I was not going to bother to say anything about this letter addressed to the Washington Post from the President of the Academy of Nutrition and Dietetics (AND), Laurie Wright, which she sent to all members.  But at least five recipients sent it to me for comment, so here goes.

From: Commission on Dietetic Registration <cdr@eatright.org>
Date: September 29, 2023 at 3:19:42 PM EDT
To: [REDACTED]
Subject: Letter to the Editor of the Washington Post from Academy President Lauri Wright

The September 13 article “The food industry pays ‘influencer’ dietitians to shape your eating habits” does a disservice to the nation’s hundred thousand plus registered dietitian nutritionists by painting broad-stroke misrepresentations about the dietetics profession and its association, the Academy of Nutrition and Dietetics.

Using examples of only seven individuals, the authors imply it is common practice for RDNs to have undisclosed affiliations with food companies and sponsors. This could not be further from the truth. More than 90 percent of registered dietitian nutritionists work in clinical health care, such as hospitals, medical centers and long-term care facilities, as well as in private practice, public and community health, school nutrition and other foodservice operations.

A growing number of practitioners do share their knowledge and expert opinions through social platforms, engaging with online communities and correcting health misinformation (much of which comes from potentially harmful fads promoted by infinitely larger numbers of uncredentialed influencers with much larger followings). The Academy of Nutrition and Dietetics has a strict Code of Ethics — which includes adhering to disclosure rules and guidelines established by the Federal Trade Commission — and has published many articles over the years about the importance of disclosure.

The authors further implied that the Academy is funded by the food and beverage industry, citing a long-since debunked “investigation” conducted by a small group of activists that disbanded six years ago. The truth lies in the facts: The Academy uses an independent advisor to manage our financial investments in all sectors of the S&P 500, and less than 3 percent of the Academy’s and its Foundation’s investments are in the food sector. Further, only 7 percent of the Academy’s revenue comes from sponsorships. This information has always been fully transparent to the public through our annual reports.

All this information was provided to the Post reporters in advance of the story, but unfortunately the writers elected to mislead their readers with a false narrative implying that non-disclosure of sponsorships is rampant in our profession. Speaking for Academy members who abide by our Code of Ethics, we expected the Post to abide by a higher journalistic standard as well.

Oh dear.  The cozy relationship between AND members and food companies is something I’ve written about extensively in my books, Food Politics and, more recently, Unsavory Truth.  

I’ve also written about the Academy’s conflicted interests on this site, most recently here.

And then there is Michele Simon’s deep dive into the Academy’s relationships with sponsors from a decade ago.

Here’s what President Wright’s defensive letter does not say:

• We apologize for the unethical behavior of some of our members and will immediately take steps to make sure no member does this again.
• Non-disclosure of sponsorship is grounds for dismissal from the Academy.
• We will strengthen our policies to make clear that the Academy will not tolerate such non-disclosure.
• We will insist not only of disclosure of paid posts, but also disclosure of the name of the sponsor.
• To make sure members fully understand what is at stake, we are providing guidelines for ethical disclosure and illustrations of what and what is not appropriate.

For your amusement, one reader sent me an Instagram example of full disclosure from Gwyneth Paltrow (who is not, to my knowledge, an AND member)—clearly labeled as a paid partnership with Copperfit.  You have to be logged in to Instagram to open the link.

I was in Mexico City last week giving the keynote at the FoodTech Summit & Expo.   I could hardly wait to get to the nearby Chedraui supermarket to see what the Mexican warning labels on food packages looked like in practice.

Mexico has high obesity prevalence, especially in children (~35%).  Public health officials hope the warning labels will alert the public to avoid overconsuming processed foods.

Here’s what I saw.

I.  It looks like at least half the products on shelves carry warnings of excessive salt, sugar, saturated fat, or calories, or artificial sweeteners.

II.  One of the regulations says that if a product aimed at children requires a warning label, it cannot display cartoon characters.  For products made before the law, supermarkets comply by pasting stickers over the cartoons.

III.  Food companies are doing everything they can to hide the warning labels.  They make sure the warnings are hidden when they stock the packages on shelves (the only reason you can see the two bottles with the warnings is that I turned them around.

The warnings must be working.  Food companies are evading, undermining, and fighting the new regulations.  Several lawsuits are in progress.  I will be following their progress with great interest.

My messages to the food technology congress:

• Do not make ultra-processed junk food.
• Stop fighting public health measures.

The study: A Randomized, Double-Blind, Placebo-Controlled Decentralized Trial to Assess Sleep, Health Outcomes, and Overall Well-Being in Healthy Adults Reporting Disturbed Sleep, Taking a Melatonin-Free Supplement. Nutrients. 2023 Aug 30;15(17):3788.  doi: 10.3390/nu15173788.

Method: The study compared the effects on sleep of two THC-plus-botanical supplements against a placebo.  The two supplements differed in proportions of THC and botanicals.

Results: The supplement with the lower amount of THC (0.35 mg) and higher amount of hops and valerian oils (75 mcg) yielded better sleep outcome than the placebo.  The supplement with a higher amount of THC had no effect versus placebo.

Conclusion: “A botanical blend containing a low concentration of THC improved sleep disturbance, anxiety, stress, and well-being in healthy individuals that reported better sleep as a primary health concern.”

Funding: This research was funded by MDbio—The Doctors Brand™.

Acknowledgments: “The authors would like to express our deepest gratitude to the participant volunteers in this study without whom this study would not have been possible. We acknowledge and appreciate the hard work of the Radicle Science study operations team and MDbio—The Doctors Brand™ for the product formulas studied.”

Conflicts of Interest: “[Four of the eight authors] are employed by Radicle Science, the company who conducted the study. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript.”

Comment: Radicle Science is a contract research company in the business of doing clinical trials with supplements to provide data on which they can make structure/function claims, the special health claims allowed for supplements that require minimal scientific substantiation.  MDbio, of course, makes the supplement used in this trial (you will be relieved to know that all their ingredients are non-GMO).

What interested me about this one is the THC (tetrahydrocannabinol) ingredient.  It’s hard to know whether it made any difference.  The supplement with higher THC levels but lower levels of botanicals had no effect.  The composition of the placebo is not disclosed in the paper,  and the data are not p).ublicly available (you can request them from the corresponding author).

Cannabis is greatly understudied as a result of long-standing prohibitions.  As more of it gets into the food supply (edibles!), it would be good to get real information about its effects.  My reading of this study suggests either that less THC is better for sleep.  The less the better?  That, we do not yet know.

The International Fund for Agricultural Development (IFAD), as part of its IFAD Research Series, released a report, Overweight and obesity in LMICs in rural development and food systems, along with a literature review.

The report finds obesity rates across developing countries to be approaching levels found in high-income countries.

The study attributes the rise to:

• Food Prices: The price gap between healthy foods (expensive) and unhealthy foods (inexpensive) is greater in developing countries than in rich developed countries.
• Diet: Sugar-sweetened beverage consumption is on the rise in developing countries and the global sales of highly processed foods rose from 67.7kg per capita in 2005 to 76.9kg in 2017.
• Culture: In some developing countries, childhood fatness is associated with health and wealth and consumption of unhealthy foods carries prestige.
• Gender: Women are more likely to be overweight or obese than men in nearly all developing countries.

One strength of this study is its consideration of the need for interventions across the entire food system:

The study results show that food system-related interventions are not overweight or obesity specific. Instead, they tap into the wider field of making diets more healthy and nutritious, and emerge as necessary strategies to set the scene for creating non-obesogenic food supply chains. The identified intervention strategies cut across different food system domains: there were production strategies for improved dietary diversity, strategies for processing (which involved food package labelling or price mechanisms), strategies for changing the food environment and strategies to address consumer behaviour.

A post on X (the site formerly known as Twitter) displayed this graph.

It comes from a policy report published on FarmDocDaily: Concentration of US Principal Crop Acres in Corn and Soybeans.

The bottom line: 30% of harvested acres is devoted to corn, and another 30% to soybeans.

These, of course, are largely genetically modified.

This is industrial agriculture at a glance.

And here’s one more, worth seeing again in this context.

Regenerative agriculture anyone?

As I keep saying, it’s a Brave New World.  Try this one: Coca-Cola launches beverage created with the help of artificial intelligence.

Earlier this year, Becks rolled out the world’s first beer and full marketing campaign made with artificial intelligence. The AB InBev-owned brand said the beer, called Beck’s Autonomous, was selected by AI as its favorite among millions of different flavor combinations it generated.

….For Coca-ColaCreations, the use of AI is a natural step that positions the drink in a way that could pique the interest of younger consumers who will want to try it, before potentially increasing their consumption of other Coca-Cola products. Similar to other beverages released under the Creations platform, the latest beverage doesn’t promote or reveal a flavor profile, such as cola, cherry or vanilla, but rather a mood or experience.

As for mood and experience, we have this: More than the Real Thing: Chinese consumers want emotion and culture, not just drinks – Coca-Cola.

Of course China is very rich in culture and heritage, but beyond this there are also many elements of the lifestyle today that consumers will also link to local culture, such as popular trends locally

…One of these is the rise in popularity of the game League of Legends locally, and with this in mind we launched a limited edition “The Hero Has Arrived” product in collaboration with the game, creating an entire platform for players and consumers to really connect with it—this was also designed to have a unique limited edition flavour with zero sugar, so it remains in line with current trends as well.

Here it is clear that this sort of innovation requires thinking that is less dependent and far beyond just the science of beverage creation—it comes from a focus on understanding local trends, consumers, items and the connections between them to form the culture, and integrating this culture into the innovation.

Comment: Yes, Coca-Cola sells bottled water but that’s not how it makes its money.  The real money is in sugary beverages and other ultra-processed drinks.  I suppose AI is as good as any other marketing expert but I sure hate to see these products flood China.  The country is having enough of a problem with its rising prevalence of obesity and related chronic diseases.

A lot of good stuff is going on about school food these days.  Here are five items.

I.  Universal school meals:

Massachusetts has become the 8^th state to authorize universal school meals for kids in public schools.

Five of the eight states that have passed universal school meal programs did so this year. Minnesota and New Mexico enacted their policies in March, with Vermont following in June,  Michigan in July and now Massachusetts.  [Others are underway; here’s a current list]

II.  The USDA’s Healthy School Meals Incentives

• Lifting Up School Meals
• Resources: Media Toolkit, School Meals Webpage, Support for Schools webpage
• List of the Healthy Meals Incentives small/rural school district grantees

III.  Water-in-schools initiatives

A new study just out: “Effectiveness of a School Drinking Water Promotion and Access Program for Overweight Prevention” finds drinking water associated with healthier weights.

• The US News and World Report article on the study.
• A short video of study findings is available in English and Spanish
• National Drinking Water Alliance article
• Water First resources are available here

IV.  Plant-based school meals

Another study, Plant-Based Trends in California’s School Lunches, produced these findings:

• 68% of districts offer plant-based options daily or weekly, a 54% increase since 2019.
• Plant-based entrees increased by 16% (but account for only 8% of entrées offered).
• Districts are serving higher quality, whole plant-based entrees.

But then things get complicated:

• Processed meat entrees account for 18% of all entrées offered, an increase of 11% since 2019.
• More the half (57%) of all offerings on school menus contain cheese, and some of these are highly processed and include meat (e.g., pepperoni pizza).

California has a School Food Best Practices Fund for purchasing high-quality plant-based offerings, along with locally grown, minimally processed and sustainably grown food.

V.   School Nutrition policies and practices

A new study, “School Nutrition Environment and Services: Policies and Practices That Promote Healthy Eating Among K-12 Students,” says these interventions work:

Providing school nutrition professionals with professional development

• Improving the palatability of school meals
• Offering taste tests
• Pre-slicing fruit
• Providing recess before lunch
• Offering incentives for trying healthier options
• Providing access to drinking water

Comment:  Yes on universal school meals.  Everyone should be working on states to pass this legislation.  As for what works in schools, these interventions are well within the possible.  Get to work!

When I saw this article—Study: Orange and pomegranate extract impacts major marker for healthy ageing—my first thought was “Who paid for this?”  Bingo.

The study: Ahles, S., Cuijpers, I., Hartgens, F. et al. The Effect of a Citrus and Pomegranate Complex on Physical Fitness and Mental Well-Being in Healthy Elderly: A Randomized Placebo-Controlled Trial. J Nutr Health Aging 26, 839–846 (2022). https://doi.org/10.1007/s12603-022-1834-4

• Objectives: This study investigates whether a citrus and pomegranate complex (CPC) improves physical fitness, mental well-being, and blood biomarkers for oxidative stress and endothelial function in healthy elderly.
• Design: A randomized placebo-controlled cross-over trial.
• Participants: The study included 36 healthy elderly aged 60–75 years old.
• Intervention and Measurements: Participants received four weeks of CPC supplementation and performed the handgrip strength and senior fitness test. Quality of life (QOL) was assessed and blood samples were analyzed for oxidative stress and endothelial function markers.
• Results: After four weeks of CPC supplementation, handgrip strength significantly improved (p=0.019), compared to placebo. Moreover, the thinking, memory, learning, and concentration facets were improved (p=0.042), compared to placebo, and plasma malondialdehyde decreased, compared to placebo (p=0.033). The intervention did not affect senior fitness and the other QOL domains and blood parameters.
• Conclusion: Four weeks of daily CPC supplementation significantly improves handgrip strength and self-evaluated measures of psychological function in healthy older adults. Further research should focus on mechanisms associated with physical performance.
• Funding: Funding: Authors IC and FT are supported by the Province of Limburg, The Netherlands [grant number HEFI-2]. This research project was supported by BioActor B.V.
• Ethics declarations: Conflict of interest: S.A. is an employee of BioActor BV. F.H. is a sports medicine consultant and owner of Sports Medicine Center Maastricht*Parkstad. All other authors declare no conflict of interest. The funders had no role in the design of the study, in the preparation of the manuscript, or in the decision to publish the results.

Comment: This is a classic example of a study nobody but the product maker would ever do.  The statement that the funders had nothing to do with the study design or anything else may or may not be true—there have been too many examples of its not being true to take any such statement seriously without much further discussion.  Even with that assurance, researchers who accept industry funding rarely recognize industry influence—it seems to occur at some unconscious level.