Food Politics

by Marion Nestle
Mar 18 2024

Industry-funded study of the week: Would you believe kimchi?

I learned about this one from a commentary from Yoni Freedhoff, MD: Kimchi: Not Magically Protective Against Weight Gain.

  • The study: Association between kimchi consumption and obesity based on BMI and abdominal obesity in Korean adults: a cross-sectional analysis of the Health Examinees study.  BMJ Open.  2024 Jan 30;14(2):e076650.  doi: 10.1136/bmjopen-2023-076650.
  • Participants: “This study analysed 115 726 participants aged 40-69 years enrolled in the Health Examinees study in Korea.”
  • Results: “In men, total kimchi consumption of 1-3 servings/day was related to a lower prevalence of obesity (OR: 0.875 in 1-2 servings/day and OR: 0.893 in 2-3 servings/day) compared with total kimchi consumption of <1 serving/day. Also, men with the highest baechu kimchi (cabbage kimchi) consumption had 10% lower odds of obesity and abdominal obesity. Participants who consumed kkakdugi (radish kimchi) ≥median were inversely associated with 8% in men and 11% in women with lower odds of abdominal obesity compared with non-consumers, respectively.”
  • Conclusions:  “This large cross-sectional study described the association between kimchi consumption and obesity. In conclusion, total kimchi consumption of 1–3 servings/day was shown to be reversely associated with obesity in men. Regarding the type of kimchi, baechu kimchi was associated with a lower prevalence of obesity in men, and kkakdugi was associated with a lower prevalence of abdominal obesity in both men and women. However, since all results showed a ‘J-shaped’ association, excessive consumption suggests the potential for an increase in obesity prevalence. As kimchi is one of the major sources of sodium intake, a moderate amount of kimchi should be recommended for the health benefits of its other components. In addition, further investigation and prospective studies are needed to confirm the relationship between kimchi consumption and obesity.”
  • Competing interests: “HJ and SS have no conflicts of interest to declare for this study. Y-RY and SWH are members of the staff at the World Institute of Kimchi.”
  • Funding: “This research was supported by grants from the World Institute of Kimchi (KE2201-1) funded by the Ministry of Science and ICT, Republic of Korea.”

Dr. Freedhoff ‘s analysis of the data:

According to the paper, men who reported eating two to three servings of kimchi per day were found to have lower rates of obesity, whereas men who reported eating three to five servings of kimchi per day were not. But these are overlapping groups! Also found was that men consuming more than five servings of kimchi per day have higher rates of obesity. When taken together, these findings do not demonstrate a statistically significant trend of kimchi intake on obesity in men. Whereas in women, things are worse in that the more kimchi reportedly consumed, the more obesity, in a trend that did (just) reach statistical significance.

Comment: Why anyone would expect kimchi (spicy fermented vegetables such as cabbage) to affect obesity one way or the other is beyond me, but the World Institute of Kimchi must want more people to eat it.  Does anyone need an excuse to eat kimchi?  It’s great on its own without needing this kind of claim.  This study is about marketing, not science.

Mar 15 2024

Weekend reading: Compassionate Eating

Tracey Harris and Terry Gibbs. Food in a Just World: Compassionate Eating in a Time of Climate Change. Polity Books, 2024. 

I blurbed it:

Food in a Just World is an up-to-the-minute introduction to issues of class, race, and gender—and species—in what we eat, as well as to how larger issues of economics and capitalism affect workers in the meat industry.  Whether you eat meat or not, the book convincingly argues that these issues demand serious attention.

Here’s what the publisher says about it:

Food in a Just World examines the violence, social breakdown, and environmental consequences of our global system of food production, distribution, and consumption. From animals in industrialized farming – but also those reared in supposedly higher-welfare practices – to low-wage essential workers, and from populations being marketed unhealthy diets to the natural ecosystems suffering daily degradation, each step of the process is built on some form of exploitation. While highlighting the broken system’s continuities from European colonialism to contemporary globalization, the authors argue that the seeds of resilience, resistance, and inclusive manifestations of cultural resurgence are already being reflected in the day-to-day actions taking place in communities around the world. Emphasizing the need for urgent change, the book looks at how genuine democracy would give individuals and communities meaningful control over the decisions that impact their lives when seeking to secure this most basic human need humanely.

 

Mar 14 2024

Foods of the future: Yum?

I’m constantly being asked what food will look like in the future, so I’ve been collecting items about new-and-unusual foods headed our way.

Do these bode well for the future of food?  You decide.

New Foods

Cultivated meat

Comment: It’s a brave new world out there.  Two issues:  (1) Is this stuff delicious?  (2) Will it make money?  Stay tuned.

Mar 13 2024

An update on Nutri-Score: despite food industry opposition, it’s doing well

A recent opinion piece in the Washington Post explains why the FDA should establish front-of-package nutrition labeling here and now: These countries are doing nutrition labels the right way

Christina Roberto, Alyssa Moran, and Kelly Brownell contrast the “stop signs you’ll see in Mexico, the Nutri-Score system used in France, or the Health Star Ratings in New Zealand” with the current lack of a system like those in the United States.

The only thing standing in the way: the food industry. It favors a label that displays grams or milligrams of key nutrients along with percent Daily Values — much like the Nutrition Facts Labelcurrently on the back or side of packages. ..By using symbols, colors and simple language, front-of-package labels adopted by other countries have educated people about what’s in their food, helped them make healthier choices and even encouraged companies to reduce salt and sugar in their products.

And here’s Fortune on the same topic, especially Nutri-Score.

This makes me think it’s time to review what’s happening in Europe with Nutri-Score.  I’ve written about this system previously, most recently here and about Its founder, Serge Hercberg’s, fights with the food industry here.

As a reminder, Nutri-Score accounts for nutrients but also sugar, salt, and saturated fat, in a composite grade A (eat) to E (avoid).

The food industry hates it.  For example, an article by authors with ties to industry argues that there is no independent evidence to support the value of Nutri-Score.  This induced Hercberg et al to rebut those points.

In response to some of these criticisms, the Nutri-Score team is updating its algorithm to respond to concerns about ultra-processing, among other matters.  See: Nutri-Score 2023 Update in Nature Food.

And despite the arguments, support for Nutri-Score is growing.  Authors not connected to Nutri-Score recommend it over other types of labeling for adoption by 27 EU nations.  See: Establishing an EU-wide front-of-pack nutrition label: Review of options and model-based evaluation.  Obesity Reviews, 07 February 2024. https://doi.org/10.1111/obr.13719

Nutri-Score is currently used in seven European countries.  It is backed by the European Public Health Association and the International Agency for Research on Cancer.

The food industry can complain all it wants, I’m guessing Nutri-Score is here to stay.  It may not capture all ultra-processed foods, but it comes close and revising the design like this should help solve that problem.

Mar 12 2024

FDA allows health claim on yogurts, sugary and not

The FDA Announces Qualified Health Claim for Yogurt and Reduced Risk of Type 2 Diabetes.

FDA intends to consider exercising its enforcement discretion for the following qualified health claims:

“Eating yogurt regularly, at least 2 cups (3 servings) per week, may reduce the risk of type 2 diabetes. FDA has concluded that there is limited information supporting this claim.”

“Eating yogurt regularly, at least 2 cups (3 servings) per week, may reduce the risk of type 2 diabetes according to limited scientific evidence.”

FDA intends to consider exercising enforcement discretion for the above qualified health claims for when all other factors for enforcement discretion identified in Section IV of this letter are met.

All I can do is laugh.  As I told CNN,

Qualified Health Claims are ridiculous on their face.

Why would any sensible person think that all you have to do to prevent type 2 diabetes is eat 2 cups of yogurt a week?…All we can hope is that the yogurt is at least unsweetened, but since it’s really hard to find unsweetened yogurt [in small cups], this is telling people who want to avoid type 2 diabetes that sweetened yogurts are good for them…According to the FDA’s review of the studies, the amount of sugar in the yogurt made no difference to the results…Therefore, according to the FDA, sugar is a non-issue.”

The reason for my amusement?  Limited evidence.  Translation: if you want to believe this, go ahead, but it’s not on the basis of compelling evidence.

Take a look at the Danone petition.  The company asked for—and got—the qualified claim on the basis of observational evidence along with consumption data indicating that Americans currently do not eat much yogurt.

Given this low consumption, such a QHC is important to encourage food companies to increase yogurt in the food supply and inform consumers of current evidence in order to help them make informed choices.

It’s not that the FDA is ignoring the sugar issue despite its allowing the claim no matter how much sugar the yogurt contains.  In its letter of acceptance of Danone’s petition, the FDA said,

we are concerned that the use of a qualified health claim on yogurts that contain a significant amount of added sugars could contribute empty calories to the diet. The Dietary Guidelines for Americans, 2020-2025 recommend limiting added sugars to less than 10 percent of total calories and note that added sugars account on average for almost 270 calories, or more than 13 percent of total calories per day in the U.S. population.

…Consequently, while there is currently no disqualifying level for added sugars, given that Americans are exceeding recommended limits on added sugars, and some yogurts on the market are high in added sugars, FDA encourages careful consideration of whether to use the claim on products that could contribute significant amounts of added sugars to the diet.

Is this a warning to Danone to avoid using the claim on sugary yogurts?  We shall have to wait and see.

In the meantime, Danone is delighted: Danone North America Announces the FDA’s Decision on Their Petition for the First-Ever Qualified Health Claim for Yogurt, Linking This Dairy Aisle Staple to a Reduced Risk of Type 2 Diabetes

In response to efforts led by Danone North America, the new claim states that “eating yogurt regularly, at least 2 cups (3 servings) per week” may reduce the risk of developing type 2 diabetes, a condition 1.4 million Americans are diagnosed with every year.

Qualified Health Claims are about selling food products, not science.

Mar 11 2024

How the food industry exerts influence VI: South African researchers (Nestlé)

Since it’s Monday when I post industry-funded studies anyway, I will add one more of these to last week’s collection.

This one comes from an articles in The Conversation: Big companies, like Nestlé, are funding health research in South Africa – why this is wrong.

At the time a group of more than 200 senior academics wrote an open letter, about conflicts of interest. Nestlé’s portfolio of foods, by its own admission, includes more than 60% that don’t meet the definition of healthy products.

In December last year, the same centre announced it had signed a memorandum of understanding with Nestlé. It signalled their intent to “forge a transformative partnership” to shape “the future of food and nutrition research and education” and transform “Africa’s food systems”.

The article mentions other such partnerships.

The article covers reasons why researchers need to avoid such partnerships, some of them based on my work on this site.

It ends by suggesting how to counter industry influence:

An online course and toolkit for research ethics committees on conflict of interest in health research provides some practical guidance.

These and other initiatives point the way forward for universities to be alert to the dangers of these “gift relationships” and to be better equipped to protect their integrity.

Mar 8 2024

How the food industry exerts influence V: Professional journals (Infant formula companies)

Dr Katie Pereira-Kotze, a part time Senior Nutritionist at First Steps Nutrition Trust wrote me to ask if I might comment on the conflicts of interest displayed at a conference sponsored by the British Journal of Midwifery (BJM).  This journal accepts sponsorship for its annual conference from breastmilk substitute companies (Nutricia, Kendamil, Nestle).

Groups concerned about the historic role of infant formula compnanies in discouraging breastfeeding in new mothers, have asked the BJM not to permit this funding.

For example, the Baby Feeding Law Group UK wrote a letter to the conference organisers in 2022.

We would also like to share with you our perceptions of the motivations of companies such as Kendamil and Nutricia for sponsoring events such as your conference. It is against the law in many countries including the UK for companies to promote infant formula. By partnering with organisations or sponsoring events, these companies avoid workplace controls on advertising and gain direct access to health care workers, including in the case of the BJM conference, midwives, and in doing so create a valuable link to pregnant and post-partum women.

The British Medical Journal (BMJ) also commented on these conflicted interests: Midwifery conference is criticised over formula milk sponsors.

Three companies that market formula milk (Aptamil, Kendamil, and Nestlé) are sponsoring the conference and have each been given a 40 minute slot during the one day conference programme.

This journal contrasted its own position on infant formula complany sponsorship with that of the midwifery jounral:

In 2019 The BMJ announced that it would no longer carry advertisements for breastmilk substitutes,4 and after pressure from clinicians and campaigners the Royal College of Paediatrics and Child Health also said that it would stop accepting funding from formula milk companies. Robert Boyle, a clinical reader in paediatric allergy at Imperial College London, told The BMJ, “Formula company marketing aims to disrupt breastfeeding, their main competitor, so that the companies can sell more formula.

Comment: The role of the commercial infant formula industry in pushing its products and discouraging breastfeeding has been well documented for decades, most recently in a series of Lancet Commission reports.  Conferences are expensive to run and the  British Journal of Midwifery undoubtedly can use the infant formula company money—but at some cost to its reputation.  The optics do not look good.  Sometimes, the money isn’t worth it.  Infant formula companies have joined cigarette and opioid companies in being viewed as producing products with great capability of doing more harm than good.  The sooner the BJM stops taking their funding, the better.

Mar 7 2024

How the food Industry exerts influence IV: Science teachers and public health professionals (beef industry)

Two examples of  beef-industry attempted influence:

I.  Science teachers

This one comes from Wired: Inside the Beef Industry’s Campaign to Influence Kids

Big Beef is wooing science teachers with webinars and lesson plans in an attempt to change kids’ perceptions of the industry.

A beef industry group is running a campaign to influence science teachers and other educators in the US. Over the past eight years, the American Farm Bureau Foundation for Agriculture (AFBFA) has produced industry-backed lesson plans, learning resources, in-person events, and webinars as part of a program to boost the cattle industry’s reputation.

What is the AFBFA?

The AFBFA is a contractor to Beef Checkoff, a US-wide program in which beef producers and importers pay a per-animal fee that funds programs to boost beef demand in the US and abroad. In 2024, Beef Checkoff has approximately $42 million to disperse across its initiatives, and a funding request reveals that the AFBFA’s campaign for 2024 is projected to cost $800,000. The allocation of Beef Checkoff funding to programs like this is approved by members of the Cattlemen’s Beef Board and the Federation of State Beef Councils, two groups that represent the cattle industry in the US.

What does this program teach?

One lesson plan provided as part of the program directs students to beef industry resources to help devise a school menu. In another lesson plan students are directed to create a presentation for a conservation agency regarding the introduction of cattle into their ecological preserve. A worksheet aimed at younger students has them practice their sums by adding up the acreage of cow pastures. Another worksheet based around a bingo game aimed at 8- to 11-year-olds asks teachers to “remind students that lean beef is a nutritions source of protein that can be incorporated in daily meals.”

As for the answer to my question yesterday about whether this kind of training works:

According to survey data included in these documents, educators who attended at least one of the AFBFA’s programs were 8 percent more likely to trust positive statements about the beef industry. Some 82 percent of educators who participated in a program had a positive perception of how cattle are raised, and 85 percent believed that the beef industry is “very important” to society.

Again, this is a USDA-sponsored checkoff program.  The US Dietary Guidelines on beef call for it to be lean and unprocessed.  The checkoff does not.

II.  Public health professionals

I received this e-mailed message from a reader who wishes to remain anonymous.

I am a member of the Kentucky Public Health Association and so receive their email newsletters. The Beef Council promotion is fairly new. It is interesting to watch an industry PR campaign with health professionals happen in real time. I’ve also just realized that I don’t believe the Association has policies around sponsorships, something I had not worried about until the past few months.

She forwarded two messages sent to her from the Kentucky Public Health Association.  These are announcements from the Kentucky Beef Council: “Happy Nationl Nutrition Month,” and “Fueling Tween and Teens with Strong Minds and Bodies.”

The second is labeled as an advertisement; the first is not.

Both encourage visits to the Beef Nutrition Education Hub to get free continuing education credits and other resources.

Both say:

Thank you to our 38,000 Kentucky Beef Farmers! Fun Fact: Kentucky is the largest beef-producing state East of the Mississippi River

This email was sent on behalf of KY Beef Council and the content within shall be attributed to the sponsor. This email shall not indicate an endorsement on behalf of KPHA.

Copyright © 2023  Kentucky Public Health Association

Comment:  The Kentucky Beef Checkoff at work!   Regardless of the Kentucky Public Health Association’s protestations, these messages give the appearance of endorsement.  It should not be doing this.