Food Politics

by Marion Nestle
Nov 15 2023

What’s up with WIC: enrollment low and declining

USDA sent out a news release about the current funding status of WIC, the  Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). 

 More than 6.7 million women, infants, and children participate in WIC — the program serves just under half of all infants born in the U.S. 

Unless Congress acts to fund the program, things could get worse.  

A new report from the U.S. Department of Agriculture’s (USDA), Food and Nutrition Service (FNS), provides estimates of people eligible for WIC benefits nationally, by state, by race and ethnicity, and, for the first time in this series of reports, by urbanicity. 

 

Evidence shows that WIC participation results in better pregnancy outcomes, including fewer infant deaths, premature births, and low birthweight infants and the program has been shown to reduce health care costs and increase preventative care and immunization rates among children. 

The USDA says WIC is Vital – but Vastly Underutilized, Research Finds 

The just released study reports that an average of 12.13 million moms, babies, and young children were eligible for WIC in 2021. However, only 51%, or 6.21 million, of those who were eligible actually participated…A failure to fully fund WIC this fiscal year means some states would likely need to put eligible families on waiting lists. 

Comment

WIC differs from SNAP in three important ways.

  1. WIC is not an entitlement; participation can only go as high as the funding permts.  Women can be eligible, but not get benefits if the money runs out.
  2. WIC charge cards allow purchase only of WIC-eligible foods.
  3. Congress required WIC to be evaluated for its effects on child health.

For a long time, the funding only covered about half of women and children eligible for WIC.  That changed about 25 years ago when Congress decided—on the basis of evidence produced by evaluations—to provide enough funding to cover everyone who was eligible.  Enrollments rose.

This report documents problems with enrollments in the program; enrollment is low and declining, especially among groups who need the benefits the most.

Any number of reasons could account for the underuse and decline:

  • Difficulties dealing with bureaucracy
  • Immigrant concerns about status vulnerability
  • Lack of transportation
  • Not speaking English
  • Stigma
  • Not knowing about eligibility
  • Lack of outreach

Yes, Congress should fund WIC at a 100% level.  It’s demonstrably one of the best programs going.

USDA should be doing all it can to address that list of barriers—all of them.

The reports

Tags: ,
Nov 14 2023

The food industry’s role in dietetic education

I frequently get sent copies of e-mailed messages sent to members of the Academy of Nutrition and Dietetics, the professional organization for people holding credentials as Registered Dietitian Nutritionists (RDN).

Disclosure: I do not hold this credential; long after I had a doctorate while I was doing a later master’s in public health, I fulfilled all of the graduate and clinical requirements but was still short one undergraduate course.

Holders of the RDN must complete 75 credits of continuing education courses every five years to maintain the credential.  Usually, dietitians must pay for courses to meet those credits.

But as my correspondents make clear, food complanies offer courses for credit—at no cost.

It is not at all difficult to fully meet credit requirements through industry-sponsored courses.

Here are some examples:

  • International STEVIA Council.  Stevia: The Science Beehind the Sweet: a complimentary webinar that will review the most recent scientific evidence supporting the use of stevia to help reduce the risk of chronic diseases and improve quality of life.  https://www.todaysdietitian.com/marketing/webinars/2023/ISC/index.html
  • This…Free CPEUs: Webinar on Dietary Diversity: Join PepsiCo Health & Nutrition Sciences on Thursday, December 7th for the latest research on incorporating more diverse foods, such as whole grains, legumes and other under-consumed food groups, in dietary patterns. This webinar will also feature a fun culinary demo! Earn 1.25 free CPEUs. Register now.
  • The Latest on Low- and No-Calorie Sweeteners: What You Need to Know. This activity is accredited by Heartland Food Products Group. 1.0 CPEU FREE
  • Looking for more free CPE opportunities?  IFIC has 20+ hours of CPEUs available here  [NOTE: IFIC, the International Food Information Council, is a food industry trade association focused on education].

Comment: One can only imagine what those sessions will say.  Do not expect anything critical about the sponsor’s products.

But here’s an even easier way to pick up a bunch of credits.

Free CPE Opportunities are Now Available for Reading the Dietary Guidelines for Americans!  A Special Treat for Professionals: Free CPE Units Available Now for Reading the Dietary Guidelines for Americans.

You can now earn 2.0 free continuing professional education (CPE) credits for reading the Introduction and Chapter 1 of the Dietary Guidelines for Americans, 2020-2025! Credits are provided by the Commission on Dietetic Registration (CDR), the credentialing body for Registered Dietitians and Dietetic Technicians, Registered.

The self-study module will equip professionals with knowledge of the scientific underpinnings that makes the Dietary Guidelines relevant across all life stages. Participants will also learn science-based advice on what to eat and drink to build a healthy diet that can promote health, help prevent diet-related chronic disease, and meet nutrient needs.

Visit CPE Opportunities | Dietary Guidelines for Americans to start earning credits and stay updated on the release of future modules.

Comment:  Let’s hope that dietitians have already read the Dietary Guidelines at some point.  Or maybe it takes free credits to get anyone to slog through its 150 pages.

In any case, AND should not be allowing food companies to “educate” dietitians.

Just to be fair: the society to which I belong, the American Society of Nutrition, is doing this.  It too should not.

 

Nov 13 2023

Weird conflicts disclosure of the week: The Portfolio Diet

Several readers wrote suggesting I take a look at the conflicts of interest statement on this paper.

It comes from the Harvard TH Chan School of Public Health, which issued a press release: Harvard study: ‘Portfolio diet’ may decrease risk of heart disease, stroke.

The portfolio diet—a plant-based diet designed to lower unhealthy cholesterol, emphasizing plant proteins (legumes), phytosterols (nuts and seeds), viscous fiber (oats, barley, berries, apples), and plant-based monounsaturated fatty acids (avocado)—may lower the risk of heart disease and stroke, according to a new study co-authored by researchers at Harvard T.H. Chan School of Public Health.

The study was published in Circulation, which also sent out a press release: Ever heard of the portfolio diet? It may lower risk for heart disease and stroke.

The study itself, Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies, produced results that should be expected from eating healthier diets.

Background: The plant-based Portfolio dietary pattern includes recognized cholesterol-lowering foods (ie, plant protein, nuts, viscous fiber, phytosterols, and plant monounsaturated fats) shown to improve several cardiovascular disease (CVD) risk factors in randomized controlled trials.

Objective: to examine the relationship between the Portfolio Diet Score (PDS) and the risk of total CVD, coronary heart disease (CHD), and stroke.

Methods: We prospectively followed 73924 women in the Nurses’ Health Study (1984–2016), 92346 women in the Nurses’ Health Study II (1991–2017), and 43970 men in the Health Professionals Follow-up Study (1986–2016) without CVD or cancer at baseline. Diet was assessed using validated food frequency questionnaires at baseline and every 4 years using a PDS that positively ranks plant protein (legumes), nuts and seeds, viscous fiber sources, phytosterols (mg/day), and plant monounsaturated fat sources, and negatively ranks foods high in saturated fat and cholesterol.

Conclusions: The PDS was associated with a lower risk of CVD, including CHD and stroke, and a more favorable blood lipid and inflammatory profile, in 3 large prospective cohorts.

This report was funded by Canadian and U.S. government research agencies.

Comment: The reason readers sent this to me had to do with the authors’ reported conflicts of interest.  These take up the equivalent of an entire page in the journal and refer to a curious mixture of financial support or connections, paid and unpaid, with government agencies and foundations, authors’ and sometimes their spouses’—in addition to long lists of financial ties to food trade associations for one or another plant food included in the Portfolio diet.

Muddying up disclosure statements like this is inappropriate.  Many connections listed do not in any way imply conflicted interests.  Mixing them up with those that do takes the focus away from financial ties that could have influenced the design or interpretation of the study.

Financial connections to food companies raise questions of credibility in nutrition research.  At the very least, they give the appearance of industry influence.

Disclosure lists like these either reflect ignorance of the significance and harm causes by conflicts of interest or deliberate disdain for its meanings.  If Circulation is requiring this mix of disclosures, it should reevaluate its policy.

Just because these disclosures come in a study from Harvard does not make them OK.

Nov 10 2023

Weekend reading: The story of Chinese food

Fuchsia Dunlop.  Invitation to a Banquet.  The Story of Chinese Food.  Norton, 2023.  420 pages.

 

 

 

 

 

 

 

 

 

 

Fuchsia Dunlop, who has lived in China, went to cooking school there, and writes Chinese cookbooks, does something different here.  She writes about the history of Chinese Food using traditional dishes (stir-fried broccoli with ginger, Shandong guofu tofu, etc)  as starting points for exploring the how and why of each of them.

Chinese food is an inescapable cultural presence all over the world…As a brand, ‘Chinese food’ has global recognition.  Yet, from another perspective, Chinese food has also been the victim of its own success.  The resounding popularity of a simplified, adapted, even bastardized form of Cantonese cuisine, first developed in North America and then scattered like confetti all over with the world, with its childish predictability and limited range, its birght colours, sweet-sour and salty flavours, deep-fried snacks and stir-fried noodles, has clouded appreciation of the diversity and sophistication of Chinese gastronomic culture. (p.5)

The book makes up for these deficits.  Dunlop relates what she found on her travels throughout China about the origins of this cuisine (cuisines, really), the basic ingredients (animal and vegetable), the techniques (chopping, steaming, stir-frying), ending with a short dissertation on Chop Suey and scholarly apparatus: chronology, notes, bibliography.

Another quotation:

When it comes to Chinese food, I see myself increasingly as a small insect scaling a great mountain of human ingenuity.  It’s paradoxical, because in many ways modern China can seem sameish.  All over the country, the same identikit modern buildings, the same brands, the same clothes…Even after the destruction of the Cultural Revolution, Chinese food bounced back in a glittering kaleidoscope of colours.  All over the country, in nondescript little restaurants in concrete buildings, with nice calligraphy in a frames, people are tucking into remarkably delicious and locally distinctive foods.  At some profound level, this is how China expresses itself, from ancient times until now, from now until eternity (p.331).

As you should be able to tell from these brief excerpts, the book is an easy read.   I particularly enjoyed reading about Dunlop’s food adventures throughout China.  She now lives in the UK but used the pandemic to share them with us.

Nov 9 2023

The latest developments on the cultivated meat front

I’m trying to keep up with what’s happening with cultivated meat.  So far, the FDA has approved a couple of cultivated chicken cell companies, and these are selling “chicken” in a couple of restaurants, one in San Francisco and the other in Washington DC.

The big issue: scaling cell production up enough to have product to sell.  It takes lots of cells–billions? trillions?—to make a portion big enough to eat.

Here’s what’s going on in this area in the U.S. and U.K.

Nov 8 2023

ProPublica’s Big Story: Wild Salmon

I’m always being asked what politics has to do with food.  My answer: everything.

Here is an example, courtesy of ProPublica and Oregon Public Broadcasting.

Enormous numbers of people depend on wild salmon for food and livelihoods.  If the salmon disappear or cannot be eaten, these people lose both.

Salmon raise other issues besides their effects on indigenous populations.

Nothing in food is simple.  Nothing in food is free of politics.

Tags: ,
Nov 7 2023

Chocolate: an update on the food politics thereof

I am suddenly deluged with items about chocolate, which seems to raise any number of food politics issues.

For today, let’s deal with three: content of toxic heavy metals, research conflicts of interest, and claims of sustainability,

I.  Heavy metals. I learned about this one from Food Safety News (FSN): Consumer Reports finds one-third of chocolate is high in heavy metals: CR today released test results that have it urging Hershey’s to get harmful lead and cadmium out of its chocolate products.

FSN conveniently provided a link to the full CR report, which says.

When we tested dark chocolate bars last year, we found lead or cadmium levels above CR’s thresholds in 23 of 28 bars, or 82 percent of them. Our results this time were similar. Of the seven bars we tested, five, or 71 percent, were above our levels for lead, cadmium, or both…Eating an ounce of four others would put you over our limit for lead.

Food Safety News also reports: Chocolate makers say they have heavy metals issue under control: The National Confectioners Association (NCA) : “Chocolate and cocoa are safe to eat and can be enjoyed as treats as they have been for centuries,” NCA says. “Food safety and product quality remain our highest priorities,… Continue Reading

ConsumerLab does its own testing for toxins in Dark Chocolate, Cocoa & Cacao Products.

Which dark chocolate and cocoa products are best?  Be careful! Several cocoa powders, cacao nibs, and some dark chocolates failed to pass our review due to contamination with high levels of cadmium, a toxic heavy metal (see What CL Found).

II.  Conflicts of interest. ConsumerLab also commented on cocoa flavanols.

Furthermore, levels of potentially beneficial cocoa flavanols ranged from just 1 mg to 374 mg in cocoa powders and mixes, 2 mg to 351 mg in dark chocolates, and 2 mg to 993 mg in supplements. Products also vary widely in calories per serving.

This took me right to an e-mail from a reader, Thijs van Rens, Professor of Economics, University of Warwick,.  He wanted me to see something he had read in The Conversation: “Flavanols are linked to better memory and heart health – here’s what foods you can eat to get these benefits.”

He pointed out that the author “…received research funding from Mars, Inc., a company engaged in flavanol research and flavanol-related commercial activities.”  He added:

I got suspicious about the funding when I read this:  “This is why flavanols extracted from cocoa are an ideal model, as they contain the two main types of flavanols.”

In fact, I was going to comment and complain about The Conversation publishing something like this, until I noticed the one-but-last paragraph:

“It’s also important to note that while the flavanols used in many studies were extracted from cocoa, unfortunately chocolate (even dark chocolate) is a very poor source of flavanols – despite what some headlines might claim. This is because these flavanols are lost during processing.”

Not sure what to make of the article. On the one hand, the author clearly states not to eat chocolate for this reason and the funding is clearly disclosed. On the other hand, how many readers will get to the one-but-last paragraph and check the disclosure statement. On balance, I could imagine Mars Inc. would be quite happy about this article.

Indeed yes.  That’s why they paid for it (but see clarification below)

III.  Sustainability.  This also came in a e-mail, this time a press release from Chocolate Scorecard, a group that rates chocolate companies on practices related to traceability, wages, child labor, deforestation, agroecology, etc.  Its key messages:

  • Sustainability claims of chocolate companies cannot necessarily be trusted.
  • Only 11% of chocolate companies can fully trace where their cocoa comes from – without knowing they cannot claim sustainability.
  • Farmers need to be paid more for their cocoa to ensure a sustainable life.

“100% sustainably sourced cocoa,” says the sign on the stand promoting a well-known chocolate brand in the supermarket. The message is not one you can necessarily trust.

…A recent report by Oxfam claims that the “net income of farmers decreased by an estimated 16.38% between the 2019/20 and 2021/22 harvesting season.” When the price of cocoa increases everything else a farmer purchases increases in price, leaving worse off in reality. This is associated with increases in profits in chocolate companies.

The Chocolate Scorecard is a collective of 37 NGO’s and Universities. They are calling on chocolate companies to commit to a ‘living income’ for cocoa farmers.

And you thought you were just eating candy.

Additions

Readers wrote to remind me to add:

Clarification

The author of the flavanol article wrote to say that my comment could be interpreted as suggesting he was paid to write it, which he was not.  That was not my intention and I apologize for giving that impression.  I do see research or commentary paid for by food companies, but such instances are rare. The “funding effect,” as I discuss in my book Unsavory Truth, gives the appearance of conflicted interest no matter what its actual level of influence.

Nov 6 2023

Industry-funded item of the week: artificial sweeteners

Hand Cardullo writes in Forbes: 87% Of Sweetened Products Contain Added Sugars Only, Study Finds.   

That seemed interesting.  But then I got to the sub-headline: New Georgetown University report cites need for more low- and no-calorie sweeteners.

As public health officials clamor to remove added sugars from food and beverage products, a new study published by the Georgetown University Business for Impact Center signals that there is much heavy lifing ahead (full disclosure: I served as an author of the paper). The report noted that added sugars dominate products containing sweeteners, with 87% of items formulated this way. Only 8% of sweetened items contain low- or no-calorie sweeteners (LNCS) only, with 5% consisting of a combination of the two. The paper concluded that increased use of LNCS was necessary to eliminate meaningful amounts of added sugars and that LNCS offered effective and safe ways to do so.

Cardullo says: “Here are some things to consider:

  • If public health organizations want to achieve their added sugar reduction goals, they must step up and communicate the efficacy and safety of LNCS in helping consumers manage and lose weight. This will go a long way in helping to clear up consumer confusion.
  • The evidence suggests that the public health community must use only the best studies to advance firm points of view on the use of LNCS.
  • To help reduce added sugars, food and beverage companies should incorporate LNCS into more of their products.”

Really?  My usual question: Who paid for this?

The paper: Moving Towards Healthier Eating Habits: Why Low- and No-Calorie Sweeteners Play a Critical Role

The funder: “Funding for this paper was provided by the Calorie Control Council” [an international association representing the low- and reduced-calorie food and beverage industry].

Comment: Here is one of the figures from the paper.

This shows that 24% of added sugars come from sugar-sweetened beverages, and another 19% come from desserts and snacks.

Cutting down on both is a good idea on its own, and one that does not require the addition or substitution of artificial sweetneners.