by Marion Nestle

Search results: sugar

Nov 18 2009

Chocolate milk redux: Nutrifluff vs. Policy

First, the “Nutrifluff,” my term for research with results that are intriguing but of unknown clinical significance.  I thank everyone who sent me links to the New York Times account of the new study linking chocolate milk to reduced inflammation.  It quotes the lead author:  “Since atherosclerosis is a low-grade inflammatory disease of the arteries, regular cocoa intake seems to prevent or reduce [it].”   But the giveaway is the next magic words that cover all bases: “more studies needed.”

The study suggests – but in no way proves – that drinking chocolate milk reduces the risk of coronary artery disease.  Inflammation is an intermediate marker of suggestive but unconfirmed clinical implications.  More research is needed, indeed.

Next, policy.  Recall the fuss over chocolate milk (see previous post on the topic)?   Marlene Schwartz of the Rudd Center at Yale has posted an explanation of her views on the matter.

The “chocolate milk controversy” story this week is not about nutrition; it’s about marketing…They explain that “more than half of all flavored milk is sold in schools,” and “the importance of flavored milk goes beyond the school market because it is a key growth area for milk processors.”

They are trying to sell their product. There is nothing wrong with that as long as their marketing efforts are not misleading. Chocolate milk is not the nutritional equivalent of regular milk. It is significantly higher in calories, sugar (often high fructose corn syrup), sodium, and usually contains artificial colors and flavors.

In the promotional video on YouTube, expert dieticians acknowledged that chocolate milk has about 60 more calories per serving than regular milk, but then quickly added that “in the grand scheme of things, that’s nothing compared to the amount of nutrients they are going to be getting.”

That sounded really familiar.

“In the grand scheme of things, these calories don’t count” is exactly what we heard from David Mackay, the CEO of Kellogg in his defense of marketing his company’s high-sugar cereals: “Twelve grams of sugar is 50 calories. A presweetened cereal as part of a regular diet for kids is not a bad thing.”

50 calories here, 60 calories there, and pretty soon we are talking about real weight gain.

Our research has found that children will eat low-sugar cereals and drink white milk when these are the foods that are served. We also found that most children will also eat a piece of fruit if you prompt them to take it. School cafeterias are the perfect place to reinforce the nutrition lessons that begin at home and promote nutrient-dense foods.

If chocolate milk were the only treat children were exposed to in schools, it would not be nearly as much of a problem.  But it is not.  In many schools, kids are offered sweet treats all day long (birthday celebrations, rewards from teachers, etc) or exposed to those readily available from vending machines.  So sweet foods have become the norm.  Norms are hard to change, but let’s at least not make them worse.

Nov 10 2009

Raise your hand for chocolate milk?

Thanks to Marlene Schwartz of the Rudd Center for Food Policy and Obesity at Yale for alerting me to this Associated Press report about the new dairy industry campaign to rescue chocolate milk from the food police.  This, you will not be surprised to hear, is the latest activity funded by the milk checkoff program, a USDA-administered program that requires certain commodity producers to contribute funds to a kitty to be used for generic marketing.  One such program is MilkPep, the incredibly well funded marketing group that together with the Dairy Council invented the “Got Milk” mustache campaign.

MilkPep is now the proud defender of chocolate milk against efforts to get it out of schools.  Why would anyone be so mean as to want to do that?  Maybe because chocolate milk has more sugar and calories than plain milk?  No matter.  MilkPet is stepping up to the plate.  Its $500,000 to $1,000,000 “raise your hand for chocolate milk” campaign takes on those pesky nutrition advocates who think that kids ought to be eating something other than sweets in schools.

The rationale for the campaign?  If you get rid of chocolate milk, kids won’t drink milk.  You will deprive kids of the nutrients in milk and contribute to the “milk deficit.”   After all, this rationale goes, chocolate milk is better than soda (Oops.  Didn’t we just hear something like this relative to the Smart Choices fiasco?).

OK.  Let’s look at what this is really about:

  • Schools represent sales of 460 million gallons of milk – more than 7% of total milk sales
  • More than half (54%) of flavored milk is sold in schools
  • Chocolate milk is a key growth area for milk processors

MilkPep has produced a slide show to help companies take action (I apologize for not linking to it but I have not yet succeeded in uploading a large file, despite many attempts).  The slides advise allies to go on a “chocolate milk offensive”:

  • Do public relations
  • Get bloggers on board
  • Engage moms through social media
  • Take advantage of SuperBowl ads – the campaign intends to fund one
  • Reach out to media

Doesn’t this sound like something ripe for satire?  Colbert!  We need you!

Additions:  Do not miss the YouTube version.  And here’s theofficial MilkPep press release.  Note the testimonials to the benefits of chocolate milk.  It’s a health food!

Oct 30 2009

Industry abandons Smart Choices!

The Connecticut Attorney General, Richard Blumenthal, announced yesterday that all eight food companies involved in the Smart Choices program have agreed to drop out pending his investigation and the FDA’s decision about front-of-package labeling.  Says Blumenthal:

Food manufacturers now realize that continued use of the logo would only mislead and compound consumer confusion. Other food labels richly deserve the same scrutiny — which we will give them with relish.

My investigation into Smart Choices, now supported by the FDA, continues to seek any scientific research or evidence behind a program that promotes mayonnaise, sugar-loaded cereal and ice cream as Smart Choices.

Many in the food and beverage industry have sugarcoated their labels — diverting and distracting consumers from nutrition truth, and pushing them toward obesity and disease. Self responsibility and good parenting are key to healthy lifestyles, but impossible when food manufacturers misguide them.

Our initiative should send a message to other food manufacturers that labeling must be completely truthful and accurate without hype or spin, especially when appealing to children. I am strongly encouraged by interest in our investigation by other attorneys general who can form a powerful coalition against misleading or deceptive food labeling.

Keep an eye out for what other city and state attorneys will be doing about food labels.   FDA: get busy!

Oct 29 2009

Family doctors resign from AAFP over Coke partnership

Yesterday, 20 family physicians in Contra Costa County, California, ripped up their membership cards in the American Academy of Family Physicians in protest over the AAFP’s partnership with Coca-Cola.

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The director of the Contra Costa Department of Health Services, Dr. William Walker, announced that he was resigning his 25-year membership in AAFP.  In his statement, Dr. Walker said:

…I am appalled and ashamed of this partnership between Coca-Cola and the American Academy of Family Physicians. How can any organization that claims to promote public health join forces with a company that promotes products that put our children at risk for obesity, heart disease and early death.

…The AAFP is supposed to be an organization that works to protect the health of children not put them at risk. Their decision to take soda money is all the more unconscionable because, unlike doctors in the 40s, they well know the negative health impact of soda. There is no shortage of documentation that soda is a major contributor to our nation’s obesity epidemic.

…Let me be clear about something: as disappointed as I am with the American Academy of Family Physicians for being duped into thinking that Coca Cola wants to help promote health, the real problem here is our children are being put at risk.

Companies like Coca Cola are polluting our communities with deceptive advertising promoting products that put our children’s health at risk.

…as a family practice doctor and the Health Officer for Contra Costa, I do have a prescription for every parent, teacher, community leader and student:

Look beyond the glitzy advertising that makes you think pouring liquid containing sugar into your body is healthy. Read the label. Look at the ingredients. I’m not suggesting that you boycott sugared drinks, but please make an informed decision about what you are consuming.

I’m calling on every city and neighborhood in our County to fight back against the industry that pushes these harmful products. I ask the American Academy of Family Physicians to end this unhealthy partnership and to join us in leading this important campaign to take back the health of our residents and end the obesity epidemic.

Strong words, indeed.  I hope that the AAFP – and other health and nutrition organizations that might consider food industry partnerships – pay close attention to these words.

* The event was covered in the Contra Costa Times. The Health Department’s website includes the press release and also a video and podcast.

Addendum:

Dr. Wendel Brunner, PhD, MD, Director of Public Health in the Contra Costa Department of Health Services has given me permission to post excerpts from his letter to a representative of the California Association of Family Physicians who had asked for more information about the protest:

“The epidemic of obesity is the greatest public health and clinical medicine issue of our time, and will lead to untold disease, shortened life spans, and medical cost. That epidemic took off rapidly in the 80’s. While genes and personal choices do have an impact on obesity, only profound environmental changes could lead to such a rapid development of the epidemic, and it will only be stopped by policy development and environmental and norm change. We need to create an environment that supports people in making good choices for themselves and their families.

One of the best choices families can make is to pretty much eliminate sweetened beverages. And the soda industry doesn’t want that to happen, so they are looking for credible groups who will say that drinking soda is OK for your health. But you know all that already, which makes this even more frustrating.

I am an old county doctor, but I still believe that physicians have a responsibility to advocate for their patients and fight to protect their health, and to first of all, do no harm. I am truly gratified to see that our younger physicians in Contra Costa have those same values too. The responsibility of a physician to their patient is a sacred trust; physicians should never sell out their patients’ health and well-being for a price, not even one “in the mid six figures”.

The AAFP needs to change their policy and thereby begin to redeem themselves. In the process, they would educate the country and do something valuable for the nations health, as well as for their own integrity. If they do not, they will continue an unfortunately long and sordid tradition of professionals and their organizations forgetting their purpose and their ethics and putting their narrow organizational financial interest above the interest of the public that they serve. Resigning membership seems to be the most effective way for physicians to provide a wake-up call to the AAFP, and at this point is the best thing a physician could do to benefit the organization.We anticipate that there will be more resignations as this story develops.

Everything cannot be blamed on the environment or peer pressures or economic factors; patients do have a personal responsibility to make good choices for their health and the health of their families. But physicians have the personal responsibility to make good choices too, and so do the professionals who work for them.

The AAFP and the individuals in it made a bad choice. They now have the responsibility to fix it.”

Oct 28 2009

San Francisco takes on Cocoa Krispies!

Now that the Smart Choices program is on hold, it’s time to take a look at what else is on food packages these days.  My current favorite example is the huge IMMUNITY banner across Kellogg’s Cocoa Krispies.

ImmunityI don’t know how you interpret this but my mind boggles at the very idea that eating Cocoa Krispies might protect kids against swine flu.

Apparently, the minds of the San Francisco attorney general’s staff are equally boggled.  They just sent a warning letter to Kellog:

“Specifically, the Immunity Claims may falsely suggest to parents that cereals like Cocoa Krispies are more healthy for their children than other breakfast foods that are not high in sugar and not highly processed.  The Immunity Claims  may also mislead parents into believing that serving this sugary cereal will actually boost their child’s immunity, leaving parents less likely to take more productive steps to protect their children’s health.”

The city attorneys are asking Kellogg to provide copies of all of the consumer and scientific research the company used to establish this claim, or else.  If they don’t get these documents, they will “seek an immediate termination or modification of the advertising claim….”

Good idea.  I can’t wait to see how Kellogg’s – ever at the leading edge of advertising claims – will respond.

But wait!  Shouldn’t the FDA be taking this on?

Oct 15 2009

Connecticut takes on Smart Choices!

Richard Blumenthal, the Connecticut Attorney General, says he is about to conduct an investigation into the Smart Choices program because it is “overly simplistic, inaccurate and ultimately misleading.”   Recall that Froot Loops, a product with sugar as its first ingredient, qualifies as a better-for-you option.  Apparently, Mr. Blumenthal is talking to the Attorneys General of other states and several want to join his investigation.  While they are at it, maybe they should also take a look at the role of the American Society of Nutrition in developing and managing this program.

But count on the American Council on Science and Health (ACSH) to defend Froot Loops as a Smart Choice.  Explains ACSH’s Jeff Stier:

Froot Loops and Lucky Charms have the ‘Smart Choices’ label. They have sugar in them, but they also contain half of a person’s daily requirement of some vitamins. If we’re able to give kids those nutrients, it should be okay to give them some sugar. If they sold these products without sugar, kids wouldn’t eat them, or they might end up adding even more on their own….Don’t companies have the right to say those foods are better than others? It’s not as if they are making specific health claims, rather these are just comparative claims.

This Richard Blumenthal is the same one who has been seeking to ban e-cigarettes…Connecticut may have more serious problems to focus on than banning e-cigarettes and worrying about companies trying to point consumers to healthier products. Froot Loops obviously isn’t the healthiest food out there, but it’s better than many others.

It’s that debatable philosophic argument again: Is a so-called “better-for-you” product necessarily a good choice?

[Note: I’m in Rome this week and am most grateful to the six people who sent me the Times article and the two who sent the ACSH post.  Thanks so much!]

Oct 9 2009

Another sad partnership story: AAFP and Coca-Cola

On October 6, the American Academy of Family Physicians (AAFP) announced its new partnership with Coca-Cola.  What does AAFP get from this?  A grant “to develop consumer education content on beverages and sweeteners for FamilyDoctor.org.”

The AAFP, says its president, looks forward to

working with The Coca-Cola Company, and other companies in the future, on the development of educational materials to teach consumers how to make the right choices and incorporate the products they love into a balanced diet and a healthy lifestyle.

Coca-Cola must be thrilled with this.  As its CEO explains in an op-ed in yesterday’s Wall Street Journal, soft drinks are entirely benign and have nothing to do with obesity.  Obesity is due to lack of physical activity and eating too much of other foods, not Coke.  His view of the situation is entirely predictable.

But what about the AAFP?  Family practice doctors have been telling me for years that it is not unusual for them to see overweight kids and adults in their practices who consume 1,000 to 2,000 calories a day from soft drinks alone.  The first piece of advice to give any overweight person is to stop drinking soft drinks (or other sugary drinks).

This partnership places the AAFP in embarrassing conflict of interest.  I gather that members were not consulted.  They need to make their voices heard.  I hope AAFP members decide that no matter what Coke paid for this partnership, their loss of credibility is not worth the price.

Addendum: Here’s what a Chicago Tribune blogger has to say about this.

Further addendum, October 10: As noted in the comments, AAFP members were consulted, more or less.  Apparently, they decided Big Food was less of a problem than Big Pharm.  Really?  How about selling out to neither?

Oct 1 2009

The soft drink industry strikes back

Today’s New York Times carries this full-page ad taking on the New York City Health Department’s campaign against sodas.

print_obesity_stupid

Although the ad says it’s paid for by the Center for Consumer Freedom (CCF), it doesn’t take much to guess who paid that group for it.  What better way to fight back than to hide behind this particular public relations agency, which specializes in defending purveyors of unhealthful products.

What CCF is about – and which companies pay for its work – are well known (for starters, see previous post).

I’m guessing the Health Department’s campaign must be having an effect if soft drink companies are so worried that they are willing to fund a group that is so consumer unfriendly.

Addendum:  no wonder they are worried.  According to a new report on soda taxation from Center for Science in the Public Interest, President Obama has said the idea is worth considering.

Scan10214

And thanks to Fred Tripp for giving me yet another CCF ad, this one from the September 30 A.M. New York.   All of this must be making soda companies worried enough to sign on with CCF.  Not a good idea.

Update October 2: I’ve just been send a link to Rachel Maddow’s comments on Rick Berman, the head of CCF.  Look for “Meet Rick Berman.”  It gives an overview of CCF accounts.  I’m not sure when it aired.