Food Politics

by Marion Nestle
Oct 27 2015

Some comments on the meat-is-carcinogenic report

Yesterday, the World Health Organization’s International Agency for Research on Cancer (IARC) issued a warning about the carcinogenic potential of processed and red meat.  This, as you might expect, caused a media flurry.  CNN News asked me for a written comment.  They titled it “The other benefit to eating less red meat.”  Here’s what I wrote:

The just-released report from the International Agency for Research on Cancer judging processed meat as clearly carcinogenic and red meat as probably carcinogenic has caused consternation among meat producers and consumers.

Meat producers do not like the “eat less meat” message. Consumers do not want to give up their bacon and hamburgers — delicious and also icons of the American way of life.

But these judgments should come as no surprise to anyone. Eating less processed and red meat has been accepted dietary advice since Ancel and Margaret Keys wrote their diet book for heart disease prevention, “Eat Well and Stay Well,” in 1959. Their advice: “restrict saturated fats, the fats in beef, pork, lamb, sausages …” They aimed this advice at reducing saturated fat to prevent heart disease. Federal committees and agencies have continued issuing such heart-disease advice to the present day.

Cancer entered the picture in the 1970s, when scientists began to link red meat — beef, pork, lamb — to the risk of cancers of the colon and rectum. Even after several decades of research, they had a hard time deciding whether the culprit in meat was fat, saturated fat, protein, carcinogens induced when meat is cooked to high temperatures or some other component.

In the mid-1990s, dietary guidelines committees advised eating lean meats and limiting intake of processed meats, still because of their high fat content. By the late 1990s, cancer experts said that red meat “probably” increases the risk of colorectal cancers, and “possibly” increases the risk of cancers of the pancreas, breast, prostate and kidney. The IARC report, based on more recent evidence, makes even stronger recommendations and favors carcinogens as the causative factors.

To put this in context: For decades, the meat industry’s big public relations problem has been that vegetarians are demonstrably healthier than meat eaters. People who do not eat red meat havemuch less of a chance of developing heart disease and bowel cancers than the average American.

More recently, the 2015 Dietary Guidelines Advisory Committee (DGAC) found diets “higher in red/processed meats…” to be associated with a greater risk of colorectal cancer, and it recommended dietary patterns and low in red and/or processed meats, but higher in vegetables, fruits, legumes, whole grains, lean meats/seafood and low-fat dairy — largely, but not necessarily exclusively, plant-based.

This is good advice for anyone.

Eating less red and processed meats has two benefits: a reduced risk for certain forms of cancer,and a reduced effect on climate change.

The DGAC deemed eating less red meat to be exceptionally beneficial to the environment as well as to human health. The IARC report strengthens the health component of the recommendation. The secretaries of USDA and Health and Human Services, however, have refused to allow environmental concerns to be considered in the 2015 dietary guidelines.

I mention the dispute over environmental “sustainability” in the dietary guidelines because largely plant-based diets are appropriate for all kinds of health concerns — obesity, type 2 diabetes, coronary heart disease and now, especially, colorectal cancer — as well as environmental concerns.

By eating less red and processed meats, you promote both your own health and that of the planet.

At issue then is how much red and processed meat is compatible with good health. The IARC commission ducked that question, although it cites evidence that as little as 100 grams (a quarter pound) of red meat a day, and half that much of processed meats, increases cancer risk by 15% to 20%.

Will an occasional hamburger or piece of bacon raise your risk that much? I don’t think so. But the evidence reviewed by IARC strongly suggests that if you do eat meat, eat less when you do, don’t eat meat every day, save processed meats for rare treats and be sure to eat plenty of vegetables.

Fortunately, this advice leaves plenty of room for delicious meals — just with meat taking up much less room on the plate.

Other comments

Oct 26 2015

Here’s why food companies sponsor research: Mars Inc.’s CocoaVia

In case you were wondering why food companies would bother to sponsor research, consider CocoaVia, a chocolate derivative.

At the New York Times’ Food for Tomorrow conference last week, Mars, Inc., gave out samples of CocoaVia cocoa extract.Capture

Here’s the one with sweetened dark chocolate.

Capture

And here’s the health claim.

Capture2

Mind you, “Promotes a healthy heart by supporting healthy blood flow” is not an FDA-approved health claim.  CocoaVia is being marketed as a dietary supplement, not a food.   The label says it’s a “daily cocoa extract supplement,” and has a Supplement Facts label rather than the Nutrition Facts label used for foods.

It’s interesting that Mars, Inc. originally marketed CocoaVia as chocolate bars.  The FDA considers candy bars to be foods, labeled with Nutrition Facts.

But by marketing CocoaVia as a supplement, Mars, Inc. can take advantage of the permissive marketing allowed by the Dietary Supplement Health and Education Act of 1994.  This act allows “structure/function” claims on supplements like the one used by CocoaVia.  By marketing CocoaVia flavanols as supplements, Mars, Inc. does not have to adhere to the FDA’s more restrictive requirements for health claims on food packages.

I’m surprised that Mars, Inc. is using the supplement route because the company has gone to a lot of trouble to establish a scientific basis for a health claim for its processed cocoa flavanols.

Is it possible that Mars, Inc. thinks the cocoa flavanol claim won’t hold up to FDA scrutiny.

Here again are the three studies funded by Mars, Inc. (I posted them as examples of industry-funded studies with results favorable to the sponsor’s interest).

1. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trialby Daniela Mastroiacovo, Catherine Kwik-Uribe, Davide Grassi, Stefano Necozione, Angelo Raffaele, Luana Pistacchio, Roberta Righetti, Raffaella Bocale, Maria Carmela Lechiara, Carmine Marini, Claudio Ferri, and Giovambattista Desideri.  Am J Clin Nutr 2015; 101:538-548 doi:10.3945/ajcn.114.092189.

  • Conclusion: These data suggest that the habitual intake of flavanols can support healthy cognitive function with age.
  • Sponsor: Mars, Inc.

2.  Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Christian Heiss & Roberto Sansone & Hakima Karimi & Moritz Krabbe & Dominik Schuler & Ana Rodriguez-Mateos & Thomas Kraemer & Miriam Margherita Cortese-Krott & Gunter G. C. Kuhnle & Jeremy P. E. Spencer & Hagen Schroeter & Marc W. Merx & Malte Kelm & for the FLAVIOLA Consortium, European Union 7th Framework Program.  AGE (2015) 37: 56 DOI 10.1007/s11357-015-9794-9

  • Conclusion: CF [cocoa flavanol] intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
  • Funding: …Additional funding was provided by an unrestricted grant by MARS, Inc…MARS, Inc. provided the standardized test drinks used in this investigation. HS is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities.

3.  Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

  • Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
  • Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].

To publicize this research, Mars, Inc.

  • Gave out samples to participants at the New York Times’ conference.

My interpretation: Mars, Inc. must expect to make some serious money on this supplement—more than enough to pay for all the research and marketing.

As for whether cocoa flavanols really do support healthy blood flow, or whether this is just the standard hyperbole only to be expected from supplement marketers, I’m reserving judgment until I see the results of independently funded studies.

Oct 23 2015

100 Mayors Sign Milan Urban Food Policy Pact

This morning, I received this press release from Franca Roiatti in Milan, announcing that on October 15 the mayors of more than 100 cities signed the Milan Urban Food Policy Pact and Framework for Action.  This pact commits these cities—New York among them—to work for more equitable and sustainable urban food systems.

The mayors made 7 commitments, among them working to

  • Develop sustainable food systems that are inclusive, resilient, safe and diverse, that provide healthy and affordable food to all people in a human rights-based framework, that minimise waste and conserve biodiversity while adapting to and mitigating impacts of climate change;
  • Engage all sectors within the food system (including neighbouring authorities, technical and academic organizations, civil society, small scale producers, and the private sector) in the formulation, implementation and assessment of all food-related policies, programmes and initiatives;
  • Use the Framework for Action as a starting point for each city to address the development of their own urban food system and we will share developments with participating cities and our national governments and international agencies when appropriate;

The Framework recommends 37 actions, among them

  • Identify, map and evaluate local initiatives
  • Develop or revise urban food policies and plans
  • Address non-communicable diseases associated with poor diets and obesity, giving specific attention where appropriate to reducing intake of sugar, salt, transfats, meat and dairy products and increasing consumption of fruits and vegetables and non-processed foods
  • Develop sustainable dietary guidelines to inform consumers, city planners (in particular for public food procurement), food service providers, retailers, producers and processors, and promote communication and training campaigns.
  • Explore regulatory and voluntary instruments to promote sustainable diets involving private and public companies as appropriate, using marketing, publicity and labelling policies; and economic incentives or disincentives; streamline regulations regarding the marketing of food and non-alcoholic beverages to children in accordance with WHO recommendations.
  • Those aimed at social and economic equity (cash transfers, school feeding programs, employment, education, training, research).
  • And those aimed at improving food production and reducing waste.

Finally, it comes with an e-book that collects 49 selected good practices from 28 signatory cities.

The point?  Even though everything about this pact and framework is voluntary, these findings and recommendations ought to be enough to give any city mayor a mandate to start working on sustainability issues.

I am looking forward to seeing how New York City uses the report and framework.

Additional documents

Oct 22 2015

Food Navigator-USA presents options for protein formulations

If you are a maker of processed foods, and have exhausted low-carb and low-fat marketing options, all you have left is proteins—the hot new marketing tool.  Protein-supplemented products are all over supermarket shelves.  Never mind that most Americans get twice the protein required, and that even vegans can easily meet and exceed protein requirements.

As FoodNavigator-USA puts it, “manufacturers are now competing to impress shoppers with how much they can pack into bars, beverages and yogurts. In this FoodNavigator-USA special edition we’ll look at what protein options are available for formulators, from new insect and algal-based proteins to pea, soy, and dairy-based proteins.”

Just remember: Diets adequate in calories are highly likely to be adequate in protein, and average protein intake in the population is twice the amount required.  From the standpoint of nutrition, protein is a non-issue.  But that doesn’t stop marketers from looking for ways to push it.

Oct 21 2015

Canada’s new government’s commitments on food and nutrition

The Washington, DC-based Center for Science in the Public Interest also operates in Canada.  It issued a comment on the recent Canadian election.

Newly elected Prime Minister Justin Trudeau has four years to implement his public health nutrition commitments.  He and his party have pledged to:

  • Introduce new restrictions on the commercial marketing of unhealthy food and beverages to children, similar to those now in place in Quebec
  • Bring in tougher regulations to eliminate trans fats, similar to those in the U.S., and to reduce salt in processed foods
  • Improve food labels to give more information on added sugars and artificial dyes in processed foods
  • Make additional investments of $40 million for Nutrition North and $80 million for the Canadian Food Inspection Agency

Sounds like a new era indeed.  This will be interesting to watch.

Oct 20 2015

Uh oh. Big Soda lobbyists weaken Mexican soda tax

Yesterday, I received this ALERT from health advocates in Mexico:

Big Soda negotiates behind doors with PRI to reduce Mexican SSB tax to 5% for drinks with 5 grams of added sugars per 100ml– Public health advocates denounce conflict of interest and speak out in defense of the tax

Yesterday Mexico’s Congressional Finance Committee proposed and voted in favor of an alarming measure to reduce the rate of the current 10% sugar-sweetened beverage tax to 5% on products with 5 grams of added sugar or less per 100 milliliters. The measure was pushed through committee vote with a reservation from only one political party and moves on to a vote in the lower house within the next 24-48 hours. Beverages with more than 5 grams of added sugar per 100 milliliters would continue to be taxed at 10% (1 peso per liter).

A columnist in one of Mexico’s most prominent dailies indicates that this negotiation between the FEMSA Coca-Cola bottling company and the PRI political party (current administration and majority vote holder in Congress and Senate) came about after attempts at a food and beverage industry negotiation with the PRI, seeking to reduce Mexico’s SSB and snack taxes. The columnist says Bimbo (&the food industry) was eventually excluded from this negotiation to focus on an attainable goal of reducing the SSB tax. (See column in Spanish: http://www.dineroenimagen.com/2015-10-19/63221 )

After several recent press conferences and an act in Congress “to trap” industry lobby mosquitos (Oct 6), continuing to call for an increase to a 20% SSB tax in accordance with national and international expert recommendations, and warning the public and decision makers of industry lobby, today civil society advocates –the Nutritional Health Alliance and ContraPESO– published a full page ad in Mexico’s most important daily asking whether legislators are on the side of public health or soda industry interests and calling on them not to cede to the industry lobby.

In the ad (see translation below and image attached), advocates warn that the most currently consumed 600 ml sugary drink on the Mexican market that has 5 grams of sugar per 100 milliliters contains 30 grams of sugar, above the WHO’s new guidelines for healthy living.

The language of the initiative to reduce the tax recognizes the SSB tax as a public health measure and the progress made, yet proceeds to reduce the tax far below the expert recommended rate, representating a setback to Mexico’s landmark tax.

FYI: Although Mexico’s lower house of Congress (Chamber of Deputies) holds authority over final budget decisions on income, Mexican legislative process entails that the budget package, once voted in the lower house, passes to the Senate for review and a vote, before passing back to the lower house for final approval.

TO SUPPORT MEXICAN ADVOCATES:
Tweet indignation over industry back-door negotiation and support for the current tax and need for an increased tax: #ImpuestoAlRefresco
Press interviews: contact comunicacion@elpoderdelconsumidor.org
If you or your association can emit a declaration or letter of support, send to:
comunicacion@elpoderdelconsumidor.org
desarrolloinstitucional@elpoderdelconsumidor.org

PUBLIC HEALTH ADVOCATES IN MEXICO – Ad in Reforma newspapers OCT 19, 2015 – IN DEFENSE OF MEXICAN SSB TAX. Translation:
Members of Congress:

Have you let yourselves be bitten by the sugar-sweetened beverage lobby mosquitos?:

Do you serve soda industry or public health interests?

– The tax on sugar-sweetened beverages is 10% (1 peso) and not 20% (2 pesos) per liter as recommended by international and national organizations.

– The proposal to lower the tax to 5% to beverages with 5 grams or less of sugar per 100 milliliters acquiesces to soda industry interests, which are the parties mainly responsible for the collapse of public health in Mexico.

– The most consumed 600 milliliter drink in Mexico has 5 grams of sugar for every 100 milliliters contains 30 grams of sugar (6 spoonfuls).

– This surpasses the 25 grams (5 spoonfuls) that the World Health Organization establishes as a maximum amount of added sugars per day in order to preserve one’s health. (1)

– Sugar is not an essential nutrient and there is solid evidence showing that its consumption is harmful to health, contributing to overweight, obesity and caries, serious public health problems in Mexico.

Sugar-sweetened beverages kill more Mexicans a year than organized crime. (2)

Whose side are you on?

DO NOT GIVE IN TO INDUSTRY PRESSURE!

Show that you work to protect the public health of the Mexican population and not Big Soda’s profits.

We demand that the special tax be preserved and increased to 20% for ALL SUGAR-SWEETENED BEVERAGES, as recommended by international and national organizations.

Oct 19 2015

Industry (and other) reactions to Soda Politics

Friends and colleagues are asking me about reactions to Soda Politics: Taking on Big Soda (and Winning).

The book has only been out for a week or two, but here’s a report on the early returns.

I’ve posted the few reviews that have come in on the Soda Politics page.  Amazon has posted five reviews so far—all 5-star—and all from people I do not know personally.

But never mind all that.  What about the reaction of the soda industry?

This too is just starting.  The industry group, IFIC (International Food Information Council), did a Food Insight on the book.,  I’m guessing the reviewer didn’t read it very carefully, since she seems to have missed my deliberately cautious interpretation of the science.

The American Beverage Association issued a press release.  Since it is not yet online, I reproduce it here.press release issued by the American Beverage Association

This says:

BEVERAGE INDUSTRY COMMITTED TO LEADING ON PUBLIC HEALTH ISSUES

In response to the publication of “Soda Politics,” a book by New York University’s Marion Nestle, the American Beverage Association issued the following statement:

Statement
“The people who make up America’s beverage companies have a long history of engaging in thoughtful discussions and meaningful actions to address the public health issues of overweight and obesity.  By bringing stakeholders together and working with leaders like President Clinton and First Lady Michelle Obama, we are delivering real and significant results.  To support our voluntary efforts, we work hard to bring consumers the fact-based information and the beverage options they need to make the right choices for themselves and their families.  And we are always interested in new opportunities to make more meaningful changes to improve public health.  We welcome discussions with anyone from government, academia, or non-profits who are willing to partner and make a difference.”

The rest is about all the good things the industry is doing.

Read the book and decide for yourself!

Oct 16 2015

Weekend reading: Tom Farley’s Saving Gotham

Tom Farley, MD.  Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives.  Norton, 2015.

Dr. Farley is the former New York City Health Commissioner under Mayor Michael Bloomberg, the second Tom in that position (the first was Tom Frieden, now head of the CDC).

He has produced a wonderfully written, personal, eye-witness, in-the-trenches account of how the New York City Department of Health and Mental Hygiene led the nation in creating public health interventions to reduce smoking, get rid of trans fats. put calorie labels on restaurant menus, and reduce soda consumption—with impressive improvements in the health of New Yorkers.

His book also covers the Department’s failures to convince the USDA to allow a pilot project to get sodas out of SNAP and the courts to support the city’s proposal to cap the sizes of sugary drinks at 16 ounces.

For me, a New York City resident  who lived through these events and wrote about some of them in Soda Politics, this book was fun, even gossipy, and disclosed things I hadn’t known.  It has much to teach anyone about how the politics of city public health agencies, how to get things done in complicated city institutions, and how to treasure even the smallest successes.

This particular health department had three things going for it: courageous health commissioners, huge city health problems that desperately needed to be addressed, and a mayor fearless (and rich) enough to take on the challenges.

Farley ends the book with a quote from Bloomberg:

While government action is not sufficient alone, it is nevertheless absolutely essential.  There are powers only governments can exercise, policies only governments can mandate and enforce, and results only governments can achieve.  To halt the worldwide epidemic of noncommunicable diseases, governments at all levels must make healthy solutions the default social option.

That is, ultimately, government’s highest duty.

Amen.

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