Food Politics

by Marion Nestle
Apr 1 2025

Vitamin A for measles: no for prevention, yes for treatment

Nutritionist that I am, I was shocked to see this headline: Remedy Supported by Kennedy Leaves Some Measles Patients More Ill

Physicians at Covenant Children’s Hospital in Lubbock, Texas, say they’ve now treated a handful of unvaccinated children who were given so much vitamin A that they had signs of liver damage.  Some of them had received unsafe doses of cod liver oil and other vitamin A supplements for several weeks in an attempt to prevent a measles infection.

Vitamin A toxicity?  Two reasons for my shock:

  1. Vitamin a toxicity is extremely rare. Amounts typically in food never cause problems except when people eat polar bear or seal liver (or, in one instance, dog liver).  Even supplements cause only occasional cases.  The New York Times last reported a case of a child overdosing on vitamin A supplements in 1981.
  2. These children were given way too much Vitamin A for way too long.

The deal on Vitamin A and measles

  • Vitamin A will not prevent measles; vaccinations prevent measles.
  • Vitamin A is, however, used to treat active cases of measles.
  • The treatment involves two doses of vitamin A, one day apart.
  • The amounts depend on the age of the child.

Rationale for use of Vitamin A to treat measles

  • The World Health Organization recommends vitamin A for all children with acute measles, regardless of country of residence
  • Children in the US can have low serum vitamin A concentrations
  • Low vitamin A concentrations correlate with more severe measles disease
  • Measles virus can deplete vitamin A stores
  • In low- and middle-income countries, vitamin A is associated with decreased mortality and morbidity

Comment

  • When RFK Jr recommends vitamin A for measles treatment, he is repeating standard advice.
  • When he states or implies that vitamin A should be routinely supplemented, or used as a preventive measure for measles rather than vaccination, he puts sick children at serious risk of vitamin A overdose and toxicity.
  • He should not recommend or imply that vitamin A is a substitute for measles vaccination.
  • When he recommends vitamin A treatment for measles, he should insist on limiting supplements to two doses.
  • Measles is preventable with vaccination.
  • Vitamin A toxicity is preventable by avoiding supplements or using them only when needed and in appropriate amounts.
  • Animal foods are the best sources of Vitamin A; brightly colored vegetables are the best sources of the Vitamin A precursor, beta-carotene.

References

 

 

Mar 31 2025

Industry-influenced opinion of the week: Ultra-processed foods

If you have any doubts about the value of the concept of ultra-processed, the breadth and extent of industry pushback against the idea is excellent evidence.  The concept is an existential threat to the processed food industry, and it is fighting back.  The Italian food industry is especially concerned because it also has the Nutri-Score front-of-pack labeling system to contend with; the letter grades on ultra-processed products tend to be C’s, D’s, and E’s—as bad as they come.

Here’s an example of the pushback.

The opinion piece: Visioli, F., Del Rio, D., Fogliano, V., Marangoni F, Ricci C, Poli A.  Ultra-processed foods and health: are we correctly interpreting the available evidence?. Eur J Clin Nutr 79, 177–180 (2025). https://doi.org/10.1038/s41430-024-01515-8

Conclusions: In summary, the available evidence regarding how different UPF were associated with health and the results of studies investigating specific food additives question the possibility that ultra-processing per se is the real culprit. Possibly, other unaccounted-for confounding factors play major roles. Consequently, the recommendation of limiting or avoiding foods carrying an unspecific “ultra-processed food” label based on the NOVA classification currently has poor scientific grounds and should be regarded as scientifically weak and in need of experimental confirmation. Furthermore, prompt public policy interventions on this topic, as advocated by some authors are premature and should be thoroughly reconsidered before being released.

Competing interests: AP and FM are the Chairman and Scientific Director, respectively, of NFI—Nutrition Foundation of Italy, a non-profit organisation partially supported by Italian and non-Italian Food Companies. All other authors declare no conflict of interest associated with this publication.

Comment: The senior (last) author and one other run the Italian Nutrition Foundation, an organization sponsored by food companies, Italan and international.  This makes the Foundation an industry front group, pretending to be independent, but not.  Its job is to further the commercial interests of its corporate sponsors, which is what it is doing here.  It is using the tobacco industry playbook: cast doubt on the research, suggest alternatives, argue against regulation.  The foundation’s authors are joined by academic and government authors, who have their own, not necessarily commercial, reasons for unhappiness with the UPF concept, which focuses on degree of processing, not nutrient content.  Yes, nutrients matter, but there are better ways of getting them than through UPFs.

Mar 28 2025

Weekend reading: Serving the Public

Kevin Morgan.  Serving the public: The good food revolution in schools, hospitals and prisons.  University of Manchester Press, 2025.  

I did a blurb for this book:

In Serving the Public, Kevin Morgan describes the political, economic, and social causes of appallingly unhealthful and disrespectful institutional feeding programs in schools, hospitals and prisons, and the human and societal consequences of such programs, in both theory and practice.  His book provides compelling examples and arguments for why and how we can–and must–do better.

Much of the book describes situations in the UK—Morgan is a professor at the University of Cardiff in Wales—but he also draws on U.S. examples (and cites my work).  Here is why he thinks public nutrition matters.

But perhaps the main danger of personalised nutrition apps…is that they fuel the neoliberal belief that access to a healthy diet is a personal and private matter at a time when it is more imperative than ever to affirm the public duty of care that governments owe their citizens, especially poor and vulnerable citizens. Why is it more imperative than ever to affirm this public duty? Because the multiple crises of food insecurity, hunger and a host of diet-related diseases, to say nothing of the existential threats from climate change, are becoming more pronounced in the low-income countries of the Global South as well as in the high-income countries of the Global North.

And here’s another major point:

It is hard to exaggerate the significance of food in prisons. Our diet affects our physical, mental and emotional wellbeing whoever we are and wherever we live. But eating assumes even more importance for prisoners as they may be confined to a cell for twenty odd hours a day – even during mealtimes – and meals help to punctuate a day that otherwise consists of hours of mind-numbing tedium. Eating in prison is a unique experience because prisoners have limited capacity to choose what, where and when they eat, with the result that they lose control over key aspects of their health, their self-esteem and even their sense of identity.

I don’t usually think about these issues, remote as they are from my daily experience.  It’s good to be reminded of the importance of institutional food and why we should do all we can to make it better.

 

Mar 27 2025

Update on plant-based

Here’s a short collection of recent items on the plant-based food market.

Plant-based products

Research

  • Plant-based diet linked to good gut health: Could two of the biggest trends in the food and beverage sector be powerful allies? And what opportunities could this create for food and beverage manufacturers?… Read more
  • ProVeg International’s latest research assessed 422 plant-based meat and 251 plant-based milk alternatives across 11 countries and spanning four continents. It found that most plant-based products outperformed their animal-based counterparts in terms of environmental impact, using less land and water while generating fewer greenhouse gas emissions.  Nutritionally, plant-based meat substitutes were found to contain less saturated fat and more fiber than traditional meats. However, salt content remains a concern…inconsistent fortification and high salt and sugar levels remain challenges for the industry.
  • A multicriteria analysis of meat and milk alternatives from nutritional, health, environmental, and cost perspectives (PNAS 121 (50) e2319010121.  https://doi.org/10.1073/pnas.2319010121): Unprocessed plant-based foods such as peas, soybeans, and beans performed best in our assessment across all domains. In comparison, processed plant-based products such as veggie burgers, traditional meat replacements such as tempeh, and plant milks were associated with less climate benefits and greater costs than unprocessed foods but still offered substantial environmental, health, and nutritional benefits compared to animal products.

Comment: There is clearly a market for such products and they certainly seem to provide environmental advantages.  Whether their taste and texture shortcomings will allow the market to expand significantly remains to be seen.

Mar 26 2025

Does the public trust the food industry? Not so much.

It turns out, the public doesn’t trust the food industry much.

Food industry trust in the dumps, but things are looking up: Consumer trust in the food industry is at dire levels. But there are modest reasons for positivity. What can the industry do to build on dwindling trust?… Read more

Why not?

 

 

 

 

 

This is affecting brand loyalty.  For this, price is also an issue.

Brand loyalty is declining, but the death knell isn’t ringing yet: The fight between branded and private label has never been so intense, yet it appears the former is losing significant ground. So what’s going on?… Read more

And, Americans don’t trust food and nutrition science either, especially if it comes from food industry scientists.

 

 

 

 

 

 

My advice?

If the food industry wants trust from the public, it should behave in a trustworthy manner.

As long as food companies put profits first, they are at high risk of compromising ethics, integrity, and trust.

The investment system would do better on trust if it valued social commitments.

This is an old story, but one worth retelling.  See this, for example.

Mar 25 2025

Keeping up with U.S. food politics

It’s not easy to figure out what’s happening on the food front in DC these days, but a lot of it does not sound good.  Here are a bunch from last week.

I.  Food Bank Support. USDA stops $500 million worth of shipments of food to food banks.

Food banks across the country are scrambling to make up a $500 million budget shortfall after the Trump administration froze funds for hundreds of shipments of produce, poultry and other items that states had planned to distribute to needy residents.

The Biden administration had slated the aid for distribution to food banks during the 2025 fiscal year through the Emergency Food Assistance Program, which is run by the Agriculture Department and backed by a federal fund known as the Commodity Credit Corporation. But in recent weeks, many food banks learned that the shipments they had expected to receive this spring had been suspended.

II.  Line speeds in meat processing plants.  USDA announces “streamlined” meat processing.  This is USDA-speak for increasing line speeds in processing plants, something terrifying to anyone who cares about worker safety and food safety.  As Food Safety News puts it, this is unsafe at any speed—again.

Once more, policymakers are making the same catastrophic mistake. Once more, industries are downplaying risk while lives hang in the balance. Once more, we are choosing efficiency over responsibility…It’s a reckless increase in processing speeds that threatens to overwhelm the very safeguards meant to protect both workers and consumers.

III.  Food safety rules.  FDA puts food safety rule on hold

In an announcement on March 20, the Food and Drug Administration said it intends to publish a proposed rule “at a later time.” The rule has already been published and approved and was set to go into effect Jan. 1, 2026. The rule was mandated by the Food Safety Modernization Act, which Congress approved in 2010.

The food industry has been pushing back against the rule since before it was written, citing expenses. Industry groups applauded the FDA’s postponement of enforcement of the rule.

IV.  Seed Banks.  DOGE is trying to fire staff of the USDA’s National Plant Germplasm System, which stores 62,000 seed samples.

In mid-February, Trump administration officials…fired some of the highly trained people who do this work. A court order has reinstated them, but it’s unclear when they will be allowed to resume their work.

On the other hand, a few useful things are happening.

V.  Infant formula. FDA launches “Operation Stork Speed to Expand Options for Safe, Reliable, and Nutritious Infant Formula for American Families.  This will involve

  • Increased testing for heavy metals and other contaminants.
  • Encouragement of companies to develop new infant formulas
  • Reviewing baby formula ingredients
  • Collaborating with NIH to address research gaps

This is in response to the loss in availability of infant formula due to contamination at an Abbott plant.  I don’t see anything in this initiative aimed at enforcing food safety rules in production plants, or anything about the ridiculous pricing of infant formula, which can range four-fold for essentially identical products (all infant formulas have to meet FDA nutrition standards).  See: FDA’s main page on Infant Formula.

According to FoodFix, this announcement came after RFK Jr. met with the CEOs of major formula makers, but before Consumer Reports issued a report finding “concerning” levels of heavy metals in some infant formula products.

USA Today reports:

The FDA’s testing is ongoing. To date, it has completed testing of 221/340 samples, which at this time, do not indicate that the contaminants are present in infant formula at levels that would trigger a public health concern.

VI.  Chemical contaminants in food. FDA has published a Chemical Contaminant Transparency Tool.  This gives action levels for each contaminant. Presumably, the 221 tests gave results that did not exceed those levels.

Comment

I’m not seeing much about Making America Healthy Again, beyond encouraging the elimination of artificial colors and trying to do something about the GRAS loophole, which lets companies essentially self-determine whether additives are safe.  Those are both worth doing, and have been a long time coming.  I still want to see this administration take strong action on:

  • Ultra-processed food
  • Food Safety
  • School meals
  • Support for small and medium farms

The cancelling of funding for the Diabetes Prevention Program, a 30-year longitudinal study, seems at odds with MAHA.  I hope the funding gets restored quicky.

Mar 24 2025

Industry-funded study of the week: prunes

The Study:  Prunes May Blunt Adverse Effects of Oral Contraceptives on Bone Health in Young Adult Women: A Randomized Clinical Trial.  DeMasi, Taylor et al.  Current Developments in Nutrition, Volume 8, Issue 9, 104417.

The rationale: Oral contraceptives (OCs) may promote bone loss.  Prunes may prevent that.

Objective: Will consuming 50 g of prunes daily prevent bone loss or increase bone accrual in OC users.

Methods: Ninety women were randomly assigned to a control group not using OCs (non-OC), an OC group not consuming prunes (OC), and an OC group consuming 50 g prunes daily (OC+P) for 12 mo.

Results:  Bone mineral density (BMD) did not change among groups, but ultradistal radius BMD increased over time within non-OC and OC+P groups. Trabecular density of the distal tibia decreased within the OC group.

Conclusions: OC use promoted minor negative effects on bone.  Consuming prunes “tended to provide a potential protective effect on trabecular density of the distal tibia and ultradistal radius in young women.”

Conflict of interest: “The authors report no conflict of interest.”

Funding: “This study was funded by the California Prune Board. The California Prune Board had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.”

Comment: I’ve put the wiggle words in red.  Why, you might well ask, would anyone expect two ounces of prunes a day to have anything to do with bone loss?  The authors do not say.  They merely observe an association of prunes with bone health in animals, and say they had seen minor prevention of bone loss in postmenopausal women in previous research.  I’m all for eating prunes if you like them, but bone health seems like a stretch.  So does the statement that the Prune Board had no role in the study.  It funded the study.  It is not going to fund studies that might not produce favorable results.  Industry funding exerts influence from the get go, whether or not recognized by authors as a conflict of interest.

 

Mar 21 2025

Weekend reading: Thinking about food systems advocacy

The United Nations has issued a digital Food Systems Thinking Guide for UN Resident Coordinators and UN Country Teams with tools and information for working collectively towards food system transformation.

It is intended as a working draft.  It provides an easy mechanism for immediate feedback.

You have to do a lot of scrolling.  When you do, you will get to key questions:

  • What is a food systems approach and why does it matter?
  • What is the state of food systems in my country?
  • Who are the actors influencing the foods system?
  • What are barriers and entry points to food system transformation?
  • How can I integrate foods systems approach into programming?
  • How can I communicate and advocate for foods systems transformation?

I took a look at the actors.  This section provides resources for engaging with stakeholders.

I also looked at barriers.  It lists things to consider and provides resources.

And I looked at communication strategies.  This one is much more complete and has useful videos and key messages along with the resources.

I see this as an advocacy toolkit focused on food system transformation.  Happy to have it.  Try it and give the UN some feedback on it to make it even better and more complete.