by Marion Nestle

Currently browsing posts about: ASN(American Society of Nutrition)

Apr 23 2010

The 2010 Dietary Guidelines: some hints at what they might say

By congressional fiat, federal agencies must revise the Dietary Guidelines every five years. This is one of those years.   The 2010 Dietary Guidelines Advisory Committee has been meeting for a couple of years and is now nearly done.

Some unnamed person from the American Society of Nutrition must be attending meetings.  The society’s Health and Nutrition Policy Newsletter (April 22) provides a report.

From the sound of it, this committee is doing some tough thinking about how to deal with “overarching issues” that affect dietary advice:

  • The high prevalence of overweight and obesity among all Americans
  • The need to focus recommendations on added sugar, fats, refined carbohydrates, and sodium (rather than the obscure concept of “discretionary calories” used in the 2005 guidelines)
  • The benefits of shifting to plant-based, rather than meat-based, diets
  • The need to help individuals achieve physical activity guidelines
  • The need to change the food environment to help individuals meet the Dietary Guidelines

Applause, please, for this last one.  It recognizes that individuals can’t do it alone.

The committee’s key findings and recommendations:

  • Vegetable protein and soy protein: little evidence for unique health benefits, but there are benefits, such as added dietary fiber intake, from diets high in vegetable and soy proteins.
  • Carbohydrates: a consistent relationship between soft drink intake and weight gain. Overweight and obese children should reduce overall energy intake, especially from added sugars (and especially in the form of soft drinks and sugar-sweetened beverages).
  • Fats: mono and polyunsaturated fats, when replacing saturated fats, decrease the risks of heart disease and Type 2 diabetes in healthy adults. No benefit from increased intakes of omega-3 fatty acids above 250-300 mg a day.  Adults should eat two servings of fish per week to obtain omega 3 fatty acids.
  • Sodium: decrease sodium intake to 2,300 mg sodium per 2,000 calorie diet to lower blood pressure in adults and children. Since 70 percent of the population is hypertensive, the goal for most individuals should be 1,500 mg per 2,000 calorie diet.
  • Potassium: because higher intakes of potassium are associated with lower blood pressure, adults should increase intake to 4,700 mg daily.

Translation: more fruits and vegetables, fewer processed foods, and changes in the food environment to make it easier for everyone to follow this advice.

Next steps: the committee is supposed to complete its report by May 12 and send it to USDA and DHHS. The agencies post the report in June for public comment. Then, agency staff write the guidelines and publish them by the end of the year.

Historical note: prior to 2005, the committee wrote the guidelines.  I was on the 1995 committee and we drafted guidelines that the agencies hardly touched (except to tinker with the alcohol guideline, as I discussed in Food Politics and What to Eat).  The guidelines have always been subject to political pressures, but with the agencies writing them, expect even more.

Let’s hope the committee’s sensible ideas will survive the process.  I will be paying close attention to how the 2010 guidelines progress.  Stay tuned.

Oct 23 2009

Smart Choices suspended! May it rest in peace.

Big news!  According to an AP report today, the group that runs the Smart Choices program has announced that it will “postpone” active recruitment of new products and will not encourage use of the logo while the FDA is in the process of examining front-of-package labeling issues.

Who says the FDA does not have any power?  I think it does.  And let’s welcome it back on the job.

As for my nutrition colleagues in the American Society of Nutrition, the group that competed to manage the program and has been defending it ever since, here’s what they now say:

Dear ASN Member,

Today the Smart Choices Program announced the decision to voluntarily postpone active operations and not encourage wider use of the Smart Choices Program logo. This move follows an announcement by FDA Commissioner, Margaret Hamburg, M.D. on Oct. 20, 2009, which said that the agency intends to develop standardized criteria on which future front-of-package (FOP) nutrition or shelf labeling will be based. In a letter captioned, “Guidance for Industry” and posted on its website, the FDA stated: “We want to work with the food industry − retailers and manufacturers alike − as well as nutrition and design experts and the Institute of Medicine, to develop an optimal, common approach to nutrition-related FOP and shelf labeling that all Americans can trust and use to build better diets and improve their health.”

ASN commends the FDA on its announcement of intent to develop standardized criteria on which front-of-pack nutrition and shelf labeling could be based. In addition, ASN fully supports the decision of the Smart Choices Program Board of Directors to postpone their active operations as FDA works to address both front-of-pack and on shelf labeling.  “ASN will continue to provide nutrition science expertise within the dialogue on front-of-pack labeling in order to best serve the interests of the health of Americans,” said ASN President Jim Hill in a statement to media.

Sincerely,

ASN Executive Board

As I have explained in previous posts about Smart Choices, the ASN should never have gotten involved in this dubious enterprise in the first place.  The organization was lucky to get out of this so easily.  I hope it does not make the same mistake again.

The press had a field day with the Smart Choices logo on Froot Loops.  As Rebecca Ruiz at Forbes puts it, “the uproar over the program has conveyed a definitive message to industry: Don’t try to disguise a nutritional sin with a stamp of approval.”

Oct 15 2009

Connecticut takes on Smart Choices!

Richard Blumenthal, the Connecticult Attorney General, says he is about to conduct an investigation into the Smart Choices program because it is “overly simplistic, inaccurate and ultimately misleading.”   Recall that Froot Loops, a product with sugar as its first ingredient, qualifies as a better-for-you option.  Apparently, Mr. Blumenthal is talking to the Attorneys General of other states and several want to join his investigation.  While they are at it, maybe they should also take a look at the role of the American Society of Nutrition in developing and managing this program.

But count on the American Council on Science and Health (ACSH) to defend Froot Loops as a Smart Choice.  Explains ACSH’s Jeff Stier:

Froot Loops and Lucky Charms have the ‘Smart Choices’ label. They have sugar in them, but they also contain half of a person’s daily requirement of some vitamins. If we’re able to give kids those nutrients, it should be okay to give them some sugar. If they sold these products without sugar, kids wouldn’t eat them, or they might end up adding even more on their own….Don’t companies have the right to say those foods are better than others? It’s not as if they are making specific health claims, rather these are just comparative claims.

This Richard Blumenthal is the same one who has been seeking to ban e-cigarettes…Connecticut may have more serious problems to focus on than banning e-cigarettes and worrying about companies trying to point consumers to healthier products. Froot Loops obviously isn’t the healthiest food out there, but it’s better than many others.

It’s that debatable philosophic argument again: Is a so-called “better-for-you” product necessarily a good choice?

[Note: I'm in Rome this week and am most grateful to the six people who sent me the Times article and the two who sent the ACSH post.  Thanks so much!]

Sep 5 2009

Kellogg’s asks for a Froot Loops correction. More on Smart (?) Choices

Froot Loops

Earlier this week, I received a phone call from Dr. Celeste Clark, Kellogg’s senior vice president for global nutrition, corporate affairs and chief sustainability officer.

She had seen my previous blog post on the Smart Choices program, and wanted me to know that Froot Loops has been reformulated to contain 3 grams of fiber, not less than 1 gram, as I had posted, and that  in all fairness, I ought to post the new version.  Sure.  Happy to.  Here it is.Froot Loops_Nutrition Facts

This higher fiber product, of course, gets us into the philosophical question:  Is a somewhat-better-for-you, highly processed food really a good choice?  Does the additional 2.5 grams of fiber convert this product to a health food?  Whether Froot Loops really is a better choice than a doughnut as the Smart Choices program contends, seems debatable.

If I read the Nutrition Facts and ingredient list correctly, Froot Loops cereal contains:

  • No fruit
  • Sugar as the first ingredient (meaning the highest in weight–41%)
  • Sugar as 44% of the calories
  • Partially hydrogenated vegetable oil and, therefore, trans fat (although less than half a gram per serving so the label can read zero)

But with an implied endorsement from the American Society of Nutrition, which is managing the Smart Choices program, I guess none of that matters.  Or maybe the added fiber cancels all that out?

I pointed out to Dr. Clark that I had just bought the fiberless Froot Loops at a grocery store in midtown Manhattan, which means the old packages must still be on the market.

I discussed this and other such products with William Neuman of the New York Times whose reporting on the Smart Choices program appears on the front page of today’s business section under the title, “For your health, Froot Loops.  Industry-backed label calls sugary cereal a ‘Smart Choice.'”

According to his well reported account, Kellogg’s and other participating companies pay up to $100,000 for that seal.  No wonder the American Society of Nutrition and everyone else involved in the program want to set nutrition standards so loosely that they can encompass as many products as possible.   The more products that qualify for the Smart Choices logo, the more money the program gets.  I’d call that a clear conflict of interest.

Neuman managed to find nutritionists who defend the program.  I am not one of them.

Update September 6: CBS did a story on Smart Choices (I’m interviewed in it)

Update September 9: The American Society of Nutrition must be getting a bit defensive about the negative publicity, as well it should be.  It has issued an explanation to members.

Aug 24 2009

Smart Choices: 44% sugar calories!

You may recall my previous posts about the new Smart Choices program.  This program was developed by food processors to identify products that are ostensibly “better for you”  because they supposedly contain more good nutrients and fewer bad ones.  This program is about marketing processed foods and I wouldn’t ordinarily take it seriously except that several nutrition professional associations are involved in this program and the American Society of Nutrition is managing it.  In effect, this means that nutritionists are endorsing products that bear the Smart Choices logo.

So what products are nutritionists endorsing?  I went grocery shopping last week and bought my first Smart Choice product: Froot Loops!

Froot Loops

Froot Loops

Look for the check mark in the upper right of the package.  Frosted Flakes also qualifies for this logo, and do take a look at what else is on the approved list.

A close look a the Nutrition Facts label of Froot Loops shows that it has 12 grams of added sugars in a 110-calorie serving.  That’s 44% of the calories (12 times 4 calories per gram divided by 110).  The usual program maximum for sugar is 25% of calories but it makes an exception for sugary breakfast cereals.  Note that the fiber content is less than one gram per serving, which makes this an especially low-fiber cereal.

Look at the amounts of sugar and fiber.OK.  I understand that companies want to market their processed foods, but I cannot understand why nutrition societies thought it would be a good idea to get involved with this marketing scheme.  It isn’t.  The American Society of Nutrition gets paid to manage this program.  It should not be doing this.

But, you may well ask, where is the FDA in regulating what goes on package labels?

Good news: I am happy to report that our new FDA is on the job!  FDA officials have written a letter to the manager of the program.  Although the letter is worded gently, I interpret its language as putting the program on high alert:

FDA and FSIS would be concerned if any FOP [Front of Package] labeling systems used criteria that were not stringent enough to protect consumers against misleading claims; were inconsistent with the Dietary Guidelines for Americans; or had the effect of encouraging consumers to choose highly processed foods and refined grains instead of fruits, vegetables, and whole grains [my emphasis].

Update August 25: I received an interesting e-mail message from a member of the Keystone group that developed the Smart Choices program.  The message confirms that this program is a scheme to make junk foods look healthy.  It says:

Glad to see your posting about Froot Loops! The negotiations over criteria were interesting. Lots of good debate on various points, but when the companies put their foot down, that was it; end of discussion. And sugar in cereals was one such point. Others included the non-necessity for breads, etc. to contain half or more whole grains and the acceptance of fortification to meet the nutrient requirement.

In other words, some people in the group argued that breads needed to contain at least half a serving of whole grains to quality and that added vitamins and minerals should not count toward qualification.  Too bad for them.  I guess the companies put down feet.  But why didn’t they speak up then?  And why aren’t they speaking up now?

May 18 2009

Reply from the American Society of Nutrition

Last week, I posted correspondence regarding the American Society of Nutrition’s (ASN) partnership with the industry-sponsored Smart Choices program.  This program places a check mark on food products that meet its nutrient standards.  I am concerned about ASN’s involvement in this project as it puts the society in conflict of interest.  Several other food rating systems are under development, among them the traffic-light system used in Great Britain.  How can the ASN objectively evaluate the relative merits of these systems if it is paid for administering – and, therefore, endorsing – Smart Choices?  I much prefer the traffic light system, have concerns about the entire approach, and think some of the standards overly generous, particularly the upper limits of 25% of calories from added sugars and 480 mg sodium per serving.  Several people who commented on my post asked to see the ASN’s response.  Here it is:

From: John E. Courtney, Ph.D., Executive Officer, American Society of Nutrition
Sent: Tuesday, May 12, 2009 10:24 AM
Subject: Sunday, May 10, 2009 10:36 AM email to Katrina Dunn

Importance: High

Dear Dr. Nestle,

Thank you for your comments on ASN and the Smart Choices program. We value feedback from our members and I’d like to take this opportunity to address some of your concerns and amend a few of the points you made. First, The Smart Choices Program is not an industry-initiated plan. The Smart Choices idea was facilitated by the Keystone Center, which works with a broad array of stakeholders to develop solutions to complex health and social problems. The Smart Choices front-of-pack symbol was developed through a series of plenary meetings over two years and intensive work groups with academics, food manufacturers, public health organizations, and with observers from federal agencies.  This unique process with a broad array of stakeholders along with the fact that the program is completely transparent sets it apart from other programs that have been developed. In the fall of 2008, Keystone Center issued a RFP for organizations interested in administering the program. The ASN Executive Board was briefed on the program, discussed and evaluated it, and approved moving forward. ASN partnered with NSF to administer the program and was selected. ASN’s role will primarily be one of oversight and facilitation of the program governance, and the Society will be responsible for maintaining the scientific integrity in the Smart Choices program. This program was discussed at the ASN Volunteer Member Leadership Summit in January and most recently at the ASN Scientific Sessions and Annual Meeting at Experimental Biology in New Orleans, LA in April, 2009.

Perhaps most exciting for the Society and consistent with its mission is that ASN will be coordinating a rigorous evaluation of the program as well as consumer research to determine the effectiveness of the program. Perhaps most importantly, ASN neither “owns” the program nor are we making any profit from the program. The funds generated from company participants will be reinvested into the program.  ASN is the pre-eminent society for nutrition researchers and practitioners and encourages scientific debate and transparency and is looking forward to evaluating the effectiveness of this program in helping consumers.

Thank you again for your comments and for your commitment to advancing nutrition research and practice.



May 11 2009

Open letter to nutrition colleagues

Over the weekend, I received a letter from the American Society of Nutrition (ASN) nominating me to join the Board of Directors of the Smart Choices program.  Smart Choices, you may recall from my previous posts on this program as well as on other such systems, is a food industry-initiated plan to put a check mark – a stamp of approval – on processed food products that meet certain nutritional criteria.  Apparently, the ASN Board agreed to administer (and, implicitly, endorse) this program without discussing the matter with the membership.  I think involvement of independent nutrition researchers with Smart Choices represents a conflict of interest and the ASN should not be involved in this effort.  Here is what I told Katrina Dunn, the ASN Program Coordinator:

Dear Katrina—

Thank you for inviting me to join the Board of Directors of the Smart Choices program.  I regret that I cannot accept.  Participating in Smart Choices represents a serious conflict of interest for nutrition educators who wish to maintain independence from the influence of the food industry on nutrition advice.

But participation also represents a serious conflict of interest for the American Society of Nutrition (ASN).  I am dismayed that the ASN—an organization devoted to the highest standards of nutrition research–is involved in this project.  I think the ASN should reconsider this involvement and withdraw immediately.

The ostensible purpose of Smart Choices is to guide the public to select more healthful foods.  I am unaware of a research basis indicating that the program is likely to succeed in this goal.

Evidence does, however, support two additional goals of the program.  The first is to provide a basis for marketing highly processed food products.  I think we would all agree that highly processed foods are, in general, demonstrably nutritionally inferior to whole or minimally processed foods.

The second is to stave off federal regulations requiring a traffic-light food rating system such as that in use in the United Kingdom.   Preliminary research indicates that consumers prefer this system to numerical scores and understand the colors to mean that they should choose green-lighted foods and avoid red-lighted foods.

The cut points selected for the Smart Choices program may meet criteria of the Dietary Guidelines, but their health benefits are debatable (the sodium cut point is particularly generous).  Surely, a great deal more research is needed before ASN directly or indirectly endorses specific processed foods simply because they meet arbitrary nutrient cut points.

These concerns all address questions of intellectual conflict of interest.  But I am also concerned about financial conflicts of interest.  If ASN receives payment for its endorsement and administration of this program, the organization—and its members—risk losing intellectual independence.

I appreciate the invitation but I believe the entire program is ill advised and I urge ASN to extricate as quickly as possible.

Sincerely yours,

Marion Nestle
Paulette Goddard Professor of Nutrition, Food Studies, and Public Health
New York University