I attended a meeting at Cornell last week at which FDA Commissioner Robert Califf answered questions from faculty and staff.

He started out by remarking on the poor health status of Americans, despite our spending twice as much on health as any other country.  He noted the disparities in health status, particularly singling out the declining health of rural Americans.

In answer to questions from panel members and, later, from the audience, he said (my notes and paraphrase, unless in quotes):

• We have real health problems on the ground right now.
• The  big issue is chronic disease, on which we are “doing terribly.”
• We have to deal with the marketing of ultra-processed foods designed to make you hungry for more.
• On tradeoffs in trying to discourage ultra-processed foods: This isn’t like drugs with clear risk/benefit calculations.  Food research has big confidence intervals and less rigorous estimates. The FDA has lots of bosses.  The executive branch and Congress can overrule anything it does.
• One Health (the movement to treat human and animal health issues as parts of a whole) is essential to the future of humanity.
• Climate change has moved pathogens into areas where they didn’t used to be.
• Action on animal antibiotics stagnated as a result of the pandemic: “We are all sinners in this regard.”
• We need a global strategy; infectious diseases do not respect borders.
• ”There is a lot of rhetoric about food safety, but the systems do not come together as they should.
• There is too much financial influence on policy.  “Policy is everyone’s job.”
• A lot of people are making a lot of money on our food and health systems, but it’s not spent on the right things.
• On the Supreme Court’s overturn of Chevron: the FDA cannot extend its rulings beyond what Congress intended.  It will slow things down.
• “We should reserve most of our energy to do our jobs well.”
• Courage is important: we must have courage to do things differently.

Comment

I was impressed by his knowledge, thoughtfulness, and concern about public health issues, especially those around food, as well as his understanding of the current political barriers against using expertise and regulation to improve food systems and public health.

He used the occasion to encourage students to consider careers in the FDA and noted the remarkably low turnover of permanent staff.

Jerry Mande sent me a link to a report of a peech the Commisioner made recently: America has a life expectancy crisis. But it’s not a political priority (Washington Post), and also to Helena Bottemiller Evich’s report, FDA Commissioner says ultra-processed foods drive addictive behavior.

So the Commissioner is giving serious thought to these issues.  So are others: see Announcement below.

The big question: who at FDA will take the lead on all this?

The FDA has just undergone a major reorganization.

As of October 1, the Human Foods Program looks like this.

The big question: who will head the new Nutrition Center of Excellence?

My big hope: Califf will appoint someone to that position who shares his committment to reducing cdiet-associated chronic disease.  Fingers crossed.

Announcement

Senator Bernie Sanders (I-Vt.), announced that his Committee on Health, Education, Labor, and Pensions (HELP) will hold a hearing on the urgent need for the FDA to “adequately protect Americans – especially children – from unhealthy foods that are pushed on consumers by the food and beverage industry.”  Here is his invitation letter to Commissioner Califf and Deputy Commissioner Jim Jones, who heads the FDA’s Human Foods Program.

When: 10:00 a.m. ET, Thursday, December 5, 2024
Where: Room 562 Dirksen Senate Office Building. The hearing will also be livestreamed on the HELP Committee’s website and Sanders’ socials.

Potatoes, a source of rapidly absorbable starch, have such a bad reputation that some nutritionists advise against eating them.  I am not one of them.  I enjoy eating potatoes and think their blood sugar-raising effects depend on how they are prepared and how muh of them you eat.

The potato industry, alarmed about advice not to eat potatoes, funds research to prove they are healthy, or at least do no harm.  Hence:

Djousse L, Zhou X, Lim J, Kim E, Sesso HD, Lee IM, Buring JE, McClelland RL, Gaziano JM, Steffen LM, Manson JE. Potato Consumption and Risk of Type 2 Diabetes Mellitus: A Harmonized Analysis of 7 Prospective Cohorts. J Nutr. 2024 Oct;154(10):3079-3087. doi: 10.1016/j.tjnut.2024.07.020.

• Results: In the primary analysis, total potato intake was not associated with T2D risk:…In secondary analyses, consumption of combined baked, boiled, and mashed potatoes was not associated with T2D risk, whereas fried potato consumption was positively associated with T2D risk:.
• Conclusions: Although consumption of total potato is not associated with T2D risk, a modest elevated risk of T2D is observed with fried potato consumption.
• Conflict of interest: LD received investigator-initiated grant from the Alliance for Potato Research and Education (as principal investigator).
• Funding: This project was supported by a grant from the Alliance Potato Research and Education (principal investigator: LD).  A lengthy list of other funders, including NIH and Mars Edge, follows.

Comment: This potato industry-funded study did not find potatoes to be associated with type 2 diabetes, which must be a huge relief to this industry. But the study did find a weak association (barely statistically significant) beween fried potatoes and type 2 diabetes.  The Potato Alliance ought to be delighted with this result.   I’m guessing the result is real (it’s what I would have predicted), but I’d be happier with it if it had been conducted by investigators independent of industry funding.  As it is, it looks like the potato industry got what it paid for.

Ronnie Cummins and André Leu.  The Regenerative Agriculture Solution: A Revolutionary Approach to Building Soil, Creating Climate Resilience, and Supporting Human and Planetary Health.  Chelsea Green, 2024.

I was asked to do a blurb for this one, and did:

This book is a testament to the vision of the late Ronnie Cummins.  His friend, André Leu, memorializes Cummins’ lifelong work with this overview of the demonstrable benefits of regenerative agriculture for everything in the book’s subtitle, and more.  Cummins’ case study on agave illustrates these benefits perfectly, making this book a useful as well as touching tribute.

This short book is a touchingly sentimental project.  It started out as Ronnie Cummins’ account of how to use agave fronds (which otherwise would be wasted), ground to the consistency of cole slaw and then fermented, for sustainable animal feed.

But Cummins died after writing only two chapters.  The publisher thought agave was too narrow a topic to make book length; it advised broadening the scope to regenerative agriculture with agave as a case study.  Leu, an old friend of Cummins’, took this on.

So there are really two books here, on two topics, by two different authors, in two distinct voices.  Even so, it works as a basic introduction to the benefits of regenerative agriculture for sustainability.

I think the agave example would be better as a monograph, but Cummins hadn’t done enough on it.  Too bad.  He was really excited about its possibilities.  Agave stores moisture from air and does not need much water to grow.

So I projected, if you could grow enough plants, in this case billions of agaves and companion trees, grow them large enough, and interplant them on millions and millions of acres of the world’s currently decarbonized and unproductive rangelands, you could conceivably draw down a critical mass of excess carbon from the atmosphere (where too much CO₂ contributes to climate change) and put in into the plants and trees aboveground, and into the soil belowground, where it belongs.  By greening the desert and the drylands you could dramatically increase soil fertility, retain and store rainfall, restore landscapes and biodiversity, reforest semi-desert areas, regenerate rural livelihoods, and eventually restabilize the climate.  I could hardly fall asleep.

This book is Cummins’ living memorial.

t foods are typically made from the by-products of human food production.  These, like offals, are plenty nutritious; we just don’t happen to want to eat them.  Pet foods therefore, reduces food waste.

A reader and friend, Patricia Gadsby, sent me this note:

Never occurred to me to ask this question before. But when the idea occurred I thought of you. What percentage of greenhouse gases are attributable to pet food? I found this.

Here’s the article she refers to:

Pedrinelli, V., Teixeira, F.A., Queiroz, M.R. et al. Environmental impact of diets for dogs and cats. Sci Rep 12, 18510 (2022). https://doi.org/10.1038/s41598-022-22631-0

The chief findings of this analysis of Brazilian pet foodss:

• Pet food has a high environmental impact.
• Wet diets have the highest.
• Dry diets have the least .
• The more animal protein, the higher the impact.
• The more calories, the greater the impact.

Like all environmental impact studies, this one depends on assumptions and tradeoffs.   The analysis does not consider the role of food waste., although the authors discuss this issue.

Several ingredients used in pet food are considered by-products, and this could be considered as a factor that reduces the impact of these foods…approximately 38% of beef, 20% of pork, and 19% of chicken is viscera or blood that is not used for human consumption31. Of all the by-products produced in Brazil, 12.8% are used in the pet food segment, and the rest is used for animal production, biodiesel, hygiene, and
cleaning, among other uses…In the present study, all types of diets contained by-products such as ofal or meat meals, although
dry and wet diets presented by-products more often than homemade diets.

I’m waiting for consensus on the assumptions.

In the meantime, two other items on pet food sustainability:

• Insect protein is a key solution to a sustainable pet food industry:  Government interest and funding are increasing for using insects to help meet climate goals.  .Read more

• Research reveals vegan diets can improve dog health: A study lead by Professor Andrew Knight at the University of Winchester in the UK found fewer cases of health disorders overall in dogs fed vegan diets. [Paid for by ProVeg International and conducted by authors linked to it and other animal welfare organizations—the full study is here].

Comment

Thanks to Phyllis Entis, author of TAINTED. From Farm Gate to Dinner Plate, Fifty Years of Food Safety Failures and TOXIC. From Factory to Food Bowl, Pet Food Is a Risky Business for the vegan diet item.  Vegan diets may be more environmentally sustainable, but are they best for a dog or cat’s health?  That question involves assumptions and tradeoffs about health and environmental impact.

The health impact would be easier to address if researchers were studying such questions.  But, as I discussed in my co-authored book about pet food issues, Feed Your Pet Right, remarkably little research is being done on dog and cat diets.  I think there are three reasons for the lack of research:

1. Pet owners do not approve of experimentation on companion animals.
2. The government does not want to bother to invest in research on pet food.
3. No pet food company wants to pay for diet studies that might not help sell pet food.

Personally, I would like to see studies examining the effects of high- and low-end commercial foods on health and sustainability.  Without them, we are left with assumptions and tradeoffs, and personal beliefs about what’s best for our beloved animals.

Two items about pet food this week.  Today: safety.  Tomorrow: environmental sustainability.

I have a long-standing interest in pet food, which I view as an integral—essential—component of our overall food system , not least because pet food uses food components that would otherwise be wasted.  I co-authored a book about pet food issues: Feed Your Pet Right.

If there are problems with the safety of pet food, you can bet those problems will occur in the food supply for humans.  I wrote a book about that too: Pet Food Politics: The Canary in the Coal Mine.

I am not the only one interested in such topics.  Phyllis Entis has written two books crticizing the safety hazards of pet foods.

• TAINTED. From Farm Gate to Dinner Plate, Fifty Years of Food Safety Failures 
• TOXIC. From Factory to Food Bowl, Pet Food Is a Risky Business

She keeps me up-to-date on the latest problems that arise.

I don’t know how closely you’re watching the pet food industry these days, but I thought this piece I just posted might interest you: When ‘truths’ collide: Darwin’s, ANSWERS, and the FDA

This was an account of an FDA Advisory and its non-consequences: Do Not Feed Certain Lots of Darwin’s Natural Selections Pet Food Due to Salmonella and Listeria monocytogenes.

The U.S. Food and Drug Administration is cautioning pet owners that FDA samples of five Darwin’s Natural Pet Products raw cat and dog food made by Arrow Reliance, Inc. tested positive for Salmonella and a sixth FDA sample tested positive for Salmonella and Listeria monocytogenes (L. mono)…If you have any of the Darwin’s Natural Selections pet food product listed above, stop feeding the product to your pets and throw it away in a secure container where other animals, including wildlife, cannot access it. Do not donate the food.

The bigger story here, as Phillis Entis explains, is that the FDA did not force the company to recall the products; it asked Darwin to rissue a recall volunarily.

But in this case, the company resisted.  It voluntarily decided not to do the recall.  Pet Food Industry (an essential source of information) tells this story.

In a September 20, 2024, memo from the company to consumers which was sent to Petfood Industry, Darwin’s Natural Pet Products had this to say given the FDA’s public notice regarding the affected lots of cat and dog food.

The memo is worth a look.  It says things like this:

• At Darwin’s, the health and safety of your pets is our absolute top priority, and we take rigorous steps to support their well-being and to foster strong lines of communication with you and our fellow community members.
• It is also very important to know that the FDA has received no consumer complaints regarding any of these lots.
• We find the FDA’s public notice to be wholly unnecessary, and ultimately, based on flawed regulatory decision-making, and we have taken steps to make this position clear to the agency.

Oh.

Food safety lawyer Bill Marler asks: Will the FDA use its Recall Authority to Mandate a Pet Food Recall due to Salmonella and Listeria?   .The FDA has that authority.  It did not use it.

That leaves you on your own to make sure you do not buy Darwin products for your pet.

The FDA provides plenty of information as a basis for you taking responsibility for such things.

Its advisory asks this question: Why is the FDA concerned about Salmonella and L. mono in pet food?

Pet foods contaminated with Salmonella and L. mono are of particular public health importance because they can affect both human and animal health. Pets can get sick from Salmonella and may also be carriers of the bacteria and pass it on to their human companions without appearing to be ill…The Federal Food, Drug, and Cosmetic Act requires that all animal foods, like human foods, be safe to eat, produced under sanitary conditions, contain no harmful substances, and be truthfully labeled. Refrigeration or freezing does not kill Salmonella or L. mono.

It provides  these resources:

• Get the Facts about Salmonella
• Salmonella (Salmonellosis)
• Get the Facts about Listeria
• Listeria (Listeriosis)

Do we need more forceful regulation of pet food?  Of course we do.

What started all this was this graph of obesity prevalence in the US from the Financial Times:

The most complete account of what happened next comes from Helena Bottemiller Evich in Food Fix (a must-read for anyone interested in following the food scene): “Have we passed peak obesity? New data sparks speculation.”

The Financial Times was the first to pick up on new data from the Centers for Disease Control and Prevention showing that the obesity rate for U.S. adults declined two percentage points between 2020 and 2023. The headline from across the pond was upbeat: “We may have passed peak obesity.” Soon, a couple of other news outlets followed, including Axios: “Americans are getting healthier by some key metrics.” The Washington Post editorial board jumped into the fray this week as well: “The obesity rate might have stopped growing. Here’s what could be working.”

The original data came from the CDC:

Plotted this way, the decline is not nearly so impressive (and severe obesity is increasing slightly).

As for the effect of the drugs, it’s much too early to say, says the epidemiologist Deirdre Tobias posting on Twitter (X).

The downtick occurred before the drugs were widely used.  Following her thread produces lots more data on that point.

We will have to wait a few more years to know how all this will play out.  I can’t wait!

Honey has an industry behind it?  Of course it does.

The National Honey Board (a USDA-sponsored checkoff entity) is working hard to convince dietitians that honey is a health food.  Here are three examples sent to me by members of the Academy of Nutrition and Dietetics, who received these ads via e-mail.

I.  “Harness the power of honey in the Mediterranean diet this summer…Incorporating honey into the MSDP [Mediterranean-style dietary pattern] is a natural fit.”

Download Our Med Diet Handout

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II.  Another reader, Katherine Walcott, sent me this one about how honey can boost probiotics.  She points out that the ad links to an article in health.com and then to studies one and two , both supported by the National Honey Board.

III.  Yet another dietitian sent me yet another ad, this one featuring dietitians extolling the benefits of honey as part of nutritious diets.

RD: Honey offers antioxidants, heart health and more

Honey may offers numerous healthful benefits: it is rich in antioxidants like flavonoids and phenolic acids, which help neutralize reactive oxygen species, potentially reducing the risk of conditions like premature aging, Type 2 diabetes and heart disease, writes registered dietitian nutritionist SaVanna Shoemaker. Honey may aid in blood sugar management by increasing adiponectin levels, though it should be consumed in moderation, especially by people with diabetes. Studies suggest honey can improve heart health by lowering blood pressure and improving blood fat levels. It also has antibacterial and anti-inflammatory properties, making it effective for treating burns, wounds and coughs in children over 1 year old, however honey should never be given to children under 1 year of age.

Comment

I need to point out the obvious: honey is a form of sugar.  It is a mix of sucrose, glucose, fructose, and traces of other sugars, minerals, and flavors.  Its main benefits?  It is delicious, but most people are unlikely to eat much of it, and not nearly as much as they might eat of sucrose table sugar.  Can it be part of nutritious diets?  Of course it can.  A health food?  Depends on how much you eat of it.

Also obvious: the purpose of the National Honey Board is to convince you to eat more honey.

III.  Personalized, as opposed to Public Health, Nutrition

Stephanie Rogus, a former doctoral studentt in my NYU department, and Peter Lurie, director of the Center for Science in the Public Interest, have a new paper out: Personalized nutrition: aligning science, regulation, and marketing. Health Affairs Scholar, Volume 2, Issue 9, September 2024, qxae107, https://doi.org/10.1093/haschl/qxae107

Proponents of personalized nutrition assert that population-based approaches to dietary recommendations have had limited impact because they have failed to take interindividual differences into account. Proponents argue that increasing or reducing consumption of particular foods in response to the results of a survey or diagnostic test allows for the development of more personalized and, it is argued, more effective recommendations.

Their paper does not deal with the flaws in individualized approached to nutritional health—“precision” nutrition: the cost, the difficulty, the lack of support, the inability to reach those who most need support, etc.  Instead, it focuses on the commercialization of personalized nutrition:

regulatory gaps have led to market growth of products with unknown efficacy that are making bold, and possibly unsubstantiated, claims. As personalized nutrition products and related treatments continue to enter the market without regulation, unreliable products may cause consumers financial, psychological, and physical harm. Stronger regulation will help engender trust in these products among consumers and ensure their safety and effectiveness.

Hard to argue with that.  Glad they wrote it.