Search results: School Nutrition Association

The big nutrition scare last week was the study in Nature finding that in mice and, maybe, humans, artificial sweeteners mess up the microbiome and make some people even more intolerant of glucose.

The authors conclude that their results call for a reassessment of massive use of artificial sweeteners.

The study is complicated and difficult to read but the Wall Street Journal has a nice summary.  It explains why the study is getting so much attention:

The new Nature study marks a significant advance because it brings together two separate areas of research—the role of sweeteners in raising blood sugar levels, and the complex workings of the vast colonies of bacteria that inhabit the gut. Individuals can have differing bacterial colonies in their gut, meaning people respond differently to what they consume.

The study involved several experiments.  These found:

• Mice fed saccharin, sucralose, or aspartame had significantly higher blood-glucose levels than mice whose diet included sugar, or just water.
• Mice with sterilized digestive tracts, who were given bacterial transplants from artificial-sweetener-fed mice, displayed higher blood sugar levels than those receiving bacterial transplants from sugar-fed mice.
• People who typically use artificial sweeteners have different kinds of bacteria in their intestines than those who do not.  They also are more glucose intolerant.
• Seven volunteers fed artificial sweeteners for four days displayed higher blood-sugar levels as well as altered populations of bacteria in their gut.

The Wall Street Journal quotes the Calorie Control Council (the trade association of makers of artificial sweeteners).  The CCC said:

The results from the mouse experiments may not apply to humans, while the human experiments had a small sample size. It said further research was needed.

Despite my lack of enthusiasm for artificial sweeteners, I think the Calorie Control Council has a point.

The excellent report by Kenneth Chang in the New York Times explains why.

At present, the scientists cannot explain how the sweeteners affect the bacteria or why the three different molecules of saccharin, aspartame and sucralose result in similar changes in the glucose metabolism.

Chang ends with this:

Dr. Frank Hu, a professor of nutrition and immunology at the Harvard School of Public Health who did not take part in the study, called it interesting but far from conclusive and added that given the number of participants, “I think the validity of the human study is questionable.”

Here’s why I’m not fond of artificial sweeteners:

• They taste bad (to me)
• They have no demonstrated effectiveness in helping people lose or maintain weight.
• They are artificial, and violate my rule to “never eat anything artificial.”

Do they mess up the microbiome and cause glucose intolerance, insulin resistance, and metabolic syndrome?

That would be fascinating, but I’m reserving judgment pending further research.

In the meantime, I’ll take sugar—in moderation, of course.

This ad was in last Sunday’s New York Times.  It appears again today with blurbs added.

Full disclosure: I’m one of the many people interviewed for the film and appear in three 10-second clips.

Fed Up! is a stunningly hard-hitting exposé of the food industry’s role in promoting unhealthy diets and childhood obesity.  It spares nothing in showing the devastating effects of obesity on kids (I found those parts painful to watch).

The film’s main message is that the food industry, in collaboration with government, is responsible for creating a food environment that promotes poor health.

It is especially tough on food company marketing and industry-sponsored research.

It is also—I think, unfortunately—tough on Michelle Obama and her Let’s Move! campaign.

Mrs. Obama is not the problem.  The food industry’s marketing and co-opting practices are the problem.

We can debate whether it was wise or useful for Let’s Move! to partner with the food industry, but the campaign has done much to bring issues of childhood obesity to public attention.

It’s ironic that the accomplishments of Let’s Move!—the White House garden, the Healthy Hunger-Free Act of 2010, the new school food nutrition standards, the new nutrition standards for WIC, and the new food label, for example—are at this very moment under fierce attack by food companies, their trade associations, and their friends in Congress.

With that said, the film is well worth seeing.  Don’t miss it.  Get your friends to see it.  Let the debates begin.

How to see Fed Up!

• Watch the trailer here.
• Find out where it’s playing here.
• Share it on social media here.
• See Katie Couric’s excellent ABC News interview here.
• Read the New York Times review here.

As for the debate, please enjoy:

• The Grocery Manufacturers Association statement about Fed Up! and its Q and A in response to the film
• International Food Information Council review
• The National Confectioners Association statement

Additions

• Jerry Hagstrom on the lack of “policy muscle”
• Nancy Huenegarth’s review in Food Safety News
• The food industry’s stealth campaign against the film
• Michele Simon’s take on the film.
• IFIC’s new point-by-point rebuttal of scientific statements in the film.
• Mark Bittman on the most important movie ever made.
• Food Policy Action — Real Fed Up Facts (in response to GMA)

My monthly first Sunday Food Matters column in the San Francisco Chronicle:

Q: I hear that the Mexican government wants to increase taxes on sodas as a way to fight diabetes. The soda industry persuaded voters to defeat soda taxes in Richmond and El Monte last year. Won’t it do the same in Mexico?

A: It might. I’m just back from a lecture trip to Mexico City where I heard plenty about the proposed soda tax and the industry’s response to it.

Last month, the Mexican government proposed an additional soda tax of one peso (about 8 cents) per liter. The idea is to raise $1.5 million per year while discouraging soda consumption, thereby helping to reduce the country’s high prevalence of obesity and Type 2 diabetes.

Mexicans drink lots of soda. By some estimates, average per capita consumption is 50 gallons a year, the highest in the world. It’s no coincidence that more than 70 percent of Mexicans are overweight or obese, and around 15 percent have Type 2 diabetes, a prevalence that terrifies health officials. This type of diabetes, if undiagnosed and untreated, can lead to blindness or foot amputations.

‘Nutrition transition’

Mexico is a classic example of a country in “nutrition transition.” As the economy improves, people increasingly buy high-calorie ready-made foods, put on weight, and raise their risk for diabetes. Meanwhile, the poorer segments of the population continue to experience high levels of stunting, iron-deficiency anemia and vitamin A deficiency.

This makes obesity a relatively new problem in Mexico, one widely understood to result from the introduction of processed foods – especially sodas – into the Mexican food market.

I could easily see how deeply sodas are embedded in Mexico’s food culture. Sodas were advertised and available everywhere. And they come in enormous three-liter bottles that cost less than the price of bottled water – only 17 pesos ($1.35) each. Clean water is not always available, making sodas the easy choice.

Sodas are cheap because Mexico grows its own sugarcane and sells it at market prices. We, however, artificially support the higher price of U.S. sugar through tariffs and quotas. That’s why our sodas are made with high fructose corn syrup. We subsidize corn production so corn syprup costs less than sugar.

Some people think cane sugar tastes better than high fructose corn syrup, although controlled taste tests don’t always back this up. It’s ironic that U.S. supermarkets now carry, at highly inflated prices, Mexican Coca-Cola sweetened with cane sugar.

Industry efforts to defeat the Mexican soda tax have been ferocious, just as they were in Richmond and El Monte last year. Producers argue that if the tax really does decrease consumption, it will cause hundreds of thousands of jobs to be lost.

I saw a newspaper advertisement from the Mexican Beverage Association that not only attacked the science relating soft drinks to obesity, but extolled the health benefits of sodas: “Sugar is nutritious; it’s a carbohydrate. Carbohydrates are essential for life. Sugar is indispensable for the brain. Soft drinks hydrate and bring energy.”

An ad from the sugarcane industry also threatened job losses – “The tax will generate unemployment and discourage productivity and investment” – and noted that workers and the poor will bear most of its burden.

The big questions

As with any such initiative, the big questions are whether the tax is likely to reduce soda consumption, obesity and diabetes, and whether the revenue will be used for widely beneficial public health purposes. Mexico’s Congress will have to address these questions when it votes on the tax in the weeks ahead.

In the meantime, a coalition of consumer and health groups, in part funded by Bloomberg Philanthropies, has been putting posters in subway stations that illustrate the amounts of sugar in soft drinks. The groups are actively advocating for the soda tax and for using its funds to provide free potable water in schools – something that does not now exist. But TV stations have refused to carry their ads for fear of losing soda advertisers.

Like their U.S. colleagues, Mexican public health authorities are searching for effective ways to reverse obesity trends. Sugary drinks are an easy target. Taxing them might happen despite industry opposition – especially if the funds are earmarked for clean water.

Editor’s notes: Marion Nestle will discuss her new book, “Eat, Drink, Vote: An Illustrated Guide to Food Politics,” with Narsai David at the Commonwealth Club on Oct. 15 at 6 p.m., and at Book Passage in Corte Madera on Oct. 19 at 11 a.m.

She is also receiving the James Beard Foundation Leadership Award for her writing about how science and public policy influence what we eat. The award ceremonies are Oct. 21 at the Hearst Tower in New York.

Marion Nestle is the author of “Eat, Drink, Vote,” “Why Calories Count: From Science to Politics,” “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at www.foodpolitics.com. E-mail: food@sfchronicle.com

My monthly (first Sunday) column in the San Francisco Chronicle appeared today.

I used the May 1 publication of the tenth anniversary edition of Food Politics (Michael Pollan wrote the Foreword) to reflect on what ‘s happened since the book first appeared in 2002.

A decade later, the Chronicle’s headline writer put it this way: 

Plenty of positive change happening

Last week, I wrote about the dairy industry’s petition to avoid having to follow FDA rules about labeling artificial sweeteners on the front of milk cartons.

Cara Wilking, Senior Staff Attorney at the Public Health Advocacy Institute at Northeastern University points out that the Sugar Association, the trade association for producers of cane and beet sugar, is right on top of this issue.

To assist consumers in making informed choices about what is sweetening the products they purchase, the Sugar Association petitioned the Food and Drug Administration (FDA) requesting changes to labeling regulations on sugar and alternative sweeteners.

In this petition we asked that artificial sweeteners and sugar alcohols be identified on the front of the package along with the amounts, similar to what is required in Canada.

If it is important to you to know if the product you purchase contains artificial sweeteners, let your congressional representatives know that FDA needs to take action on this important consumer issue.

The Sugar Association, obviously, represents the producers of cane and beet sugar. It wants to sell more sugar.  It doesn’t like artificial sweeteners much.  [Recall: it doesn’t like me much either—go to Media and scroll down to the bottom to read the Sugar Association’s letter threatening to sue me].

In contrast, the dairy industry wants to sell more milk.  Sweetened milk, no matter with what, sells to kids.  School kids are a big market for the dairy industry.  This market, however, is not doing well these days, according to the dairy industry’s August 2012 School Channel Survey.

Schools and processors are realizing 59% of current potential…Milk potential stands at 6.29 milks per student each week…Actual usage is 3.74 milks per student each week.  Elementary schools: 70% of potential being realized, down 1 point Secondary schools: 50%, down 1 point over last year.

Achieving ‘a milk with every meal’ translates into nearly 300 million incremental gallons….

Of course artificial sweeteners should be prominently labeled.  The Sugar Association has this one right.

Whatever your opinion, you can file comments at www.regulations.gov. Search for docket number FDA-2009-P-0147.

 

Michael Pollan’s Cooked comes out April 23 but the New York Times jumped the gun and reviewed it yesterday.   I can’t wait for the copy I ordered to arrive so I can read it for myself.

Whenever the book comes, this seems like a good time to post Geoffrey Cannon’s interviews with some of Pollan’s academic foodie fans (including me) about how we assess his work.  These appraisals are now posted in World Nutrition, the online journal of the World Public Health Nutrition Association.

Geoffrey Cannon: When did you come across Michael Pollan?

I had been reading Michael Pollan’s articles in the New York Times Magazine with admiration, to say the least, so when he invited me to participate in a food conference he was running at Berkeley in the fall of 2002, soon after he arrived to teach there, I was looking forward to meeting him. The conference was splendid. It brought together a huge number of journalists, academics, filmmakers, and government and industry officials. The speakers were glittery. Alice Waters did the catering. The side trips were to a farm in Bolinas and an olive orchard in Sonoma run by the owners of the San Francisco Chronicle (they had sketches by Wayne Thibaud tacked to the bathroom walls). Sometime after that, I spoke in one of his classes. But the first meeting I remember in detail must have been in about 2004. I asked for his advice about the book I was working on at the time, which later became What to Eat.

What impressed you at that time?

We met for lunch at Chez Panisse, where he was clearly a regular (I was still having trouble getting a reservation). I wanted his advice about how to write for a general audience. He said he wasn’t the right person to ask, because he didn’t write as an expert. His starting point in developing books was from lack of expertise. As he learned, he brought readers along with him. This turned out to be hugely helpful.

I got to know him better in the spring of 2006 when I taught at Berkeley in a complicated arrangement between three schools. I was paid by public policy, had an office in public health, but journalism – meaning Michael – ran the life support. The following spring I went back to Berkeley to teach a course in science journalism in his program. We did some speaking gigs together.

Rate his work and impact

Obviously, I think he is terrific but I have to do full disclosure. He just wrote the splendid foreword to the tenth anniversary edition of Food Politics. I’ll just say this: lots of people in the US have been working on the food movement for decades, but his work reaches so large and so passionate an audience that he has to be given much of the credit for its expansion.

Quote one of his sayings that stays with you

In What to Eat, I said dietary principles were simple: eat less, move more, eat plenty of fruits and vegetables, don’t eat too much junk food. Pollan says: Eat food. Mostly plants. Not too much. Oh to be able to write like that.

 Give an example of where he has made a difference

Students read his work and want to act. Our NYU programs in food studies are filled with people who read Pollan and want to do something to make the food system healthier and better for the planet.

Has his work changed your thinking and if so, how?

I don’t think I ever understood the importance of meat animals in balanced ecological systems to the extent that I now do. The idea of the omnivore’s dilemma is mind-changing on its own. I like it because it is so inclusive of different ways of eating and enjoying food. And I can’t wait to read Cooked.

Does his work have relevance outside the USA?

People outside the US are going to have to answer this one but of course it does. Food systems are global. How we in America eat affects the food systems of countries everywhere else and, to some extent, vice versa.

In what ways if any do you think he is mistaken?

I’m of the belief that although health very much depends on what you eat, body weight depends on how much you eat no matter where the calories come from (one of the theses of my new book Why Calories Count). We argue about this all the time. Eventually, the science will get to the point where this gets resolved one way or the other. In the meantime, it’s fun to debate.

Reference: Gussow J, Kirschenmann F, Uauy R, Schell O, Nestle M, Popkin B, Cannon G, Monteiro C. The American genius. [Appraisals].  World Nutrition 2013;4:150-170.  My answers to Geoffrey Cannon’s questions start on page 161.

Addition, May 1.  World Nutrition has published a second set of Appraisals, with some commentary.

JAMA Pediatrics has just published the online version of a study by Daniel Taber et al, Association Between State Laws Governing School Meal Nutrition Content and Student Weight Status: Implications for New USDA School Meal Standards.

I wrote the accompanying editorial: School meals: A starting point for countering childhood obesity.

In it, I review how researchers like Taber et al are demonstrating how regulations aimed at changing the environment of food choice seem to be helping children and adults eat more healthfully.

That is why regulation is worth consideration.

The food industry cannot make significant changes on its own.  Food companies are beholden to stockholders and returns to investors.

We can’t count on consumer demand.  It’s up against the billions of dollars spent on food marketing, advertising, and lobbying.

It’s government’s role to level the playing field.

Studies like this one are beginning to show positive results.

If you take junk food and sodas out of schools, kids don’t eat as much of them and are healthier.  If you have strict nutrition standards for school food, the food is healthier and so are the kids.

This may all seem self-evident, but now we have research to prove it.

Government agencies should pay close attention and figure out everything they can do to make the food environment healthier for children and adults.

My double-page op-ed in today’s New York Daily News:

Liberty from big soda: Why Bloomberg’s ‘ban’ should be only the beginning of a public health revolution

 

 

 

Barring any late legal surprises, Mayor Bloomberg’s 16-ounce cap on sugary sodas goes into effect on Tuesday, March 12. After that, restaurants, movie theaters, sports venues and food carts will not be permitted to sell extra-large portions of sugar-packed drinks.

Stay calm. This does not signal the end of democracy in America. This is not the nanny state gone out of control.

If we want Americans to be healthy, we are going to have to take actions like this – and many more – and do so soon. It’s long past time to tax sugar soda, crack down further on what gets sold in our schools, tackle abusive marketing practices, demand a redesign of labels – and extend the soda cap, no matter how controversial it may seem. This must be the beginning, not the end, of efforts toward a healthier America.

In short, we need a series of serious changes to make the healthy choice the easy choice. The soda size cap is a nudge in that direction. You will still be able to drink all the soda, and down all the sugar, that you want. The cap on soda size makes it just a tiny bit harder for you to do so.

That “tiny bit harder” is its point. If you have to order two sodas instead of one, maybe you won’t. If you have to add sugar to your coffee drink yourself, maybe you will only add one or two teaspoons instead of the 10 or more someone else put in there for you.

For a public health nutritionist like me, the soda size cap is a terrific idea. Unlike other foods, sodas are a unique target for intervention. They contain sugars – and sugar calories – but nothing else of nutritional value. They are candy in liquid form. Candy has a place in healthy diets, but a small one. So it should be for sodas.

It’s no surprise that people who drink large amounts of liquid candy have worse diets, are heavier, and have more health problems than those who do not. And it looks like the body doesn’t compute the calories from liquid sugars as accurately as it does for sugars in foods.

On top of that, big sizes make the problems worse. To state the obvious, larger portions have more calories. If an 8-ounce soft drink provides 100 calories, then a 16-ounce drink provides 200, a 32-ounce drink provides 400 and a 64-ounce drink provides 800.

But big sizes also have other effects. They induce people to eat and drink more than they would if given smaller portions. Big sizes confuse people into underestimating the number of calories consumed.

Most people eat whatever size is in front of them – the “default,” in public health-speak – and are content with that amount. So a reasonable goal of public health intervention is to change the default drink to a smaller size. Hence: Bloomberg’s 16-ounce size cap.

From my nutritionist’s perspective, a 16-ounce soda is still generous. Just one contains the equivalent of 12 packets of sugar. Just one provides 10% of the daily calorie needs of someone who typically eats 2,000 calories a day. Just one contains the upper limit of sugar intake that health officials recommend for an entire day. Once you down a 16-ounce soda, it’s best to stop right there.

You may find this hard to believe, but the original Coca-Cola was 6.5 ounces, smaller than any size available today. In the 1950s, Coke advertised its 16-ounce bottle as large enough to serve three.

Times have changed. The sizes of foods and drinks have expanded, and so have waistlines. This is no coincidence. On the basis of calories alone, larger portions are all you need to explain why Americans are putting on pounds.

City officials concerned about the health of their citizens, as those in New York most definitely are, want to do everything they can to prevent obesity and the illnesses that go with it. Their rationale is humanitarian, but also fiscal. Poor health is expensive for both individuals and society. You don’t believe that excessive weight is an issue? Just ask the military.

We can thank Big Soda – Coca-Cola, Pepsi and their trade association, the American Beverage Association – for the contribution of big sodas to weight gain. Soda companies have spent fortunes to create demand, to make drinking large amounts seem normal, to market sodas as essential for health and happiness and, these days, to fight Bloomberg’s soda cap and take the city to court over it.

Soda companies may make things you like to drink, but they are not social service agencies. Their job is to get you to buy more soda to satisfy the financial demands of investors. They are about business. They are not about fun or happiness or personal choice – and they certainly are not about health.

The soda industry may profess to care more about your well-being these days, but it ultimately will not do anything to promote health if doing so harms sales.

So-called “nanny-state” measures – like bans on driving while drunk, smoking in public places and, now, selling absurdly large sugary drinks – help to level the playing field. Such measures are about giving everyone an equal opportunity to live a safer and healthier life.

At the moment, it is up to you to make healthier choices, but that’s not easy in the face of relentless soda marketing. Governments have a responsibility to provide healthier environments for their citizens.

Here are some additional actions New York City should take, if only it were allowed to.

Close the loopholes. The city does not have jurisdiction over sales of sodas in convenience stores and supermarkets. The state does. Gov. Cuomo denied Mayor Bloomberg’s request to extend the size cap to those stores, not on principle but because he hadn’t thought about it. He should, right now. Let’s keep all sugary drinks to 16 ounces or less.

Fix the price differential. A 7.5-ounce can of soda costs twice as much per ounce as a two-liter bottle, and you can’t buy just one; it comes in an 8-pack. Price determines sales. If a 16-ounce soda costs a dollar, a 32-ounce soda should cost two dollars.

Tax sodas. Most people wouldn’t dream of eating candy all day, but soda companies have made it seem normal to drink sodas from morning to night. Raising the price of sodas would discourage sales, especially among young people most susceptible to marketing efforts and most vulnerable to weight gain. A one-cent tax per ounce should do the trick and raise plenty of needed revenue besides.

Remove vending machines from schools. Yes, the Beverage Association only puts “better-for-you” drinks in school vending machines, but sugar-filled sports drinks are still liquid candy. And kids should not have to pay for water in schools.

Restrict marketing of sodas to children. Soda companies market extensively to children and adolescents, especially those in low-income neighborhoods. Just look at billboards, celebrity photos on soda cans and Pepsi’s $50 million dollar deal with Beyoncé. They should not be permitted to market to kids this way. We already have restrictions on cigarette and alcohol marketing to kids. It breaks no new ground to add sodas to the list.

Don’t let SNAP (food stamp) benefits be used for sodas. Bloomberg tried this, but the federal Department of Agriculture said no. There is absolutely no reason that taxpayer-subsidized food assistance for low-income people should go toward junk with no nutritional value. He should try again.

Show full calories on the front of containers. The current way calories are tallied, in a measure called “calories-per-serving,” is confusing because the servings are unrealistically small and people don’t do the math. Soda cans already give the full calories in tiny type on the Nutrition Facts label, but I want to see the full calories in big type on the front.

Actions like these will evoke ferocious opposition from the soda industry, and it will spare no expense to make sure such things never happen. We would surely hear more and more howls of “nanny-state” from those who insist Bloomberg has led us to the brink of a public health police state. Polls say that many New Yorkers oppose the 16-ounce cap and would oppose measures like this, too.

But I can’t tell whether the opposition comes from genuine concern about limits on personal choice or because soda companies have spent millions of dollars to protect their interests and gin up histrionic, misinformed opposition.

Come Tuesday, the 16-ounce soda is the new default size in New York City. While waiting for the court decision and for politics to play out, why not give it a chance? Maybe it will help you live a healthier and longer life.