by Marion Nestle

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May 20 2015

Case study on why regulation matters: salt reduction in the UK

Thanks to Courtney Scott, a doctoral student at University of North Carolina, for sending me this account of the fate of Britain’s salt reduction strategies, published in the BMJ (British Medical Journal).

The lead author on the article is Dr. Graham MacGregor, Britain’s leading advocate for diets lower in salt.  It is about the derailing of Britain’s remarkable successful salt reduction strategy.

Under the auspices of Britain’s Food Standards Agency (FSA), the salt reduction program initiated in the early 2000s—getting companies to slowly but steadily reduce the salt in their products—was working well.

Most impressive: salt intake, blood pressure, heart disease, and stroke declined in parallel with the decline in salt in the food supply.

But in 2010, Britain elected a more conservative government.

Andrew Lansley was appointed secretary of state for health, and he moved the responsibility for nutrition from the FSA to the Department of Health. This disrupted the salt reduction programme, making it unclear who would be responsible for the policy. In 2011 Lansley launched the responsibility deal, whereby he made the alcohol and food industries responsible for reducing alcohol consumption and improving nutrition, respectively. As a result, salt reduction lost momentum.

The key points of the article:

  • Most of the foods that industry currently provide are very high in salt, fat, and sugars and are therefore more likely to cause cardiovascular disease and predispose to cancer than healthier alternatives.

  • The UK’s salt reduction programme…led to a significant reduction in population salt intake, accompanied by reductions in blood pressure and cardiovascular mortality.

  • The programme has been set back by the coalition government’s decision to hand power back to the food industry as part of the responsibility deal.

  • An independent agency for nutrition with a transparent monitoring programme is urgently needed to improve the food that we eat.

As I’ve explained previously, most salt—80% or more—in American diets is already in processed and prepared foods when they are presented to us.  That’s where the salt reduction has to come from.  As the authors explain,

Members of the food industry have said that they are keen to reformulate their foods to make them healthier. All they require is to be on a “level playing field” with the other major companies, so that they can make their foods healthier in a structured, incremental way. They need to be assured that there are proper reporting mechanisms in place and that all of the companies are being monitored equally. Enforcement is required, and if it doesn’t work, regulation or legislation must be enacted.

The debates over salt may be the most contentious in the field of nutrition (as the Washington Post puts it), but the parallels between the British decline in salt intake and in salt-related disease are impressive.

On a population basis, eating less salt is healthier.

This is something you can’t easily do on your own.  The food industry has to do it.  And food companies don’t want to, for obvious reasons.

Hence: the need for regulation.

May 15 2015

Weekend reading: Barry Estabrook’s Pig Tales

Barry Estabrook.  Pig Tales: An Omnivore’s Quest for Sustainable Meat.  WW Norton, 2015.

I was happy to be asked to blurb this one.  It’s a great read:

Estabrook tells two powerful stories here.  The first is about the appalling ways in which Big Pig raises animals, pollutes the environment, and uses the political system to avoid and fight regulation.  The second is about how skilled animal husbandry and respect for the intelligence of pigs produces calmer animals, more delicious meat, and a far more satisfying life for farmers and pigs alike.  Pig Tales is beautifully written.  It is also deeply touching.

May 8 2015

Milan Food Expo: The James Beard American Restaurant

Along with the U.S. Pavillion at the Expo, the James Beard Foundation organized a pop-up restaurant at the top of the Galleria.  It opens today.

Here’s the view:2015-05-03 18.49.39

The location is spectacular, and the restaurant carries out the themes of the US Pavilion–red, white, and blue throughout.

2015-05-03 20.05.04

Chefs appear on a rotating basis with a schedule set up in advance.

If you are in the Galleria, it’s worth a visit!

 

May 1 2015

Weekend reading: The Oxford Companion to Sugar and Sweets

Darra Goldstein, editor.  The Oxford Companion to Sugar and Sweets.  Oxford University Press, 2015.

Full disclosure: I have two entries in this book, one with Daniel Bowman Simon.

  • Simon DB, Nestle M.  Soda lobbies.  In: Goldstein D.  The Oxford Companion to Sugar and Sweets.  Oxford University Press, 2015:681-682.
  • Nestle M.  Soda.  In: Goldstein D.  The Oxford Companion to Sugar and Sweets.  Oxford University Press, 2015:623-624.

With that out of the way, I can only think that the editors of this book, Darra Goldstein and Michael Krondl, must have had the best time pulling this together.

The encyclopedia starts with an elegant introduction by Sidney Mintz, author of Sweetness and Power, the one book that tops everyone’s list of must reads in food studies.

The remaining 800 pages or so are devoted to entries by 265 authors on matters as diverse or arcane as dulce de leche, nanbangashi (“southern barbarian sweets”), syllabub, and whoopie pie (look them up).  I especially like the Appendixes: lists of films featuring sugar and chocolate, songs about sugar and candy (often as a metaphor), and museums.

The illustrations are lavish, especially the two sets of gorgeous color inserts.  Subtlety: The Marvelous Sugar Baby, alas, is gone from the Domino Sugar Factory in Brooklyn, but it lives on here.  For that alone….

Apr 27 2015

Chipotle goes GMO-free: a brief comment

Chipotle’s announcement that it will only be sourcing GMO-free ingredients is eliciting much press (see the article in the New York Times, for example).

Here’s what I’m telling reporters:

No, this is not a safety issue.  GMO corn ingredients were not making Chipotle customers sick.

Yes, this is a matter of trust.  Chipotle customers are offended that GMO foods are not labeled and that they have no choice about whether to eat them.

The GM industry has fought labeling since 1994 when the FDA first approved GM foods for production.  Even then, there was plenty of evidence that the public wanted these foods labeled.  But the industry is still pouring million of dollars into fighting labeling initiatives.

This—and the rise in sales of organic foods—are a direct result of the industry’s own actions.

Apr 23 2015

Why we need regulation: education for SNAP participants?

PoliticoPro Morning Agriculture reports on USDA Secretary Tom Vilsack’s speech to the Consumer Federation of America’s National Food Policy Conference in Washington, DC.

About changing the rules so that SNAP benefits could not be used to buy unhealthy foods, Vilsack said:

[recipients] may buy a little bit more soda, but they might buy less salty snacks than we do.  They might purchase a little more of this than we do, than non-SNAP families, but we purchase a lot more sugary stuff than they do in other categories, so it’s kind of a wash…It’s also extremely difficult to set up a system that distinguishes between various items.  You set that system up, what’s going to happen is that people won’t be able to buy apple juice, they won’t be able to buy orange juice… Our thinking is that a better way to approach this is to educate people so they make the right choice, they make the healthy choice [my emphasis].

Ah yes.  Education.  As an educator, I’m all for it, but let’s get real.

For this analysis, I am indebted to Daniel Bowman Simon, who does the math:

  • SNAP benefits =  $70 billion in 2014, for about 46 million participants.
  • Therefore, the average SNAP participant received about $1504 per year in SNAP benefits.
  • The USDA provides Nutrition Education and Obesity Prevention Grants for SNAP (see section 241)= $375 million.
  • Therefore, the average SNAP participant received about $8 per year in nutrition education.
  • The USDA also provides double-value awards ($31 million) to help SNAP participants buy fruits and vegetables.
  • This adds an average of 66 cents per year for each SNAP participant to make healthy choices.

Thought for today:  How much nutrition education does $8.66 buy?

This is why regulation of the SNAP package is a better approach—once we get past congressional attempts to cut the program out of existance (an exaggeration, but you know what I mean).

Apr 20 2015

Sugar politics: never a dull moment

Here are two more items on the endless disputes over sugar intake.

1.  The IOM’s 25% of calories from sugar “recommendation”

I was surprised to see the Institute of Medicine’s upper limit of sugar safety cited in a JAMA commentary on sugars and heart disease. The authors disagreed with the conclusions of a study by Yang et al. in JAMA Internal Medicine:

Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.

The authors of the commentary say:

The relationship between added sugar intake and CVD mortality remains unresolved. The study by Yang et al1 does not support implementation of health policies limiting sugar intake because a relatively small fraction of the total population ingests excessive amounts of sugar by the IOM criteria….Laws attempting to limit excess sugar intake have been passed and overturned on legal grounds. Aside from the legal questions, there is insufficient scientific evidence to support pursuit of policies limiting sugar intake.

They then go on to say:

The Institute of Medicine (IOM) recommendation is that less than 25% of total kilocalories come from added sugar.

Oops.  The IOM made no such recommendation.

Instead, the IOM said 25% of calories was the upper limit of safe sugar intake for nutrient deficiencies.  The risk of nutrient deficiencies increases above that percentage.  That IOM report said nothing about the relationship of sugar quantity to risk of chronic diseases.

Most health authorities recommend no more than 10% of calories from added sugars as a means to reduce the risk of obesity, diabetes, and heart disease.

Most research shows that chronic disease risks increase with increasing sugar intake.

 2.  What is the FDA doing about “Added Sugars” on food labels?

According to all sources, the FDA is still working on what to do about Added Sugars on the new Nutrition Facts panel.  It is engaged in two studies of this question.

It says the added sugars study is complete and the data are being analyzed.  It says the format study is in the works.

The FDA was criticized for proposing added sugars on the label without having done the research first.  Apparently, the White House Office of Management and Budget took 9 months to approve the FDA’s proposal to do the sugar research.  The approval came after the FDA issued its label proposal.

The bottom line on sugar: Less is better.

Apr 14 2015

Sugar politics: the sagas never end

I’ve been collecting items on sugars.  Here are the first two.  Two more will come later this week.

1.  The American Academy of Pediatrics Council on Nutrition has new guidance on sugars in schools.

Although access to junk foods remains an issue in schools, the Council blames the problem on students, parents, and staff.  It advises:

A positive emphasis on nutritional value, variety,appropriate portion, and encouragement for a steady improvement in quality will be a more effective approach for improving nutrition and health than simply advocating for the elimination of added sugars.

Really?  Evidence, please.

I ask because Kellogg could not be happier with this approach.  A little sugar, it says, may help kids eat more nutritious foods.

Surely it’s not a coincidence that one of the authors discloses receiving support from the National Dairy Council and the American Dairy Association, and the other receives support from the Nestle Nutrition Institute.

In any case, we aren’t talking about a little sugar in schools.  We are talking about candy, cupcakes, and drinks brought in for birthdays, treats, and after school celebrations.

2.  Sugar in the Trans Pacific Partnership (TPP)

This, you will of course recall, is the controversial multinational trade agreement currently under negotiation (see my previous post on this topic).

Japan wants to keep its tariff on sugar.

It now appears that the Japanese sugar industry gave a 1 million yen donation to a political group that supports Minister of Agriculture Koya Nishikawa, just before he became involved in the TPP talks in 2013.

As one commentator put it, considering Nishikawa’s central role in the TPP negotiations,

his receipt of a donation from an industry group brings his morals as a politician into question. Nishikawa stated that he returned the donation in light of his capacity as agricultural minister, but this is unlikely to resolve the situation…In March 2013, it was announced that the Japan Sugar Refiners’ Association would receive 1.3 billion yen in subsidies under a Ministry of Agriculture, Forestry and Fisheries’ project.

At the very least, this situation looks like blatant conflict of interest.

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