by Marion Nestle

Currently browsing posts about: Sugars

Jul 15 2016

Big Sugar and Florida’s Everglades: Money Talks

The Los Angeles Times has reprinted a story about Big Sugar’s hold on Florida politics.  The story appeared first in the Miami Herald (but don’t even try to read it there; the ads make the site impenetrable).

The LA Times version is worth a look.

Between 1994 and 2016, a review of state Division of Elections records by The Miami Herald/Tampa Bay Times Tallahassee bureau shows, the sugar industry led by United States Sugar and Florida Crystals has steered a whopping $57.8 million in direct and in-kind contributions to state and local political campaigns. (The total does not include federal contributions.)

It appears to be money well spent. On issue after issue, regulators, legislators and governors have erred on the side of softening the impact of adverse rules and regulations on cane growers and other powerful and polluting agriculture interests, including cattle operations north of Lake Okeechobee.

The sugar industry beat back a voter-approved amendment that would have forced it to pay for cleaning up its own nutrient-rich runoff into the Everglades, instead shifting much of the cost to taxpayers. It won repeated delays of strict water quality standards. It has fended off calls for buyouts even after one of the largest companies, U.S. Sugar, offered to sell itself to the state. And it has undermined attempts to use a second constitutional amendment, Amendment 1, to be used to buy farmland for Everglades cleanup.

You have to love U.S. sugar policy.  It’s just so weird.

On the one hand, we have dietary guidelines that say “Limit calories from added sugars.”

On the other, we support sugar prices with a system of sugar quotas and tariffs that makes U.S. sugar cost more than sugar on the world market (but not enough to decrease consumption).

We let sugar producers indiscriminately pollute land and water and “encourage” elected officials to turn a blind eye and shift the costs of cleanup to taxpayers.

If ever we needed evidence why linking agricultural policy to health and environmental policies is so essential, the contradictions of sugar policy make the case.

Jun 28 2016

My Time Magazine op-ed: We are still confused about calories

While I was in Israel last week, Time Magazine published an op-ed it had invited me to write.  Here it is.

Even in ‘healthy’ foods, calories can tick up fast

Nutrition professor that I am, if I could teach just one thing to the American public, it is this: Larger portions have more calories.

Please don’t laugh.

If we all understood this, the United States would not have an obesity problem. And the recent revelation that places like Chipotle and Panera serve meals with more calories than McDonald’s would surprise nobody. We would realize the former’s “health” aura blinds people. But this basic rule applies to those places, too.

We would also, strangely, thank McDonald’s for at least one thing: It limits portion sizes. It’s easy to pile on calories by asking for a little more of this, then a refill of that—without realizing that the calories surpass those in McDonald’s meals.

It’s not easy to understand calories. They are not intuitive because they’re abstract. They cannot be seen, tasted or smelled, and are extraordinarily difficult to count accurately, even for scientists. My colleague Lisa Young, author of The Portion Teller, once asked an entry-level nutrition class to guess the calories in 8-ounce and 64-ounce soft drinks. We didn’t expect students to know that an 8-ounce Coke has 100 calories—but we certainly expected them to multiply whatever they guessed by eight for the 64-ounce drink. But the average multiplier was three.

The unintuitive relationship between amounts eaten and calorie intake is one of the reasons behind public health campaigns like the new soda tax in Philadelphia, which in part aims to get people to think twice before drinking sugary beverages. No nutritionist worries about an occasional 90-calorie mini-can of soda. But many people drink sugary beverages in 12-ounce, 20-ounce or liter sizes. Bigger sizes mean more calories, and more calories means more weight unless you compensate with physical activity.

But exercising off calories takes a lot of work. That was the message of aNew York City health department campaign demonstrating the need to walk the three miles from Union Square to Brooklyn to compensate for the nearly 300 calories in a 20-ounce soft drink.

And let’s not forget that all of the calories in soft drinks come from sugars, which provide nothing but calories—no vitamins, no minerals, no fiber. They may be delicious, but they have no redeeming nutritional value. That’s why their calories get called “empty.”

Does where calories come from make any difference? Yes, but in complicated ways. Weight balance depends on calories. But managing weight—and overall health—very much depends on where those calories come from. It’s not so easy to overeat vegetables, fruits and whole grains, or relatively unprocessed foods of any kind, because these tend to be bulky and fill you up before you eat too much. You can still gain weight on these healthy foods, but it’s harder. Chipotle may have healthier calories than McDonald’s, but its calories still count.

Sugars post particular problems because they induce insulin production, but also because they make foods taste good. We eat something sweet and want more of it. We start loving sweet tastes in infancy. Breast milk is sweet; it contains a tablespoon of lactose per cup and that’s there for a reason—to make babies do the work of nursing.

But sodas are very sweet. A 12-ounce soda contains more than threetablespoons of sugars—and the calories that go with them.

It’s also very hard to separate the effects of sugars from their calories. If scientists want to know whether the calories from sugars are worse than those from any other foods, they need to feed people precisely the same number of calories from diets widely varying in their content of sugar, other carbohydrates, protein, and fat for a long enough period of time to get meaningful results. The only way to do something like this would be to keep the study subjects under lock and key for as long as it takes—inconvenient, to say the least, and very expensive.

Until the science is resolved, we can all agree that eating less sugar is a good idea for just about everyone. Sugars are nutritionally empty, are hidden in foods, and encourage overeating.

Notice that I said less, not none. Personally, I love desserts and would never want to give up sugars entirely or ask anyone else to do so. I just follow my own dietary advice: eat lots of vegetables and other relatively unprocessed “real” foods, and for everything else, pay attention to portion size. This way, an occasional sugary treat is a pleasure and nothing to worry about.

Marion Nestle is professor of nutrition, food studies, and public health at New York University and co-author of Why Calories Count. Her most recent book is Soda Politics: Taking on Big Soda (and Winning).

Jun 21 2016

The Sugar Association’s latest spin on the science

I’m in Israel this week where “eat-less-sugar” is just as big an issue as it is in the United States (translation: “without sugar”)

The U.S. Sugar Association is using an article in JAMA about the rising prevalence of obesity to argue that sugar cannot be responsible.  Sugar intake has declined in the U.S. since 2000, largely because of the decline in consumption of soft drinks.

Sugar, says the Sugar Association, cannot cause obesity (it’s energy balance).

Evidence?  The numbers don’t add up.

Oops.  Better take a look at the actual data from the JAMA paper:

What this figure shows is only a small increase in obesity over the last 10 years for men (on the left) and women (on the right)—for those above the 50th percentile of body mass index.

My interpretation:

  • Yes, sugar consumption is down.  That’s excellent progress but there’s still a long way to go.
  • Yes, calories count, and physical activity is good for health.
  • But—the decline is sugar consumption correlates with a leveling off of obesity in adults, just as would be predicted.
  • Even so, eating less sugar is a good idea for just about everyone.

Most Americans consume twice the sugar recommended.  Less would be better, but the “10% of calories” recommendation still leaves plenty of room for dessert.

Apr 28 2016

The Guardian’s article on the “sugar conspiracy”

I mentioned yesterday that whenever something comes out saying that “everything you thought you knew about nutrition is wrong,” it’s a sign that some skepticism may be in order.

Here is another example: The article on the “sugar conspiracy“ by Ian Leslie published in The Guardian.  This strongly criticizes the work of Ancel Keys, whose work was largely but by no means exclusively responsible for the diet-heart hypothesis linking excessive intake of animal fats to heart disease risk.

I love conspiracy theories as much as anyone else and appreciated how the author made his case for this one.  My sense of his article was that it had grains of truth (Gary Taubes and Cristin Kearns, for example, report that Keys had funding from the sugar industry).  But the overall thrust of the article seemed excessively hyperbolic and based on selective picking of the data (cherry-picking).

Going through the piece line by line to identify errors and misinterpretations was not something I thought worth the trouble.

Fortunately, someone else did.

Katherine Docimo Pett, a master’s degree candidate in biochemical and molecular nutrition at Tufts University, who blogs as Nutrition Wonk, sent me her detailed critique of the paper.  She explains:

So I decided to look into the Seven Countries Study and I found a number of occasions where “The Sugar Conspiracy” misinterprets the evidence.  So buckle yourselves up, conspiracy theorists, because in this post, I’m going to cover the history of the diet-heart hypothesis – namely The Seven Countries Study and the subsequent research mentioned in “The Sugar Conspiracy.”

If you can wade through her lengthy analysis, you will be hard pressed to disagree with her conclusion:

In “The Sugar Conspiracy,” the author makes a lot of assumptions about intent, the usefulness of epidemiology, and even the conclusions of papers.  However, upon closer inspection, a lot of his evidence doesn’t hold up under scrutiny.

The idea that Keys claimed in his Seven Countries Study that correlation proved causation is false.  Keys just said that cholesterol is a mediator for heart disease and that saturated fat raises cholesterol, both of which later turned out to be true.  The Menotti “reanalysis” did not find that sugar is more closely correlated with heart disease than fat, and even if it did, it is a simple regression – it controlled for zero confounders, way fewer than were controlled for in the original Seven Countries Study.  Finally, there is plenty of evidence to suggest that substituting saturated fatty foods in favor of unsaturated fats is a good idea [Clarification: she must mean substituting unsaturated for saturated].

It is absolutely worthwhile to debate the merits of all scientific findings or even the merits of an entire field, like epidemiology.  Scientists, even nutrition scientists, do this all the time.  The problem, though, is that if basic facts are actually based on misinformation, you can’t build a real case for or against anything.

Amen.

Footnote: Sarah Tracy, an historian at the University of Oklahoma, has been working on a biography of Ancel Keys for quite some time.  I can’t wait for her to get it done (she probably can’t either), as it is likely to give us a thoughtful, balanced account of the significance of his work.

Apr 19 2016

A rare industry-funded study with unhappy results for the Honey Board funder

The USDA has just done a write up on a study it funded in collaboration with the National Honey Board:  Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.

This was one of the 12 industry-negative studies I posted to my collection of 168 industry-funded studies from March 2015 to March 2016.

 

The USDA article explains:

Controversy exists over whether all sweeteners produce the same metabolic effects in consumers despite the sweeteners’ chemical similarities. A study conducted by U.S. Department of Agriculture (USDA) researchers indicates that consuming lower amounts of added sugars is a more effective approach to health than finding a sugar that is more neutral in terms of its health effects…Volunteers [consuming honey, white cane sugar, or HFCS] did not show any differences in blood sugar levels based on the dietary sugar source. In addition, blood levels of triglyceride, an indicator of blood fat concentrations (a marker for heart disease risk), increased in response to all three sugars tested.

White cane sugar is 50% glucose and 50% fructose, linked together (but quickly separated in the body).  Honey and High Fructose Corn Syrup are glucose and fructose, already separated, but with slightly higher percentages of fructose.  Biochemically, they are not all that different.

So the results of this study, disappointing as they may have been to the Honey Board, were predictable on the basis of basic sugar biochemistry.

 

Mar 24 2016

Beverage Daily’s Special Edition: Calorie-Cutting Initiatiatives

One of the newsletters I subscribe to, BeverageDaily.com, has a special edition—a collection of its articles—on what the industry is doing to address its biggest problem: reducing sugar.

What is the beverage industry doing to cut calories?

Health and wellness is at the forefront of consumers’ minds, and sugar gets plenty of bad press. Obesity is as big a concern as ever, and soft drinks are in the firing line.

What is the beverage industry doing to reduce calories? How are market leaders reformulating and revamping their portfolios; and what healthier brands are appearing?

From alternative sweeteners to packaging sizes, we look at what the industry is doing to cut calories – and how well these initiatives are working.

From reformulation to nutritional labeling, the non-alcoholic beverage industry has adopted a variety of strategies to reduce the calorie content of drinks. We look at how different strategies from around the world are being implemented. .. Read

You can see why the industry has a problem.  Sugar tastes good.  These other things not so much.

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.
Jan 11 2016

The 2015 Dietary Guidelines’ hidden advice about sugary drinks: definitely there, but hard to find 

I’m indebted to Maria Godoy of NPR’s The Salt for pointing out where in the new 2015 Dietary Guidelines you can find advice about cutting down on sugary drinks.  As she puts it, this is easy to miss.

Here’s my wonky analysis.

In my post about the 2015 Dietary Guidelines, I noted that they are unambiguous about the need to reduce added sugars to 10% or less of calories.  But what they say about cutting down on sugary drinks—the leading source of sugars in US diets—is buried deep in the text.  Fortunately, Deborah Noble of slowfoodfast.com has performed a great public service by producing the 2015 Dietary Guidelines in a searchable pdf format.Here’s where to find advice about cutting down on sugary drinks:

The Executive Summary: See under “Cross-Cutting Topics of Public Health Importance:”

Similarly, added sugars should be reduced in the diet and not replaced with low-calorie sweeteners, but rather with healthy options, such as water in place of sugar-sweetened beverages.

Figure 2-10 explains:

The major source of added sugars in typical U.S. diets is beverages, which include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters.

Reading the Figure tells you that beverages comprise a whopping 47% of added sugars (closer to half if you add in sweetened milks, teas, and coffees).  The text following the Figure says:

Shift to reduce added sugars consumption to less than 10 percent of calories per day: Individuals have many potential options for reducing the intake of added sugars. Strategies include choosing beverages with no added sugars, such as water, in place of sugar-sweetened beverages, reducing portions of sugar-sweetened beverages, drinking these beverages less often, and selecting beverages low in added sugars.

Strategies?  How about just saying: “Cut down on sugary drinks” or “Drink water instead of sugary drinks.”

Figure ES-1 in the Executive Summary illustrates the 2015-2020 Dietary Guidelines for Americans at a Glance.  All it says is:

Limit calories from added sugars…Consume an eating pattern low in added sugars…Cut back on food and beverages higher in these components to amounts that fit within healthy eating patterns.

Figure 3.2 shows Implementation of the Guidelines through MyPlate: “Drink and eat less…added sugars,” but nothing about sugary drinks.

This circumspection is weird.  Clear, straightforward advice to cut down on sugary beverages has plenty of historical precedent.

Both Figures ES-1 and 3.2 are most certainly derived from a USDA graphic on the MyPlate website (dated January 2016).  This says flat out:

Drink water instead of sugary drinks.

This statement, in turn, derives from:

  • The precepts issued with the 2010 Dietary Guidelines in January 2011
  • The statements issued with the MyPlate graphic in June 2011

myplate

  • The USDA’s May 2012 tip for making better beverage choices.

The 2015 DGAC (Dietary Guidelines Advisory Committee) repeatedly urged limits on consumption of sugar-sweetened beverages.  Statements like this one, for example, appear throughout the document:

To decrease dietary intake from added sugars, the U.S. population should reduce consumption of sugar-sweetened beverages.

Why did the USDA and HHS writing committee choose to waffle about his point?

This cannot be an accident.  It must be deliberate.  And it can have only one explanation: politics.

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