Food Politics

by Marion Nestle
Aug 29 2014

Global Nutrition Report: How US Citizens Can Hold Government Accountable for Preventing Malnutrition

Lawrence Haddad, senior researcher at the International Food Policy Research Institute (IFPRI), invited me to comment on how to strengthen accountability in the fight against malnutrition in the United States.

This is a contribution to the Global Nutrition Report, a project chaired by the Governments of Malawi and the UK as an outcome of the 2013 Nutrition for Growth Summit in London.

My comments are in response to this specific question:

Q.  How can citizens of the United States hold their government accountable for preventing and reversing malnutrition?

A.  This question has no easy answer.  To begin with, we see practically no cases of severe undernutrition among U.S. citizens, in the sense that it occurs in the developing world.  Only rarely, do adults or children exhibit overt clinical signs of vitamin or mineral deficiency, let along acute malnutrition.  Instead, in America we talk about “food insecurity,” defined by government agencies as consistent, dependable, legal access to enough food on a daily basis to support active healthy living.

The U.S. Department of Agriculture (USDA) monitors the extent of food insecurity among the population in two ways.  It counts the number of individuals who apply and qualify for participation in the Supplemental Nutrition Assistance Program (formerly known as Food Stamps), and it collects data from surveys and publishes the results in annual reports on Household Food Security.  By both measures, nearly 15 percent of the U.S. population is judged to be food insecure—one out of every six adults.  Nearly six percent of the population is considered to be severely food insecure and, therefore, at risk of malnutrition but not necessarily displaying clinical signs.

Americans who qualify as food insecure are more likely than average to be poor, single parents, African-American or Hispanic, and living either in large cities or in rural areas.  They also, paradoxically, are more likely to be overweight or obese.  An explanation for the lack of clinical signs of malnutrition and of overweight is that nearly 60 percent of those considered food insecure participate in one or more of the three largest federal food and nutrition assistance programs (SNAP, the Special Supplemental Program for Women, Infants, and Children or WIC, and National School Lunch Program.  An unspecified percentage also obtains free food from privately run charitable food banks or soup kitchens. As the USDA likes to explain, its 15 domestic food and nutrition assistance programs “form a nutritional safety net for millions of children and low-income adults” and account for more than 70 percent of USDA’s annual budget.

What the USDA says less about is the quality of that food.  SNAP has minimal limitations on what can be purchased with benefits, and retailers lobby hard to make sure program participants can continue to buy cheap, high-calorie foods and beverages.  WIC, in contrast, permits purchase of a limited number of foods meeting certain nutrition standards.  Recently, school meals have been required to meet nutrition standards, but these too are under lobbying pressure by food companies.

Because of the high cost of these programs—SNAP alone costs taxpayers $80 billion a year—arguments about what to do about food insecurity come down to matters of money.  They only rarely focus on ways to ensure that even the poorest Americans get enough food to eat, let alone healthy food.  Accountability, therefore, must confront the views of many congressional representatives that assistance programs represent “nanny-state” government and induce dependence among recipients.

Given this situation, American anti-hunger advocates are limited in what they can expect to accomplish in the current political era.  As one sympathetic Congressman, Jim McGovern (Dem-MA) once explained, hunger does not resonate with Congress.  Because the government already monitors food insecurity, the next steps must aim to get it to do something about the problem.  This means reducing poverty and income inequities (which in part means reducing educational inequities, providing a stronger safety net for single parents and those living in cities and rural areas, and reaching out to the 40 percent of people who qualify as food insecure but receive no federal food or nutrition assistance benefits.  It also means bringing anti-hunger and anti-obesity together to support healthier food options for low-income Americans.

All of this will cost money at a time when the interest of Congress in food assistance is only as a means to cut benefits.  This, in turn, means that the only way to fix the hunger problem in the United States is to change election campaign laws so that individuals who care about such issues have a chance of being elected.   Recent decisions of the Supreme Court in Citizens United and in McCutcheon make it clear that it favors no or insignificant limits on campaign contributions for corporations or wealthy individuals.    The one bright spot is the national movement that has emerged to obtain a raise the minimum wage, especially for restaurant and farm workers.  Most recipients of federal food assistance are employed, but at wages too low to bring them out of poverty.  Paying living wages would solve most problems of food insecurity in America.

 

Aug 27 2014

On two views of GMOs: Michael Specter vs. Vandana Shiva and Gary Hirshberg

Michael Specter’s article “Seeds of Doubt” in the current issue of The New Yorker  is a critical profile of  India’s Vandana Shiva and her active opposition to genetically modified foods.  At the end, it offers this somewhat temporizing statement:

Genetically modified crops will not solve the problem of the hundreds of millions of people who go to bed hungry every night. It would be far better if the world’s foods contained an adequate supply of vitamins. It would also help the people of many poverty-stricken countries if their governments were less corrupt. Working roads would do more to reduce nutritional deficits than any G.M.O. possibly could, and so would a more equitable distribution of the Earth’s dwindling supply of freshwater. No single crop or approach to farming can possibly feed the world. To prevent billions of people from living in hunger, we will need to use every one of them.

Despite this peace offering, his article elicited a firm rebuttal from Dr. Shiva. It also elicited a rebuttal from Gary Hirshberg, chair of Just Label It. If you want to get into the weeds of the GMO arguments, all three of these pieces are well worth reading.

They raise and debate the same arguments I discussed in Safe Food: The Politics of Food Safety, first published in 2003 and out in a second edition in 2010. As I explain in the book, the gist of the arguments comes from two apparently irreconcilable views of GMO foods:

  1. The “science-based” position: If GMOs are safe (which they demonstrably are), there can be no rational reason to oppose them.
  2. The “societal value-based” position: Even if GMOs are safe (and this is debatable), there are still plenty of other reasons to oppose them.

Specter holds the first position.  Shiva and Hirshberg hold the second. Those who hold the “science-based” position would do well to take societal values more seriously.

Seed patents, monoculture, weed resistance, and other such concerns trouble people who care about food systems that promote health, protect the environment, and provide social justice.

Labeling, right from the start, would have acknowledged the importance of such values. Until GMO foods are labeled as such, the same arguments are likely to go on endlessly, with no reconciliation in sight.

Additions:

Aug 25 2014

More money in food: USDA’s food dollar

While I’m thinking about the role of money in food, take a look at USDA’s new food dollar series.

Farm and agribusiness get 11.8 cents on the dollar.

The real money is in adding value through processing (18.6 cents) and food service (33.7 cents).

When farmers complain that it’s hard to make a living, they aren’t kidding.

Screenshot 2014-08-20 09.50.54

 

 

 

 

 

 

 

 

 

Aug 21 2014

Mercury in fish–again. Watch out for tuna.

In June I wrote about the FDA’s advice to pregnant women to avoid eating fish high in methylmercury.  The advisory said to avoid the four fish highest in methylmercury:  shark, swordfish, king mackerel, and tilefish.

I was surprised that the advisory didn’t warn about the high mercury levels in albacore tuna, and I was skeptical about the FDA’s  insistence that pregnant women must eat fish.

Now Consumer Reports advises pregnant women not to eat tuna at all.

Consumer Reports:

So what’s going on here?

In my book, What to Eat, I included a chapter on this very topic: “The Methylmercury Dilemma.”  Here’s a quote:

Albacore tuna clearly belonged on the list of fish to avoid, but advice to restrict its consumption would surely affect the livelihoods of people who fish for, can, and sell tuna.   Because hardly anyone knows the difference between one kind of tuna and another, fish companies worried that consumers would interpret advice to avoid albacore tuna as advice to avoid all tuna.  Industry lobbyists urged the FDA to keep albacore tuna off the methylmercury advisory.   Somehow, albacore tuna got left off.

That was in 2006.   Consumer Reports tells us that pretty much all tuna is too high in methylmercury to be consumed by pregnant women.  So this comment still seems relevant, no?

Evidence: Here’s the response from the National Fisheries Institute:  “Consumer Reports has long history of intentionally mischaracterizing tuna.”

Aug 20 2014

Money in food

It’s a slow news week so I’m digging in to some items saved over the course of the year.

Here’s one from The Hartman Group, a market-research consulting firm: “Why [software] investors are pouring their lettuce into food.”

The article is about start-ups funded by software billionaires, but its point—there’s money to be made in food—reminds me of Fred Kaufman’s work on food commodity trading.

Making money from food is good when it keeps people employed and pays living wages.

It’s not so good when it adds to world hunger.

Aug 18 2014

Food Navigator on what’s happening with the nutrition label

Food Navigator—USA’s Elaine Watson just put together a special edition on the revamping of the Nutrition Facts label.  Her title: Radical overhaul or a missed opportunity?

To understand what’s happening with food labels, you can start with the FDA’s home page on its proposed revisions.  The comment period has ended.  You can read the comments that have been filed on the Nutrition and Supplement Facts panels, and those filed on the proposed changes to the standards for serving sizes.  These are fun to read; opinions, to say the least, vary.

But back to Food Navigator, which collects in various pieces on the topic in one place.  The “Radical overhaul” piece contains a summary of the major provisions.  Others in the series are also useful (I’m quoted in some of them):

Does vitamin D belong on the Nutrition Facts panel?

FDA proposals to list “added sugars” on the Nutrition Facts panel have already generated heated debate, so it’s perhaps unsurprising that its plan to include vitamin D is proving equally controversial…

Should ‘added sugars’ be listed on the Nutrition Facts panel?

A row is brewing over the merits of including ‘added sugars’ on the Nutrition Facts panel, with critics arguing that our bodies don’t distinguish between ‘naturally occurring’ and ‘added’ sugar – and neither should food labels – and supporters saying it will help consumers identify foods with more empty calories.

 Nutrition Facts overhaul is a missed opportunity for long chain omega-3s EPA and DHA, says GOED

The FDA’s overhaul of the Nutrition Facts panel misses a public health opportunity by prohibiting firms from even highlighting long chain omega-3 fatty acids EPA and DHA on the panel, says GOED.

What are the biggest contributors of added sugars to the US diet?

Check out this analysis of NHANES data to see where our added sugars are coming from plus read new comments about the ‘added sugars’ labeling proposal from Ocean Spray cranberries and others.

Former FDA commissioner: Nutrition Facts overhaul doesn’t go far enough

FDA proposals to overhaul the Nutrition Facts panel on food labels don’t got far enough, says former FDA commissioner David Kessler, M.D.

Behavioral scientists: Changing serving sizes on Nutrition Facts label could have unintended consequences

FDA proposals to change the way serving sizes are calculated to better reflect real-life eating behavior could encourage some people to eat even more unless the wording is changed, says one expert group.

Until phosphorus gets on the USDA’s radar, labeling policy won’t change: NKF

While phosphorus is an essential nutrient found naturally in some foods such as egg yolk and milk, it is increasingly added to packaged foods via a raft of phosphorus additives, and some experts believe it should be listed on the Nutrition Facts panel.

Canada’s proposed Nutrition Label changes emphasize calories, sugar

Health Canada is proposing changes to nutrition labels that would make them easier for consumers to read.

RD: There’s a health continuum for every food; what pillars do you want to stand on?

Rachel Cheatham, RD, founder of nutrition strategy consultancy FoodScape Group, talks food labeling at the IFT show.

Is your product ready for nutrition label changes?

“A 16-ounce drink and a two-ounce bag of potato chips are a single serving. If it’s bigger than that, from 200 to 400%, then you need to declare two columns of information—one for the serving size and one for the whole container.”

Proposed nutrition labels more effective than current labels: survey

Consumers find proposed labels easier to read in less time.

How much do consumers use (and understand) nutrition labels?

New research from the NPD Group is questioning how many US consumers even routinely check nutrition labels anymore.

 FDA’s proposed nutrition label changes emphasize calories, serving sizes

If approved, the new labels would place a bigger emphasis on total calories and update serving sizes, while also drawing attention to added sugars and nutrients such as Vitamin D and potassium.

CRN, NPA submit comments on FDA’s proposed changes to food, supplement labels

Both the Council for Responsible Nutrition and the Natural Products Association have submitted a comments on FDA’s proposed revisions for food and dietary supplement labels.

The FDA’s next step is to deal with the comments and issue final rules.  By when?

Eventually.  Stay tuned.

Aug 15 2014

Weekend reading: Globalization and Food Sovereignty

Peter Andrée, Jeffrey Ayres, Michael J. Bosia, and Marie-Josée Massicotte.  Globalization and Food Sovereignty: Global and Local Change in the New Politics of Food.  University of Toronto Press, 2014.

New Picture (1)

This is a book in a series on political economy and public policy, edited by political science professors in Canada and the United States with deep interests in food movements.  The chapters, by various authors, define food sovereignty as “a central issue that cuts across social, political, economic, cultural, and ecological domains.”  They deal with such matters as fair trade, local food, food security, and other food movements in places such as Cuba, Australia, France, and Brazil.

The editors say:

This volume posits that–given the incrasing attention to the politics of food as local, national, and global–it is important to incorporate these new areanas of political action much more widely into curriculums and scholarship and focus especially the framework and methodologies of political science on the profoundly political issues raised by the food sovereignty response…we seek to develop the study of food politics as a more engaged arena within the social sciences….

I say, yes!

 

 

Aug 14 2014

It’s salt war time again: new research, arguments over public health recommendations, and issues of conflicts of interest

Here are the burning questions about sodium (which is 40% of salt) intake:

(a) Does too much dietary sodium cause high blood pressure?   Answer: an unambiguous yes (although not necessarily in everyone).

(b) Are public health recommendations to reduce salt intake warranted?  I think so, but others disagree.

(c) If so, to what level?  Although virtually all committees reviewing the evidence on salt and hypertension view public health recommendations as warranted, and advise an upper limit of about 2 grams of sodium (5 grams of salt, a bit more than a teaspoon (see table from the Wall Street Journal), these too are under debate.

These recommendations are strongly opposed by The Salt Institute, the trade association for the salt industry, its industry supporters, and some groups of investigators.

Now the New England Journal of Medicine weighs in with three new studies, an editorial, and a cartoon video.  The papers:

Start with the video,  narrated by the editor, Dr. Jeffrey Drazen (click on video link on the right side).  It gives an excellent summary of the three papers.  Despite their methodological differences, all confirm (a).  They disagree on (c) and, therefore, (b).

Are public health recommendations warranted?

But note Dr. Drazen’s suggestion: “throw away the salt shaker.”

He is in favor of reducing salt intake.  But the salt shaker is not where most dietary salt comes from.  At least 75% of salt in American diets comes from restaurant and processed foods.   As Dr. Yoni Freedhoff explains:

If you’d like to reduce the sodium in your diet, rather than keep a running tally of how much you’re actually consuming, why not try instead to determine what percentage of your diet comes from restaurants and boxes? Sure, there’s data to suggest you might simply find other ways to add salt to your diet. But visit restaurants and consume processed foods less frequently, and I’d be willing to wager that you’ll be far more likely to see health benefits than were you to simply fill your grocery cart with low-sodium versions of highly processed foods.

Individuals cannot cut down on salt on their own.  That’s one reason why public health policies are needed—to get restaurants and processed food manufacturers to reduce salt content.

Two of the papers say that the only people who need to cut down on salt are those with hypertension and older people (one of the studies says that means people over age 55).

You can’t expect 70 or 80 million people to reduce salt intake on their own.  Hence: public health recommendations.

Conflict of interest alert

Some of the investigators report receiving grants or fees from companies that make anti-hypertensive drugs but the editorial accompanying the papers is of special concern.   Written by Dr. Suzanne Oparil, it says about one of the studies:

These provocative findings beg for a randomized, controlled outcome trial to compare reduced sodium intake with usual diet. In the absence of such a trial, the results argue against reduction of dietary sodium as an isolated public health recommendation.

These conclusions sent me right to her conflict-of-interest disclosure statement.  Although Dr. Oparil reports receiving grants or fees from companies making anti-hypertensive drugs—-and, even more remarkable, from The Salt Institute—she states that she has no conflicts of interest.

I think she does.

Implications

Her editorial is especially unfortunate because it influences the way reporters write about the studies.

The Associated Press account, for example, begins:

A large international study questions the conventional wisdom that most people should cut back on salt, suggesting that the amount most folks consume is OK for heart health — and too little may be as bad as too much. The findings came under immediate attack by other scientists.

As well they should.  Blood pressure rises with age and huge swaths of the population would be healthier eating less salt.   The AP reporter quoted me saying so:

“People don’t eat salt, they eat food,” she said. “Lots of people have high blood pressure and lots of people are getting older,” making salt a growing concern, she said. “That’s the context in which this is taking place.”

The three studies are complicated to interpret because of differences in methods and discrepancies in outcomes.  They agree that if you already have hypertension or are “elderly,” or eat a lot of salt, you should cut down.

This seems like a good idea for just about anyone.   People don’t eat salt; they eat foods containing salt, and foods high in salt tend to be high in other things best consumed in small amounts.

The studies also talk about the protective effects of potassium, best obtained from vegetables.

Eat a lot of vegetables and not too much junk food, and you don’t have to worry about any of this.

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