Food Politics

by Marion Nestle
Mar 8 2016

Another five industry-funded studies with sponsor-favorable results. The score: 145/12

Thanks to a reader for sending these items from a journal that I don’t usually come across.  These bring the casually collected total since last March to 145 studies favorable to the sponsor versus 12 that are not.

Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States: diet modeling study based on NHANES 2007–2010Erin E Quann, Victor L Fulgoni III and Nancy Auestad. Nutrition Journal 2015; 14:90 DOI: 10.1186/s12937-015-0057-5

  • Conclusion: Increasing dairy food consumption to recommended amounts is one practical dietary change that could significantly improve the population’s adequacy for certain vitamins and minerals that are currently under-consumed, as well as have a positive impact on health.
  • Funding: The study and the writing of the manuscript were supported by Dairy Management Inc.

Association of lunch meat consumption with nutrient intake, diet quality and health risk factors in U.S. children and adults: NHANES 2007–201Sanjiv Agarwal, Victor L. Fulgoni III and Eric P. Berg. Nutrition Journal. 2015;14:128.  DOI: 10.1186/s12937-015-011f8-9

  • Conclusions: The results of this study may provide insight into how to better utilize lunch meats in the diets of U.S. children and adults.
  • Funding: The present study was funded by North American Meat Institute.

A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancerLauren C. Bylsma and Dominik D. Alexander.  Nutrition Journal. 2015;14:125. DOI: 10.1186/s12937-015-0111-3

  • Conclusion: Dose-response analyses did not reveal significant patterns of associations between red or processed meat and prostate cancer….although we observed a weak positive summary estimate for processed meats.
  • Funding: This work was supported in part by the National Cattlemen’s Beef Association (NCBA), a contractor to the Beef Checkoff. NCBA did not contribute to the writing, analysis, interpretation of the research findings, or the decision to publish…LCB and DDA are employees of EpidStat Institute. EpidStat received partial funding from the National Cattlemen’s Beef Association (NCBA), a contractor to the Beef Checkoff, for work related to this manuscript. The conceptualization, writing, analysis, and interpretation of research findings was performed independently.

Are restrictive guidelines for added sugars science based?  Jennifer Erickson and Joanne Slavin.  Nutrition Journal. 2015;14:124.  DOI: 10.1186/s12937-015-0114-0

  • Conclusion: However, there is currently no evidence stating that added sugar is more harmful than excess calories from any other food source. The addition of restrictive added sugar recommendations may not be the most effective intervention in the treatment and prevention of obesity and other health concerns.
  • Disclosure: Jennifer Erickson, is a PhD student in Nutrition at the University of Minnesota working with Dr. Joanne Slavin. Joanne Slavin is a professor in the Department of Food Science and Nutrition, University of Minnesota.  In the past 5 years, she has given 150 scientific presentations in 13 countries. Many of these meetings received sponsorship from companies and associations with an interest in carbohydrates and nutritive sweeteners…Her research funding for the past 5 years has included grants from General Mills, Inc., Tate and Lyle, Nestle Health Sciences, Kellogg Company, USA Rice, USA Pears, Minnesota Beef Council, Minnesota Cultivated Wild Rice Council, Barilla Company, USDA, American Egg Board, American Pulse Association, MNDrive Global Food Ventures, International Life Science Institute (ILSI), and the Mushroom Council. She serves on the scientific advisory board for Tate and Lyle, Kerry Ingredients, Atkins Nutritionals, Midwest Dairy Association and the Alliance for Potato Research and Education (APRE). She holds a 1/3 interest in the Slavin Sisters Farm LLC, a 119 acre farm in Walworth, WI.

Cow’s milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCTM. V. Pontes, T. C. M. Ribeiro, H. Ribeiro, A. P. de Mattos, I. R. Almeida, V. M. Leal, G. N. Cabral, S. Stolz, W. Zhuang and D. M. F. Scalabrin.  Nutrition Journal. 2016;15:19.  DOI: 10.1186/s12937-016-0138-0

  • Conclusion: A cow’s milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract.
  • Funding: This study was funded by Mead Johnson Nutrition…The study products were provided by Mead Johnson Nutrition. Dr. Scalabrin, S. Stolz, and W. Zhuang work in Clinical Research, Department of Medical Affairs at Mead Johnson Nutrition. All of the remaining authors have no financial relationships to disclose.

Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001–2012.  Ann M. Albertson, Marla Reicks, Nandan Joshi and Carolyn K. Gugger.  Nutrition Journal 2016;15:8.  DOI: 10.1186/s12937-016-0126-4

  • Conclusions: The data from the current study suggest that greater whole grain consumption is associated with better intakes of nutrients and healthier body weight in children and adults. Continued efforts to promote increased intake of whole grain foods are warranted.
  • Competing interests:  Marla Reicks received an unrestricted gift from the General Mills Bell Institute of Health and Nutrition during the manuscript preparation to support research at the University of Minnesota.  Carolyn Gugger and Nandan Joshi are current employees and stockholders of General Mills, Inc.  Ann Albertson was an employee of General Mills, Inc during the conception, analysis and initial preparation of the manuscript. She is currently retired from General Mills.
  • Non-financial competing interests: General Mills, Inc is a global consumer foods company that manufactures and sells products across a broad variety of food categories, including grain-based foods. General Mills product portfolio includes ready-to-eat cereals, cereal bars, baked goods, flour, and salty snacks that may contain whole grain.
Mar 7 2016

Sugar: in Australia, it’s “Better for You”

At my lecture at the University of Sydney last week, a member of the audience presented me with a 750-gram package of Low GI [Glycemic Index] cane sugar, labeled “Better for you.”

This product is sugar.  Its ingredient list says “pure cane sugar.”

The label also says:

  • 100% Natural
  • Longer Lasting Energy

The Glycemic Index (GI) refers to the comparative ability of 50 grams of a food to raise blood glucose levels.  The standard is pure glucose, which has a  GI of 100.

This sugar has a GI of 50.  Hence: “Low GI.”

Of course it does.  Cane sugar is sucrose: 50% glucose, 50% fructose.  It’s half fructose, which is absorbed more slowly and has a much lower GI.

The CSR website says:

CSR LoGiCane™ uses world first technology to develop a sugar with a naturally Low Glycemic Index (GI). It works by spraying an all natural molasses extract onto raw sugar. This molasses naturally increases sugar’s resistance to digestion. By having a low GI, CSR LoGiCane™ takes longer to be digested, resulting in a slower release of energy, which can help curb hunger cravings. CSR LoGiCane™ represents innovation in sugar – the same sweet tasting natural sugar, with the added benefit of carrying the official Low GI symbol and a Low GI rating of just 50.

No, I am not making this up.

I can’t imagine that the difference in speed of absorption of cane sugar and of sprayed cane sugar is measurable, let alone meaningful.

And what about the fructose?  Fructose is the source of much concern about the effects of excessive intake on liver and heart function, so much that Dr. Robert Lustig considers it a “poison.”

This particular brand of sugar carries a certification seal from the Glycemic Index Foundation, whose motto is “making healthy choices easy.”  It is supported by the University of Sydney and the Juvenile Diabetes Research Foundation.

The Foundation generates income by licensing the low GI Symbol to manufacturers of healthier low GI foods.

Is “low GI” cane sugar healthier than cane sugar?   The mind boggles.

The World Health Organization recommends that added sugars of any kind comprise no more than 10% of calories, with 5% being even better.  for many people, this translates to eating less sugar of any kind.  Good advice.

Mar 5 2016

Three books about eating: 3. A Short History

This is the third book about eating I’ve been posting about.  The first two were here and here.

Graham Dukes & Elisabet Helsing.  A Short History of Eating.  The London Press, 2016.

Dukes and Helsing, married couple, English and Norwegian respectively, and friends of long standing, have produced a light-hearted, entertainingly illustrated romp through the history of the human diet, from breast milk (on which Helsing is expert) to bubble gum, based on their research into a wide range of sources, literary as well as anthropological.   The authors quote poems in appropriate places:

When mighty Roast Beef was the Englishman’s food,

It ennobled our brains and enriched our blood.

Our soldiers were brave and our courtiers were good

Oh! the Roast Beef of old England.

The illustrations display cartoons, ads, portraits, and botanicals.

Here is an excerpt to give you the flavor…

Marie Antoinette, the last Queen of France before the Revolution, is often cited—almost certainly wrongly—as having suggested that since during a famine the starving population lacked bread they should eat cake instead…But if Marie Antoinette truly did propose that the populace eat cake, what sort of cake, familiar in her royal circle, might that have been?  Modern reference sources define a brioche today as a light yeast bread with butter and eggs…A better clue…may be that provided by that infamous rascal of the day, the Marquis de Sade.  In July 1783, from his prison cell in Vincennes…he wrote a letter to his patient wife imploring her to send him: “…four dozen meringues; two dozen sponge cakes (large): four dozen chocolate pastille candies with vanilla….”

Mar 4 2016

Julia Belluz (Vox) on my collection of studies sponsored by food companies

Julia Belluz of Vox has just done a story on my collection of studies funded by food companies.  Here are a few excerpts.  For the entire article and its excellent illustrations, click on the link):

About a year ago, Marion Nestle finally got sick of the rotten state of nutrition science.

Everywhere she looked, she found glaring conflicts of interest. “Without any trouble, I could identify industry-funded nutrition studies by their titles,” says the New York University professor. “It was so obvious”…But Nestle is not the first to notice this problem. Many nutrition researchers have been complaining about conflict-of-interest problems in their field for some time now. Whereas other fields, like medicine, have been putting in place safeguards to protect against undue industry influence, the field of nutrition has lagged behind in this regard.  And other research backs up Nestle’s findings. Take this review of studies on sugary drinks. Independently funded studies tend to find a correlation between soda consumption and poor health outcomes. Studies funded by soda makers, by contrast, are less likely to find such correlations. Or take this investigation of 206 publications on the health effects of milk, soft drinks, and fruit juices. Studies that were funded by beverage companies were four to eight times more likely to come to favorable conclusions about the health effects of those beverages.

The reporter interviewed researchers who work in food and nutrition about all this.

They all acknowledged that she was tapping into a real problem, one that’s been difficult for their community to address.  So why are conflicts of interest allowed to persist in nutrition research?  One root cause is the need for funding. Right now nutrition science is relatively underfunded by government, leaving lots of space for food companies and industry groups to step in and sponsor research…Tradition also plays a role. “Nutrition science has always been close to producers,” Dutch nutrition researcher Martijn Katan told me. “There’s such a direct interest in the outcomes of research for producers”…And food companies have ample incentive to promote this research. Under Food and Drug Administration rules, any health claims that they want to make on their packaging has to be backed up by scientific research. So the food industry has a keen interest in funding research — and favorable research that their profits may depend on.

She quotes Martijn Katan:

In the long term,” Katan said, “the deepest harm being done is that it undermines the credibility of science. In the short term, it means some people will eat more butter or cheese than is good for them, and that it will take longer to get people off soda.”

Her conclusion:

None of the researchers I spoke to suggested we should abolish industry funding of food and nutrition studies. As Katan has written, these collaborations can lead to fruitful discoveries…Instead, they wanted to see more awareness about the problem, more scrutiny of industry-funded research, and organized efforts to control conflicts of interest. “It’s not the quality of the science that’s at issue,” Nestle explains. “The studies are carried out according to strong scientific principles. But the bias seems to come in around the research question that’s asked, the interpretation of the results, putting a positive spin on findings even when the results are neutral.” That’s not good for science or for public health.

Mar 3 2016

More industry-funded studies with industry-favorable results. The score 140/12.

A nutrient profiling system for the (re)formulation of a global food and beverage portfolio.  Antonis Vlassopoulos · Gabriel Masset · Veronique Rheiner Charles ·Cassandra Hoover · Caroline Chesneau‑Guillemont · Fabienne Leroy ·Undine Lehmann · Jörg Spieldenner · E‑Siong Tee · Mike Gibney ·Adam Drewnowski.  Eur J Nutr DOI 0.1007/s00394-016-1161-9.

  • Conclusions:  The NNPS sets feasible and yet challenging targets for public health-oriented reformulation of a varied product portfolio; its application was associated with improved nutrient density in eight major food categories in the USA and France.
  • Funding: The research presented herein was funded by Nestec Ltd, which is a wholly owned affiliate of Nestlé S.A.  The first eight authors are employed by Nestlé.
  • Comment: the paper is the basis of a Nestlé infographic.

Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial.  Heather C Stobaugh, Kelsey N Ryan, Julie A Kennedy, Jennifer B Grise, Audrey H Crocker, Chrissie Thakwalakwa, Patricia E Litkowski, Kenneth M Maleta, Mark J Manary, and Indi Trehan.  Am J Clin Nutr  First published February 10, 2016, doi: 10.3945/​ajcn.115.124636.

  • Conclusion: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF [ready-to-use supplemental food], although the whey RUSF supplement provided less total protein and energy than the soy RUSF.
  • Funding for this project was provided by the Danish Dairy Research Foundation, Arla Foods Ingredients Group P/S, and the US Dairy Export Council. IT was supported by the Children’s Discovery Institute of Washington University in St. Louis and St. Louis Children’s Hospital…The funders had no role in the design or implementation of the study and no role in the analysis or interpretation of the data.

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UKL. Claxton, M. Taylor & E. Kay.  British Dental Journal 220, 121 – 127 (2016).  Published online: 12 February 2016 | doi:10.1038/sj.bdj.2016.94

  • Conclusion If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year…This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved.
  • Declaration: This study and writing support for the manuscript were funded by Wrigley Oral Healthcare Programme.

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base Richard D. Feinman, Wendy K. Pogozelski , Arne Astrup M.D., Richard K. Bernstein M.D., Eugene J. Fine M.S., M.D. , Eric C. Westman M.D., M.H.S.  , Anthony Accurso M.D. , Lynda Frassetto M.D.  , Barbara A. Gower Ph.D.  , Samy I. McFarlane M.D.  , Jörgen Vesti Nielsen M.D.  , Thure Krarup M.D. , Laura Saslow Ph.D. , Karl S. Roth M.D. , Mary C. Vernon M.D. , Jeff S. Volek R.D., Ph.D. , Gilbert B. Wilshire M.D. , Annika Dahlqvist M.D.r , Ralf Sundberg M.D., Ph.D.  , Ann Childers M.D.  , Katharine Morrison M.R.C.G.P.  , Anssi H. Manninen M.H.S.  , Hussain M. Dashti M.D., Ph.D., F.A.C.S.,  F.I.C.S., Richard J. Wood Ph.D., Jay Wortman M.D. , Nicolai Worm Ph.D.  Nutrition. January 2015 Volume 31, Issue 1, Pages 1–13 DOI: http://dx.doi.org/10.1016/j.nut.2014.06.011

  • Conclusion: Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1.
  • Disclosure: AA is consultant/member of advisory boards for the Dutch Beer Knowledge Institute, NL, Global Dairy Platform, USA, Jenny Craig, USA, McCain Foods Limited, USA, McDonald’s, USA, and Gerson Lehrman Group, USA (ad hoc consultant for clients). He is recipient of honoraria and travel grants as speaker for a wide range of Danish and international concerns. He has conducted research funded by a number of organizations with interests in the food production and marketing sector. RDF writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation. EJF has received grant support from the Veronica and Robert C. Atkins Foundation. TK sits on an advisory board for Eli Lilly and gives lectures for Lilly about the diabetic diet. NW has written popular-audience books on low-carbohydrate diets and is a consultant and promoter for Leberfasten/Hepafast, a specific low-carbohydrate meal replacement program. JW is on the Scientific Advisory Board of Atkins Nutritionals Inc. with paid retainer, honoraria, and travel costs. None of the other authors have anything to declare.
  • Comment: The Atkins Diet is low-carbohydrate.

Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial David G. Marrero, PhD, Kelly N. B. Palmer, MHS, Erin O. Phillips, BA, Karen Miller-Kovach, EBMA, MS, Gary D. Foster, PhD, and Chandan K. Saha, PhD. Am J Public Health. Published online ahead of print February 18, 2016: e1–e8. doi:10.2105/AJPH.2015.303035

  • Conclusions. A large weight-management program is effective for achieving lifestyle changes associated with diabetes prevention. Such programs could significantly increase the availability of diabetes prevention programs worldwide making an immediate and significant public health impact.
  • Funding: This study was funded by Weight Watchers International.

It’s close to a year since I first started collecting these studies.  When the year is up, I will do some analysis.  Until then, the bottom line is that it’s easier to find industry-funded studies with results favorable to the sponsor than it is to find those that are not.

Mar 2 2016

National Restaurant Association gets judge to delay New York City’s salt warning

Grub Street reports that an appeals court has just delayed New York City’s salt warning label.

Oddly, this follows what happened just a few days ago when a state judge denied the National Restaurant Association’s lawsuit to block the warnings.

The NRA is relentless about such things.  Recall how it opposed, successfully, Mayor Bloomberg’s proposal to cap soda sizes at 16 ounces.

The Daily News says nothing will happen on the salt warning until a March 18 hearing before judges at the Appellate Division in Manhattan.

Because most salt in American diets is put into foods by chefs and food processors, the warning label could alert consumers to the huge amounts of salt they add.  Many foods and meals will be affected.  No wonder the NRA doesn’t like it.

That organization ends up on the wrong side of public health all too often.  It needs to back off on this one.

Mar 1 2016

PAHO issues nutrition standards for ultraprocessed foods. Beverage Associations object.

Cheers to the Pan American Health Organization/World Health Organization for releasing nutritional profile standards for making it easier for governments to distinguish fresh and minimally processed foods from ultraprocessed.  The idea here is to encourage populations to consume traditional diets (see press release).

Ultra-processed foods are defined as industrially formulated food products that contain substances extracted from foods (such as casein, milk whey, and protein isolates) or substances synthesized from food constituents (such as hydrogenated oils, modified starches, and flavors). Drawing on the best scientific evidence available, the model classifies processed and ultra-processed foods and beverages as having “excessive” amounts of sugar, salt and fat according to the following criteria:

  • Excessive sugar if the amount of added sugars is 10% or more of total calories
  • Excessive fat if the calories from all fats are 30% or more of total calories
  • Excessive saturated fat if calories from saturated fats are 10% or more of total calories
  • Excessive trans fat if calories from trans fats are 1% or more of total calories
  • Excessive sodium if the ratio of sodium (in milligrams) to calories (kcal) is 1:1 or higher.

PAHO’s point in setting these standards is to encourage governments to:

  • Restrict the marketing of unhealthy food and beverages to children (see PAHO Plan of Action for the Prevention of Obesity in Children and Adolescents)
  • Regulate school food environments (feeding programs and food and beverages sold in schools)
  • Use front-of-package (FOP) warning labels
  • Define taxation policies to limit consumption of unhealthy food
  • Assess agricultural subsidies
  • Identify foods to be provided by social programs to vulnerable groups.

Yes!

Alas, not everyone is as enthusiastic as I am about the profiles.  The International Council of Beverages Associations released this statement:

We agree that obesity is a global health challenge, and ICBA and its members welcome the opportunity to work with PAHO and other stakeholders to pursue effective and practical solutions. There are some areas, however, where we believe that use of PAHO’s Nutrient Profile Model may not provide helpful guidance to consumers.  There is not current scientific consensus in all areas that the Nutrient Profile Model addresses. It will not be useful if families find that nearly 80% of the foods and beverages in their grocery carts are unacceptable. Such a radical message is not likely to be followed by most individuals…we encourage governments and scientific bodies to offer food and dietary recommendations and national policies that are based on the totality of scientific evidence and provide realistic, positive encouragement to consumers to have a real impact promoting healthful diets and preventing obesity and non-communicable diseases.

 

The PAHO profiles may need tweaking, but they are a great first step.  Now let’s see how they get implemented.

Feb 29 2016

Dairy food politics, Australia. Kangaroo politics too.

Dairy politics

This Melbourne newspaper has a front page story about Australia’s efforts to sell milk to China.Capture

The government allowed a Chinese billionaire to buy the biggest dairy farm in Tasmania for a mere $280 million (an Australian dollar is worth 70 cents U.S.).  The buyer has promised to process the milk into cheese, butter, spreads, and milk powder for infant formula in local Fonterra facilities in order to maintain current prices.

The worry, according to Independent member of Parliament Andrew Wilkie:

The new owner could decide to process the milk elsewhere, or to have it processed at Fonterra but allocated to an overseas market.  There is now uncertainty of supply and price in the market, and understandable fear we’re going to see a repeat of the baby formula episode where so much is going overseas Australians simply can’t buy it here and if they can, it’s at an inflated price.

An editorial in the same issue says:

There is real concern that the new owner of the 17,800-hectare Van Duenen’s Land Company in Tasmania might prefer to supply the Chinese market.  A tin of baby formula sells in China for four times its price in Australia, where supermarket shelves have been stripped bare….Last year, another Chinese billionaire bought two major cattle stations in Australia’s far north…Australians need to know how much of the country has been sold off to foreign investors.

I continue to remain baffled about the massive efforts to get dairy products into China.  Few traditional diets in China contained dairy foods and lactose intolerance, mild to severe, is widespread in Asian populations.

Dairy farming has replaced sheep farming in New Zealand, with devastating effects on the environment.

Kangaroo politics

This newspaper also describes efforts to cull kangaroos for use in pet food.  Kangaroos pose the same traffic-hazard problems that deer do in the U.S.

They are a major hazard [on the roads] and they’re a major concern.  We spend a lot of time picking up dead kangaroos.

Although the article didn’t say so, I’m guessing arguments over the culling are similar to those about deer and similarly splits animal lovers from gardeners and traffic officials.

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