. The agency should also work with members of Congress who have introduced bills intended to fix GRAS and to have FDA reevaluate old food safety decisions in light of new science.

Amen to that.

Is anyone else as upset as I am about the Debt Limit bill just passed by the House and Senate and signed by the President?

Senator Bernie Sanders, maybe.  Here’s why he voted against it.

Yes, the bill:

• Averted a default on the debt which everyone agrees would have been catastrophic (but the crisis should have been prevented in the first place)
• Will probably not cut SNAP benefits by much if at all (if you believe the Congressional Budget Office)
• Could have been a lot worse (a very low bar)
• Is considered a big win by the White House (oh dear)

But, and it’s a big but:

• It proved that bullying works.

The bullies know it, and are exulting.

The Farm Bill is next.  Watch what the bullies do to it.

What ever happened to government of the people, by the people, for the people?

Existential angst, anyone?  I’ve got plenty.

Here’s another one that several readers have asked me about: Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial.  Authors: Lok-Kin Yeung, Daniel M. Alschuler, Melanie Wall, Howard D. Sesso, JoAnn E. Manson, Adam M. Brickman.  American Journal of Clinical Nutrition. DOI:https://doi.org/10.1016/j.ajcnut.2023.05.011

The study: “Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y.”  Primary outcome measure: change in episodic memory (immediate recall performance on the ModRey test, after 1 y of intervention).  Secondary outcome measures: changes in episodic memory over 3 y of follow-up,  and in performance on neuropsychological tasks of novel object recognition and executive function over 3 y.

Results: “Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes…we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change.”

Conflict of interest: HDS, JEM, and AMB received investigator-initiated grant support to their institutions from Mars Edge. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. HDS received investigator-initiated grants from Pure Encapsulations and Pfizer Inc and honoraria and/or travel for lectures from the Council for Responsible Nutrition, BASF, NIH, and the
American Society of Nutrition during the conduct of the study. No funding sources had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Funding: This work was supported by an investigator-initiated grant from Mars Edge, a segment of Mars Inc dedicated to nutrition research. Pfizer Consumer Healthcare (now Haleon) provided support through the
partial provision of study pills and packaging.

Comment:  This study continues to surprise me.  As I’ve written before, it is part of the COSMOS trial, which is also supported by grants from NIH and a private foundation.  In my previous post on it, I noted that despite being funded by Pfizer (which makes Centrum Silver multivitamin supplements), the study did not show benefits of the supplement for prevention of cardiovascular disease or cancer—a rare exception to the rule that industry-funded studies tend to favor the sponsor’s interests.  But here we go again, this time with an equally surprising result but for a different reason: most multivitamin studies have shown no benefits whereas this one says if you take Centrum Silver, it will give you another three years of no loss in memory.  Wow!  I’ll be Pfizer is thrilled.

Here’s what the NIH National Center for Complementary and Integrative Health says about multivitamins:

I’m just getting to this report from Food and Water Watch: The Economic Cost of Food Monopolies: Dirty Dairy Racket

Food & Water Watch took a look at what’s happening to the U.S. dairy industry.  Its conclusions are not surprising if you have been following these trends.

• Big dairies have driven out small.  Only about 30 percent of all U.S. milk is produced on family-scale farms.
• Dairy is not profitable.  “Thanks to the gutting of federal supply management policy,” overproduction and increased production costs gave caysed milk prices to plummet.
• Consolidation doesn’t help.  Three dairy coops control 83 percent of milk sales: DFA (Dairy Farmers of America), Land O’ Lakes, and California Dairies, Inc.).

Here’s one comparison: Dairy association CEP salaries as compared to dairy farmer income.

The next Farm Bill could help fix some of this by:

• Restoring supply management
• Stopping proliferation of factory dairy farms
• Reforming the farm safety net
• Setting fair prices

The American Beverage Association, which represents Big (and also Medium) Soda, is now advertising in Politico.

America’s leading beverage companies – The Coca-Cola Company, Keurig Dr Pepper and PepsiCo – are bringing consumers more choices with less sugar. From sparkling, flavored and bottled waters to zero sugar sodas, sports drinks, juices and teas, consumers have more options than ever. In fact, nearly 60% of beverages sold today have zero sugar. Americans are looking for more choices to support their efforts to find balance, and America’s beverage companies are delivering. Explore choices at BalanceUS.org.

Ultra-processed foods—defined operationally as industrially produced foods formulated to be irresistably delicious that can’t be made in home kitchens (because you don’t have the machinery or the ingredients—are by now well established to be associated with weight gain and weight-related chronic diseases.

Evidence now suggests the association is causal.  Ultra-processed diets induce people to eat more calories without realizing it.

Alas for food companies.  Ultra-processed products are among their most profitable.

The British Nutrition Foundation to the rescue!

• It has issued a position statement on ultra-processed foods.   It complains that:
• The classification system omits foods the Foundation considers healthy.
• It implies that expensive artisanal products are superior for health (advice to reduce UPF raises questions of equity).
• The research is largely observational.
• The food environment is a key driver of poor health.
• Making products that are not ultra-processed may have unintended consequences.
• Demonizing ultra-processed foods could foster feelings of guilt and stigma.
• Messages to avoid UPF might discourage industry from reformulation.
• Food processing plays a releant role in food system sustainability and food security.

When I read things like this, I have the usual question: Who paid for this?

The British Nutrition Foundation says:

BNF’s funding comes from: membership subscriptions; donations and project grants from food producers and manufacturers, retailers and food service companies; contracts with government departments; conferences, publications and training; overseas projects; funding from grant providing bodies, trusts and other charities.

If it lists its corporate sponsors, I can’t find it.

But PowerBase says:

The British Nutrition Foundation (BNF) is the key food industry front group in the UK. The BNF promotes itself as a source of impartial information, but it does not always make its links with industry clear.

The BNF is hard at work on behalf of food companies who wish the entire UPF concept would just disappear.  See, for example, “How do we differentiate not demonise –Is there a role for healthier processed foods in an age of food insecurity? Proceedings of a roundtable event” published in the Nutrition Bulletin.  The themes that emerged from the conference:

• problems with the use of definitions for UPF,
• the lack of causal evidence and defined mechanisms linking processing per se with poor health outcomes,
• advice that may result in consumer confusion.
• misalignment of UPF foods with dietary guidelines
• unintended consequences for vulnerable groups

Comment: 

OK, the food industry is fighting back.  I think it’s a losing battle.  The UPF concept has so much evidence backing up its usefulness.  But I will say one thing about the point about unintended consequences.   It’s OK for rich people to avoid UPF but OK for poor people to eat them?  I think the food industry is in trouble on this one.  It has gotten away with pushing junk food for way too long.  The British Nutrition Foundation would be much more crredible if it put public health first.