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I’ve been mulling over the article in the New York Times (March 13) about the effects of an itinerant lifestyle and the threat of deportation on the children of farmworkers in California.  If ever there was an example of how the political gets personal, this is it.

The article focuses on a third-grade teacher, Oscar Ramos, who is on the front lines trying to give these kids a chance in life, let alone at the American dream.  It describes what he’s up against: nearly all his students are near the poverty line, and nearly 80% have limited English.  They move frequently and live under crowded conditions.

But the often disrupted lives of the children of migrants here is likely to grow still more complicated as the national debate over immigration grows sharper.

Efforts by lawmakers to rescind automatic citizenship for children born in the United States to illegal immigrants are already stoking fears among many agricultural workers, and that has consequences for their children.

Some parents, as they move with the crops, are already keeping their children out of school when they get to Arizona because they are worried about the bureaucracy and tougher restrictions in the state.

The article is long but well worth reading.  If nothing else, take a look at the photographs.

This is how our relatively inexpensive food gets to us.   The costs, as the economists tell us, are externalized.  Here is one of those externalized costs–the potential of those kids to become functioning citizens in our democratic society.

Today’s New York Times has a story about how Mexico is trying to improve school food in an effort to help prevent childhood obesity.

By all measures, Mexico is one of the fattest countries in the world, and the obesity starts early. One in three children is overweight or obese, according to the government. So the nation’s health and education officials stepped in last year to limit what schools could sell at recess. (Schools in Mexico do not provide lunch.)

The officials quickly became snared in a web of special interests led by Mexico’s powerful snack food companies, which found support from regulators in the Ministry of the Economy. The result was a knot of rules that went into effect on Jan. 1.

“What’s left is a regulatory Frankenstein,” said Alejandro Calvillo, Mexico’s most vocal opponent of junk food, particularly soft drinks, in the schools. “They are surrendering a captive market to the companies to generate consumers at a young age.”

By all reports, schools in many Latin American countries sell candy and soft drinks in lieu of real food.  Kids pretty quickly get used to the idea that those foods mean lunch, and eating them is normal.  Never mind the effects of such diets on teeth—dental decay is increasing rapidly—and body weights.

By coincidence, I just received a paper from Brazilian investigators documenting the way soft drink companies are funding physical education activities in that country.  That’s one way to deflect attention from aggressive marketing in schools and other venues.

Last year, Coca-Cola, Pepsi-Cola, and Kraft reported rising profits from overseas sales.  With the U.S. market for their products flat or declining, companies are looking to developing markets for increased sales.  Obesity is sure to follow.

Yet another study confirms the obvious: kids prefer foods with cartoons on the package. Why should this be obvious?  Why else would the cartoons be there if not to sell products to kids?

The latest study comes from the Archives of Pediatrics and Adolescent Medicine.

It says pretty much the same thing as the study published in Pediatrics last year by investigators from the Yale Rudd Center.

The newer study did something cute. It invented a cereal box and tested kids’ responses to it and variations with and without cartoons of the penguins Mumble and Gloria from the movie Happy Feet .

The results:

• Kids preferred the taste of the cereals with cartoons
• They preferred boxes labeled “Healthy Bits” more than “Sugar Bits”
• They most preferred “Healthy Bits” with a cartoon
• They least preferred “Sugar Bits” without a cartoon

This is why is would be a good idea to just say no to cartoons on food packages aimed at kids.

Michael Osterholm writes in the current New England Journal of Medicine that despite claims that foodborne illness is declining in the United States, that is only part of the story. His editorial refers to the now-published study of Salmonella Saintpaul that I talked about in a previous post.  He says:

All these findings, however, must be interpreted with caution, since most of the decreases occurred between 1996 and 2000, and there has been little additional change since then.

When the 2009 incidence of infections with the eight primary bacterial and parasitic pathogens is compared with their incidence in the period from 2006 through 2008, no significant change can be seen for six pathogens; only the infection rates with shigella and STEC O157 show significant decreases (see graph).

In addition, recent studies have demonstrated a significant increase in the incidence of foodborne disease caused by emerging non-O157 STEC, suggesting that surveillance for O157 is no longer sufficient to determine the effect of foodborne STEC infections.

On the basis of FoodNet data for the past 14 years,we must conclude that the improvements made in the late 1990s in the safety of our food supply are still having a positive effect. But we’ve made little additional progress in the past decade.

The graph he refers to comes from Pathogen. It represents the percent change in laboratory-confirmed foodborne infections from 2006–2007 to 2009.  The horizontal line represents no change.

Food allergies pose labeling and other problems for food manufacturers.  FoodQualityNews.com summarizes recent stories on what’s happening with food allergies, from the perspective of its European food industry clients.

Enzyme treatment may remove peanut allergens, suggests study: An enzymatic treatment process may effectively reduce allergens in roasted peanuts by up to 100 per cent, according to new research.

FoodNavigator conference to address food allergy challenges: Incidence of food allergies and intolerances is on the rise in Europe, and there are big gains to be made by companies who provide products that are safe and enjoyable for sufferers. Some challenges remain, however, such as appropriate labelling, and future threshold levels. 

The balancing act of allergen labelling: The food industry has a responsibility to label allergenic ingredients as big and bold as they can – but also not to over-egg the slimmest of slim possibilities that a trace amount of an allergen may have slipped into a product.
Germany develops rapid detection systems for food allergens

German researchers are aiming to develop rapid detection systems to identify allergenic substances in foodstuffs, according to a workshop on analytical methods for allergen detection staged in Berlin this week. 

UK leads free-from launches in major European markets: Mintel data: People with food allergies and intolerances in the UK have the more new products to meet their dietary needs than consumers in other major European markets, indicates data from Mintel, but there has been a general increase in launches across the EU in the last six years.

Allergy prediction tool could revolutionise allergen labelling: As allergy diagnoses among children continue to rise, a new online calculator is said to provide fast, cheap and highly accurate predictions, with potential implications for better-targeted on-pack allergen labelling.

Allergies, as I have discussed in previous posts, are difficult to diagnose and it’s hard to avoid something you are allergic to if you can’t figure out what it is.  Rates of food allergies seem to be increasing, for reasons not well understood.  The leading hypothesis is cleaner environments, but research can’t confirm that cause.  This is one area where the trite phrase, more research needed, really means something.

I was pleased to see the article in last Sunday’s New York Times about New York City’s efforts to improve school food.   The story focused on PS 56, a school that serves low-income kids in Brooklyn.

The article  describes the food revolution that is taking place in New York City schools, one described in an excellent report by Hunter College faculty.

In singling out PS 56, the writer chose a good example.

I visited there a year or so ago, and wrote about it at the time under the title “School food: it can be done!”  Its cafeteria is an astonishing place.  The food smelled good.  It tasted good.  The staff cared whether the kids ate what they cooked.

When I asked whether this school was typical, the answer was “not exactly.”  How come it worked?  Everyone pointed to the principal, Deborah Clark-Johnson, who believes it’s important to feed kids well and who totally supported the cafeteria staff.

So one way to improve school food is to recruit caring staff.

Another, for older kids, is to encourage them to make better choices.  An article in the Boston Globe discusses Cornell professor Brian Wansink’s work in this area:

But it turns out that students are susceptible to the same marketing strategies that grocery stores have been using for years. Several experiments have shown that children will be more likely to eat items if they see them early in the lunch line and find them attractive and convenient to pick up. Putting fruit in a good-looking bowl works. So does putting a salad bar in a prominent place. Calling your carrots “X-ray vision carrots” can double sales.

I’ve discussed Professor Wansink’s work on lunch line redesign in an earlier post.  It raises an interesting question: is this the right strategy, or should schools just serve healthy food in the first place?

This is worth discussion.  Want to weigh in?

The FDA just announced that it is planning to research health claims on infant formulas such as “supports brain and eye development.’’ The FDA wants to:

assess women’s understanding of and response to various statements on infant formula labels. The study results will be used to help the Agency to understand the role that certain types of statements on infant formula labels have in influencing formula choice….The study will focus on purchase choice, perceived similarity of the formula to breast milk, and perceived likelihood that the formula has certain health benefits.

Translation: the FDA thinks that claims for omega-3 fatty acids—DHA, in this case—on infant formulas mislead mothers into thinking the formulas are better than breast milk.

Despite lack of evidence for benefits, infant formula makers have been so successful in marketing the addition of these omega-3 fatty acids that you can hardly buy a formula without them.

I was in Ecuador a few months ago and saw this sign:

The idea?  Omega-3’s will make your kid smart.

My book, What to Eat, has a chapter on infant formula and baby food. Here are some relevant excerpts:

Infant formulas cause controversy and are endlessly contentious for three important reasons. Formulas are (1) largely unnecessary (most mothers can breast feed their infants), (2) not as perfect as breast milk for feeding babies, and (3) more expensive than breast feeding.

Breast milk is nutritionally superior to formula, but from a marketing standpoint it has one serious disadvantage: it is free. Beyond one-time purchases of breast pumps, storage bottles, or special clothing, nobody makes money from it.

For mothers who cannot, should not, or do not want to breast feed, formula is a socially and nutritionally acceptable substitute. But formula companies do not only promote formulas to mothers who must use formula. In subtle and not-so-subtle ways, they promote the use of formulas to all pregnant women and new mothers.

I go on to explain that because formula is the sole food for infants, its composition is highly regulated. Therefore, all infant formulas have the same composition, and all virtually indistinguishable.

Competition for market share explains why formula companies want to put distinctive nutrients in their formulas–especially nutrients considered “conditional.” A conditional nutrient is one that might have some benefits under some circumstances. Even if the health benefits are minimal or questionable, they can be used in advertising.

That is the principal reason why so many formulas now have fatty acids added—omega 6 arachidonic acid (ARA) and omega-3 docosahexaenoic acid —the same one that is in fish oil. These two fatty acids are normally present in breast milk, and there is some evidence, weak and questionable as it may be, that they support infant brain development and vision.

Formula makers got the FDA to agree that ARA and DHA are normal components of food (which they are) and, therefore, are Generally Recognized As Safe (GRAS). This means that companies could add ARA and DHA to infant formulas without having to prove that either of them really did anything useful or beneficial.

I then explain that the FDA apparently agreed to the GRAS petition with some reluctance, as indicated by its answer to the question, “What is the evidence that addition of DHA and ARA to infant formulas is beneficial?”

The scientific evidence is mixed. Some studies in infants suggest that including these fatty acids in infant formulas may have positive effects on visual function and neural development over the short term. Other studies in infants do not confirm these benefits. There are no currently available published reports from clinical studies that address whether any long-term beneficial effects exist.

My interpretation of the proposed research study is that the FDA thinks the addition of ARA and DHA may discourage mothers from breastfeeding and may unnecessarily cause them to buy more expensive formula.

If you agree, tell the FDA you think the study is a great idea, and the sooner it gets going, the better.

You can file comments at http://www.regulations.gov.  Refer to Docket No. FDA–2011–N–0098]

I write a monthly (first Sunday) Food Matters column for the San Francisco Chronicle.  Today’s is about the difficulties of doing nutrition research.  The Chronicle headline writer titled it, “Be skeptical of food studies.”  Oops.

I’m not skeptical about Food Studies—the capitalized field of study—at all.  My NYU department started undergraduate, master’s, and doctoral programs in Food Studies in 1996 and they have flourished ever since.

The column is about small-letter food studies, meaning nutrition and food research studies:

Q: You were quoted saying that you didn’t believe newspaper reports linking diet sodas to an increased risk of stroke and heart disease. How do you decide whether research is good or bad?

A: This one was easy. I didn’t think it made sense. Mind you, I’m no fan of diet sodas. They violate my rule never to eat anything artificial. And I don’t like the taste of artificial sweeteners.

Whenever a study comes out claiming harm – or benefits – from eating a single food or ingredient, I get skeptical. That’s why I also questioned these recent study results: high-fructose corn syrup (HFCS) makes rats gain weight faster than sucrose (table sugar); zinc supplements prevent symptoms of the common cold; and pomegranate juice has greater health benefits than any other kind of fruit.

When I read about single-factor studies, I want to know three things: Is the result biologically plausible? Did the study control for other dietary, behavioral or lifestyle factors that could have influenced the result? And who sponsored it?

Plausibility: The diet soda study used a self-reported questionnaire to find out how often people reported drinking diet sodas. Nine years later, people who reported habitually drinking diet sodas had a 60 percent higher rate of stroke and heart attacks. The rate was somewhat lower when controlled for age, sex, race, smoking, exercise, alcohol, daily calories and metabolic syndrome.

Leaving aside the unreliability of self-reported dietary intake, the study raises a more important question. Was it designed to investigate the link between diet sodas and stroke or was this just an accidental finding? The questionnaire undoubtedly asked hundreds of questions about diet and other matters. Just by chance, some of them could be giving results that look meaningful. And the increase in stroke risk seems surprisingly high for something not previously known to be a stroke risk factor.

Mostly, I can’t think of a biological reason why diet sodas might lead to cardiovascular disease unless they are an indicator for some other stroke risk factor such as obesity, high blood pressure or binge drinking. It would take a study designed to test this idea specifically – and a good biological explanation – to convince me that diet sodas cause strokes.

The plausibility issue also rises in the HFCS study. Again, I’m not a fan of HFCS – we would all be healthier if we ate less sugar – but from a biochemical standpoint, HFCS and table sugar are pretty much the same. They have similar amounts of glucose and fructose, are digested as quickly and are metabolized the same way. Even the average amounts consumed are about the same. That soda companies are replacing HFCS with sucrose is strictly about marketing, not health.

Controls: The zinc-and-colds study was a comprehensive review (a “meta-analysis”) of previous studies done since the first one in 1984. Eleven studies have showed some benefit; seven have not. All of them were placebo controlled, double-blind. This meant that half the participants were given a dummy pill, and neither participants nor investigators were supposed to know who was taking what.

But in some studies, the zinc takers complained about the taste of the pills, hinting that they knew what they were.

I’ve heard this before. In the early 1970s, National Institutes of Health investigators did a study of vitamin C and the common cold. They got about 300 NIH employees to take either vitamin C or a placebo, double-blind. The tantalizing result: People taking vitamin C reported fewer colds and milder symptoms than people taking placebos.

Alas, many participants withdrew from the study before it ended. When asked why, they admitted tasting the pills. The investigators reanalyzed the results. Bingo! No matter what pill the participants actually took, those who thought they were taking vitamin C reported fewer colds and milder symptoms.

If the studies were not really blinded, the zinc results are questionable. I have no doubt that many people feel better when they take zinc supplements, but I’m not sure whether that’s because of something zinc really does or just its placebo effect.

Sponsorship: Vested interests influence the design and interpretation of studies. The best-designed studies control for factors that might influence results. Even so, their results require interpretation. Interpretation requires interpreters. Interpreters bring their own biases into the interpretation.

I mention pomegranate juice because one of its major producers sponsors studies to hype its benefits. Yes, pomegranates are delicious, but antioxidant powerhouses? So are most fruits. Pomegranates may have high antioxidant activity, but compared with what? Its maker does not say. Sponsored research is also about marketing, not health.

Nutrition research is hard to do, which makes study design and interpretation particularly challenging. Nutrition is a thinking person’s field, requiring careful analysis at every step. When you hear a result that sounds too good to be true, it usually is.