Every year, CA–A Cancer Journal for Clinicians publishes an annual review of cancer statistics.

The report has some good news: trends in the overall death rates from cancer show significant declines, for both men and women.

The overall incidence (new case) rates are holding steady or a down a little since 1990,but are still above the rates in 1975.

The incidence patterns differ for cancers at different sites:

In men, lung cancers are down undoubtedly due to less cigarette smoking.  Prostate and colorectal cancers are down, perhaps due to favorable dietary changes.

In women, lung cancers have leveled off and colorectal cancers are down, but breast cancers don’t seem to budge.

As for the comparison to heart disease, that’s interesting too.  In 2005, cancer surpassed heart disease as the leading cause of death in people younger than age 85.

Plenty of good news here, but plenty more to be done.

The  big news last week—and it is very big news—is that Walmart has signed on to the Coalition of Immokalee Workers’ (CIW) Fair Food Program.

Under this program, Walmart agrees to pay Florida tomato pickers one penny more for each pound harvested — and says it will apply that premium to other fresh produce sold by the chain.

A penny a pound may not sound like much, especially since Walmart took in $466 billion  in revenue last year.

But it means that workers who are now paid 50 cents for a 32-pound basket will get 82 cents, and their wages can go from $50 to $90 dollars a day.

As Tom Philpott explains in Mother Jones

Late Thursday, CIW netted the biggest fish of all: Walmart, by far the largest private food buyer in the US. A company that muscled its way to the top of the US corporate heap by pinching pennies—squeezing suppliers and its own workers relentlessly—has now agreed to shell out an extra penny per pound for tomatoes.

CIW has shown yet again that scrappy workers, sufficiently organized, can win concessions from even the most ruthless companies.

Barry Estabrook, whose book Tomatoland has done so much to bring attention to the CIW’s accomplishments, writes in Civil Eats

The struggle for labor justice in the fields of the United States—and perhaps far beyond—took an historic stride forward yesterday. At a folding table in a metal-clad produce packing shed beside a tomato field in southwestern Florida, two high-ranking executives from the giant retailer Walmart, which sells more groceries than any other company in the world, sat down beside two Mexican farmworkers and signed an agreement to join the Fair Food Program…The implications of the Walmart decision cannot be understated. Enormous pressure will be placed on competing grocery giants to follow Walmart’s lead.

Good work, CIW.

Can it really be this easy?  Morrison’s, a grocery chain in the U.K., put cardboard cutouts of doctors near the produce section.

A new pilot scheme in a Morrisons store in Salford, using cardboard cut-outs of local GPs in the fresh produce aisles delivered a 20% rise in the sales of fresh fruit and a 30% uplift for frozen fruit.

All of this is part of Great Britain’s Public Health “Responsibility Deal,” which aims to enlist businesses to voluntarily promote health objectives.

The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.

Organisations signing up to the Responsibility Deal commit to taking action voluntarily to improve public health through their responsibilities as employers, as well as through their commercial actions and their community activities. Organisations can sign up to be either national partners or local partners.

The principles and ambitions of the Responsibility Deal are set out in its core commitments and supporting pledges.

This is all it takes?  Really?

Why do I think this won’t work nearly as well in America?  We have a long way to go, says the USDA.

What might work?  Celebrities?  Sports figures?  Political figures?

As Food Navigator-USA puts it, “No, wheat does not make people fat and sick.”

Bread lover that I am, I consider recent research to be giving us good news.

Food Navigator is referring to a review of research on whole wheat and health just published in the Journal of Cereal Science of all places.  The authors conclude that unless you have celiac disease or wheat allergies, eating whole-wheat foods is good for you.

In fact, foods containing whole-wheat, which have been prepared in customary ways (such as baked or extruded), and eaten in recommended amounts, have been associated with significant reductions in risks for type 2 diabetes, heart disease, and a more favourable long term weight management. Nevertheless, individuals that have a genetic predisposition for developing celiac disease, or who are sensitive or allergic to wheat proteins, will benefit from avoiding wheat and other cereals that contain proteins related to gluten, including primitive wheat species (einkorn, emmer, spelt) and varieties, rye and barley…Based on the available evidence, we conclude that whole-wheat consumption cannot be linked to increased prevalence of obesity in the general population.

The authors find little evidence in support of popular myths:

• Proliferation of wheat products parallels obesity and is causally related.  No, it does not.
• Wheat starch differs from starches in other foods in especially undesirable ways.  No, it does not.
• Whole wheat bread has a higher glycemic index than sugar.  No, it does not.
• Wheat contains opioids that make people addictive. No, they do not.

In the meantime, the FDA has been working on updating its 2006 guidance to industry about how to label statements about whole grains. The agency has been conducting research on how consumers judge:

• Food products, including nutritional attributes, overall healthiness, and health benefits.
• Labeling statements in terms of their credibility, helpfulness, and other attributes.
• Terms and statements such as “Made with Whole Grain”, “Multi-Grain”, and “100% Whole Wheat.”
• Whole grain statements beyond the scope of the statements themselves (i.e., halo effects).
• How whole grain statements influence consumer use of the Nutrition Facts.

Can’t wait to see the results.  They ought to be out soon.

Congress can’t pass a farm bill but it has plenty of time to micromanage nutrition and health.  Buried in the pork-filled Consolidated Appropriations Act of 2014 (see Monday’s post) are some zingers.  Here’s one:

This refers to the ill-fated IWG report I’ve discussed previously. To recap:

• Congress asked the FTC to examine the effects of food marketing to children and make recommendations.
• The FTC, USDA, FDA, and CDC got together and produced a report recommending voluntary guidelines for marketing to children based on the nutritional quality of the foods.
• I thought the guidelines were weak in addition to being voluntary (they allowed lots of junk foods to qualify).
• The food industry disagreed, strongly, and went to Congress to object.
• Congress caved in to industry pressure and said the report could not be released unless the FTC produced a cost-benefit analysis.
• End of story.
• Why Congress feels that it’s necessary to do this again is beyond me.

I suppose we should be glad our legislators are at least doing something.

As for the food industry’s role in all this: when food companies say they are doing everything they can to reduce marketing junk foods to kids, you now know what they really mean.

By an act of Congress, dietary supplements are regulated less strictly than conventional foods, so much so that some beverage manufacturers would much prefer to have their products labeled as dietary supplements than foods, energy shots, for example.

Under the law, the FDA pretty much has to keep hands off of supplements, except when something egregious happens, like people getting sick or dying.

The FDA is now trying to clarify the difference between beverages that are supplements and those that are drugs.  It just issued:

• Industry Guidance on Distinguishing Liquid Dietary Supplements from Beverages
• Industry Guidance on Considerations Regarding Substances Added to Foods, Including Beverages and Dietary Supplements
• Federal Register Notice for the Industry Guidance on Considerations Regarding Substances Added to Foods, Including Beverages and Dietary Supplements
• Federal Register Notice for the Industry Guidance on Distinguishing Liquid Dietary Supplements from Beverages

These documents, however, are guidance.  The are not regulations:

This guidance represents the Food and Drug Administration’s (FDA’s) current thinking on this topic.  It does not create or confer any rights for or on any person and does not operate to bind FDA or the public.  You may use an alternative approach if the approach satisfies the requirements of the applicable statutes and regulations.

Why is FDA doing this?  I’m guessing for two reasons.

1.  The weird ingredients in energy drinks:

We have observed an increase in the marketing of liquid products with a wide array of ingredients and intended uses.  Some of these products are marketed as dietary supplements, and others as conventional foods. 

We have seen a growth in the marketplace of beverages and other conventional foods that contain novel substances, such as added botanical ingredients or their extracts.  Some of these substances have not previously been used in conventional foods and may be unapproved food additives.

2.  The high caffeine levels in those drinks.

Other substances that have been present in the food supply for many years are now being added to beverages and other conventional foods at levels in excess of their traditional use levels, or in new beverages or other conventional foods.  This trend raises questions regarding whether these new uses are unapproved food additive uses.

Caffeine is GRAS (generally recognized as safe) at the levels added to soft drinks.

But the levels in energy drinks are so much higher that the FDA has questions about whether GRAS applies to them.

These guidance documents are open for comment.  If you care about such issues, weigh in now.

In the strange way the U.S. government works, Congress has produced the “Consolidated Appropriations Act of 2014,” which authorizes payments for government services, including those related to agriculture.

This is not the farm bill.  It’s what Congress decides taxpayers will pay for in the farm bill as well as bills that cover other programs run by USDA.

The House summary of agriculture appropriations is a lot easier to read than the bill itself, although it contains its share of double speak.  Try this:

WIC – This program provides supplemental nutritional foods needed by pregnant and nursing mothers, babies and young children. The bill provides full funding for WIC at $6.7 billion – $153 million below the fiscal year 2013 enacted level…This level will ensure all eligible participants will be served.

Can someone please explain to me how a cut of $153 million will ensure service to everyone who is eligible?  WIC is not an entitlement; eligible people cannot be served once the money runs out.

The bill does provide full spending—$82.2 billion—for SNAP, but only because it has to.  SNAP is an entitlement and spending for it is mandatory.  Unless, of course, Congress ever passes the farm bill, which currently contains a $9 billion proposed cut.

And here’s more double speak.  “The legislation includes several provisions to reduce spending and increase oversight of taxpayer dollars.”  How?  By authorizing spending for:

• Oversight and monitoring requirements for the WIC program, including a directive for the Secretary of Agriculture to increase oversight of vendors to help rein in food costs;
• A provision requiring USDA to submit a plan for reducing high error rates and improper payments in the National School Lunch and School Breakfast Programs;
• Requirements for the Secretary of Agriculture to help weed out and eliminate waste, fraud, and abuse in the SNAP program – including a directive to ban fraudulent vendors, and a prohibition on advertisements or outreach with foreign governments.

And why does the FDA’s budget still get decided by committees dealing with agricultural appropriations?

The FDA is a public health agency in the Department of Health and Human Services, which is funded by entirely different committees which you might think understand its mission a lot better than committees fussing about legislation that

restricts the Grain Inspection, Packers and Stockyards Administration (GIPSA) from implementing certain regulations that would allow harmful government interference in the private market for the livestock and poultry industry.

I can hardly wait to see what the farm bill will look like.

I’ve only just come across this USDA chart, which first appeared in an article in Amber Waves.

USDA’s Economic Research Service (ERS) researchers looked at 1998-2006 grocery store food expenditures and compared what consumers buy to dietary guidelines for healthy eating.  

Oops.