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With the politics out of the way (see yesterday’s post), let’s talk about what’s superb in the Dietary Guidelines Advisory Committee Report: the scientific review and analysis.

This was based on reviews produced by the Nutrition Evidence Library (NEL), which apparently recruited dozens of people to identify articles, assess their quality by uniform criteria, and rank the overall evidence as limited, moderate, or strong and consistent or inconsistent.

I particularly like the way the report organizes the research review by questions (of which there are 56, if I counted right).  The questions cover a great range of topics.  Examples:

• What nutrients and dietary components are overconsumed by the general public?
• Can a daily multivitamin/mineral supplement prevent chronic disease?
• What is the role of prebiotics and probiotics in health?
• What are health effects related to consumption of nuts?
• What are the health effects related to consumption of chocolate?
• How do the health outcomes of a vegetarian diet compare to those of a diet which customarily includes animal products?
• How are non-caloric sweeteners related to energy intake and body weight?
• What amount of water is recommended for health?

Questions are followed immediately by Conclusions, Implications, and Review of the Evidence. All of this is written with great clarity, accompanied by thoughtful comments, and packed with useful information.

Here is just one example (I’ve emphasized the evaluative words):

What is the Relationship between Vegetable Protein and/or Soy Protein and Selected Health Outcomes? Few studies are available, and the limited body of evidence suggests that vegetable protein does not offer special protection against type 2 diabetes, coronary heart disease, and selected cancers. Moderate evidence from both cohort and cross-sectional studies show that intake of  vegetable protein is generally linked to lower blood pressure. Moderate evidence suggests soy protein may have small effects on total and low density lipoprotein cholesterol in adults with normal or elevated blood lipids, although results from systematic reviews are inconsistent. A moderate body of consistent evidence finds no unique benefit of soy protein on body weight. A limited and inconsistent body of evidence shows that soy protein does not provide any unique benefits in blood pressure control.

Readers may disagree with the committee’s research interpretations, but its conclusions deserve serious consideration.

And, if anyone wants to know the state of the available science on any of a large number of questions in nutrition, this report is the place to look first.

Student alert: I will be using this report in classes.

I’ve heard rumors that some members of the Dietary Guidelines Advisory Committee (DGAC) believe that commentators did not give a fair shake to their recently released report (see previous post).

I complained that the DGAC report is difficult to read because its pieces are presented online in a great many individual pdf files that must be downloaded separately.  Fortunately, Cornell student Daniel Green created a single Web-based file.

I have now read the report, or at least browsed through its 699 pages, and I agree that it is better than it first appeared and deserves a revisit (which I am doing in two parts, the second tomorrow).

As with previous Dietary Guidelines, both politics and science underlie this report.  The science components of this report are stunning—as good as such things get—and make this document an invaluable resource.

Why did everyone, including me, miss this?  Politics, of course.  The politics appear unchanged from previous versions (for that, see Food Politics).

The science in this report gives clear guidance for action.  But the report obfuscates its most important messages.

The Executive Summary makes the advice seem dull. The Summary is the part everyone reads first and often the only part anyone reads.  Try this:

The 2010 DGAC report concludes that good health and optimal functionality across the life span are achievable goals but require a lifestyle approach including a total diet that is energy balanced and nutrient dense…SoFAS (added sugars and solid fats) contribute approximately 35 percent of calories to the American diet….Reducing the intake of SoFAS can lead to a badly needed reduction in energy intake and inclusion of more healthful foods into the total diet.

Obesity, it says, is a big problem.  The food environment is a big problem.  What to do about them?  SoFAS.

The report introduces a new euphemism, SoFAS (Solid Fats and Added Sugars).  The meaning of added sugars is obvious.  But what are solid fats?  For that, you must wait until page 183 (on the Daniel Green file):

Solid fats are fats that are solid at room temperature. Solid fats come from many animal foods and can be made from vegetable oils through hydrogenation. Some common solid fats are butter, beef tallow (tallow, suet), chicken fat, pork fat (lard), stick margarine, and shortening. Foods high in solid fats include many cheeses, creams, ice cream, well-marbled cuts of meats, regular ground beef, bacon, sausages, poultry skin, and many baked goods (such as cookies, crackers, donuts, pastries, and croissants).

Earlier (p. 24), the report listed the principal food sources of SoFAS:

Solid fats (percent of solid fat intake)

• Grain-based desserts, including cakes, cookies, pies, doughnuts, and granola bars (10.9%)
• Regular cheese (7.7%)
• Sausage, franks, bacon, and ribs (7.1%)
• Pizza (5.9%)
• Fried white potatoes, including French fries and hash browns (5.5%)
• Dairy-based desserts, such as ice cream (5.1%)

Added sugars (percent of added sugars intake)

• Soda (36.6%)
• Grain-based desserts (11.7%)
• Fruit drinks (11.5%)
• Dairy-based desserts (6.4%)
• Candy (6.2%)

The report does not say to eat less of these foods; it talks about nutrients.  In various places in the report, the report says [with my comments in brackets]:

• Significantly reduce intake of foods containing added sugars and solid fats because these dietary components contribute excess calories and few, if any, nutrients. In addition, reduce sodium intake and lower intake of refined grains, especially refined grains that are coupled with added sugar, solid fat, and sodium. [Nutrients, not foods].
• Eat less of these: calories from SoFAS, added sugars, solid fats, refined grains, sodium, saturated fat. [Ditto]
• Significantly lower excessive calorie intake from added sugars, solid fats, and some refined grain products. [Ditto]
• Strategies to prevent childhood obesity should include efforts to reduce surplus energy intake, especially energy from foods and beverages that provide empty calories from added sugars and solid fats. [Ditto]
• Intake of caloric beverages, including SSB [sugar-sweetened beverages], sweetened coffee and tea, energy drinks, and other drinks high in calories and low in nutrients should be reduced in consumers needing to lower body weight.  [Only overweight people need to worry about these foods?]

Only once does the report say the clear and simple: “Avoid sugar-sweetened beverages” (p. 65).  Nowhere does it explicitly say to eat less steak, hamburger, French fries, pizza, cookies, or ice cream.

Like previous editions of the Dietary Guidelines, this one talks about foods in the context of eat more (fruits and vegetables).  For eat less advice, it switches to nutrients.  I’d call this obfuscation (and politics).

But the report—for the first time—emphasizes environmental influences on obesity:

The 2010 DGAC recognizes that the current food environment does not adequately facilitate the ability of Americans to follow the evidence-based recommendations outlined in the 2010 DGAC Report. Population growth, availability of fresh water, arable land constraints, climate change, current policies, and business practices are among some of the major challenges that need to be addressed in order to ensure that these recommendations can be implemented nationally.

What business practices?  It doesn’t say.  It does, however, recommend:

• Improve foods sold and served in schools, including school breakfast, lunch, and afterschool meals and competitive foods so that they meet the recommendations of the IOM report on school meals….
• Increase comprehensive health, nutrition, and physical education programs and curricula in US schools and preschools, including food preparation, food safety, cooking, and physical education classes and improved quality of recess….
• Remove sugar-sweetened beverages and high-calorie snacks from schools, recreation facilities, and other places where children gather.
• Develop and enforce responsible zoning policies for the location of fast food restaurants near schools and places where children play….

This is excellent advice.  But how about some suggestions about what individuals might do about it?

The report says little about food marketing.  Beyond “Develop and enforce effective policies regarding marketing of food and beverage products to children…,” the report says virtually nothing about the well documented impact of food marketing on children’s food choices, dietary intake, and health.  Unless I missed it someplace, the research review does not cite the Institute of Medicine’s 2006 landmark report, Food Marketing to Children and Youth: Threat or Opportunity.

It buries the need for policy changes in long wordy lists.  It states the needs for low-income Americans to have access to and afford healthier foods; to produce fruits, vegetables, and grains sustainably; to ensure household food security; to promote sustainable aquaculture; and to encourage the food service industry to serve healthier foods and smaller portions.  It does not—and perhaps cannot—recommend policy changes to achieve these important goals.

Overall, the report contains plenty of material for food, nutrition, and health advocates to work with, but you have to read between the lines to find it.

Recall the process.  This committee’s report is advisory. From 1980 through 2000,  dietary guidelines advisory committees actually wrote the final Dietary Guidelines.   No more.  Since 2005, the sponsoring agencies decide what the Dietary Guidelines will say.

The report is open for public comment until July 8.  If you think the Dietary Guidelines should provide clear, unambiguous advice about how people should eat to avoid obesity and how we can create a healthier food environment, now would be a good time to express your opinion.  Here’s how.

Tomorrow: The reason why this report is an invaluable resource—its science review.

Yesterday, I got a last-minute invitation to listen in on a USDA conference call announcing the release of the report of the joint USDA-DHHS Dietary Guidelines Advisory Committee (see www.dietaryguidelines.gov).

The call was remarkable for how little information it produced.  It was scheduled for half an hour, but started 12 minutes late.  Officials used most of the time to talk about how the committee was appointed, how the committee process worked, how transparent everything was, and how staff of USDA’s new Evidence-Based Nutrition Library (NEL) provided much of the research basis for the guidelines.  This left hardly any time for asking questions, and only five got asked.

From what I heard, the committee report says pretty much what previous accounts said it would (see my post on this).  If my notes on the call are correct, the committee report will recommend:

• Maintain appropriate body weight through diet and physical activity
• Shift to a more plant-based diet
• Eat more seafood; eat more low-fat dairy products; limit meat intake
• Eat less solid fats; eat less of added sugars
• Reduce sodium; eat fewer refined grains
• Follow physical activity guidelines

Is this news?  Isn’t this always what the dietary guidelines say?  Here, just for fun, are the first set of guidelines that came out in 1980.

The main difference seems to be the way the evidence was judged and in some of the details: the target for saturated fat is 7% and for sodium a gradual reduction to 1500 mg/day.

If so, that’s a lot of trouble to go through to get to basically the same place.  I summarized that place in What to Eat as “Eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.”  Michael Pollen did it even more succinctly: “Eat food.  Mostly plants.  Not too much.”

So why would two federal agencies and 13 committee members go to all this trouble?

The quick answer is that the agencies have to.  Congress says they have to review the guidelines every five years.

The longer answer, which I discuss in Food Politics and What to Eat, is that every word of the dietary guidelines is fraught with politics.

According to Food Chemical News (June 14),

The document is frequently the source of much controversy in the food industry because of the way it is used to promote certain ingredients and eating habits…Observers expect some controversy this year over recommendations made with regard to salt, a subject discussed frequently in committee meetings, as well a possible suggestion to replace two servings of grain with two servings of vegetables.

Another controversy is brewing in regards to the information on which the report was based. On Friday, the American Meat Institute, the National Cattleman’s Beef Association, the Grocery Manufacturer’s Association and the Grain Foods Foundation were among 23 groups that asked USDA and HHS to provide access to the Nutrition Evidence Library, which contains all the research used by the Dietary Guidelines committee when making their recommendations. “Without access to the data from which the DGAC drew its conclusions and recommendations, the public may not be able to provide meaningful comments,” the letter states.

Right. And now let’s see what the agencies do with this report (here’s the USDA press release on what happens next and how to comment).  This report is, after all, merely advisory. Now, the real politics begins!

Additions:

Here is all the information about the Advisory Committee’s report, and the report itself (but why didn’t they put it in one easy pdf file?).

And here is USA Today’s take on it: “Panel: obesity is century’s greatest public health threat.”

Further addition, June 16: Thanks to Daniel Green (Cornell) for putting the report together in one enormous (19MB) file.

European candy makers have been responding to concerns about obesity by taking their ordinary chocolate bars and packaging them so the pack contains two pieces, instead of just one.  Do people eat just one?  According to Dutch researchers, they do not.

Candy eaters “still perceive the entire package as one unit instead of two, because they come in the same wrapper. This also makes them less storable.”

Suggestion: how about making smaller candy bars to begin with?

As readers of this blog know, I am not a fan of health claims on food packages or supplements.  I think they are inherently misleading.   It’s hard for me to believe that eating any one food product or supplement will have a significant effect on disease risk.

It is one thing to say that a nutrient is required for good health.  It is quite another to say that products containing that nutrient are going to have the same effect.  We would all be better off eating foods rather than food products.

That’s why health claims are really about marketing, not health.

Food marketers work hard to get approval for health claims.  America is well ahead of Europe in allowing them.  European regulatory agencies are still trying to hold health claims to reasonable scientific standards.

The European Food Safety Authority (EFSA) has been turning down requests for health claims right and left, but recently broke down and  approved one for iron, requested by the Association de la Transformation Laitière Française, a trade association of French dairy cooperatives.  Iron, of course, is an essential nutrient.

EFSA said the association could say: “Iron contributes to normal cognitive development of children.” But EFSA said the association could not say: “Iron is necessary for the cognitive development of children.”

I don’t think dairy products should say either, but that’s just me.

As for supplements:  In December, Food Chemical News reported that supplement firms in the European Union are considering filing a case with the World Trade Organization over EFSA’s refusal of so many of their proposed claims.   They consider the rejections a barrier to trade.  The firms are looking for a non-European Union country to make their case.

Never underestimate the self-interest of makers of food products and supplements in the struggles over health claims.

USDA’s 2002 organic rules said that dairy herds must have access to pasture.  They did not say the animals had to actually be fed on pasture.   This loophole is now supposed to be fixed.  USDA has just issued new rules.

Starting in June, organic dairy herds must be sent to pasture for the entire grazing season of at least 120 days and must get at least 30% of their food from pasture during that season.  Smaller organic dairy farmers are already doing this.  Now the big ones will have to come into line. And about time too.

Here’s how the New York Times explains this action.

Before this final rule, the Cornucopia Institute had a number of concerns (in 2008). The proposed rules were bundled together with provisions that had not been properly reviewed by the National Organic Standards Board (NOSB).  These problems have now been solved.

Mark Kastel of the Cornocopia Institute writes:

In its final version we are virtually 100% satisfied (still doing some technical review).  Even more importantly we are highly impressed by the professional approach taken by Kathleen Merrigan and the staff at the organic program as to how they plan to implement this.

He sends the Institute’s most recent press release celebrating the new rules.

Score this one as a win for organic advocates!

I thought we were finished with melamine by now, but no such luck.   Recall that we first encountered Chinese melamine (ordinarily a benign component of plastic dinnerware and countertops) as a toxic adulterant of pet food in 2007.  Melamine, it turned out, had been used for decades to boost the apparent – not actual – protein content of foods and ingredients.  It is high in nitrogen and the test for protein in foods measures nitrogen, not protein itself.

In the wake of the pet food scandal, China cracked down on food safety violations.  That did not stop use of melamine and within just a few months, it turned up in infant formula and caused a reported 300,000 Chinese babies to develop kidney problems.  Chinese authorities again dealt harshly with perpetrators, executing some and giving others long prison sentences (to catch up with this story, see previous posts).

And now here we go again, and with one of the same companies implicated in the 2008 infant formula problem – Shanghai Panda Dairy Company.  Chinese authorities are again cracking down but, as the New York Times reports, the problem seems intractable.

Why?  Maybe Chinese adulterators are getting a double message.  Here are a couple of items I picked up off Chinese news sources on the Internet (Google the names to find the sites):

• Li Changjiang, the director of the inspection agency that failed to deal with the melamine problem, was forced to resign from the agency. He has overcome his disgrace, more or less.  He was just appointed deputy head of a major anti-pornography group.
• Zhao Lianhai organized the parents of victims of the infant formula adulteration to try to get compensation.  He was put under house arrest in November and formally arrested in December.

Melamine is an enormous embarrassment to the Chinese and they will get a grip on it eventually, but let’s hope sooner rather than later.  In the meantime, best to avoid food products made in China that are supposed to contain protein from milk or soybeans.

Update January 6: today’s Wall Street Journal reports that Chinese authorities have known about the melamine in milk:

Tuesday, the newspaper 21st Century Business Herald reported industry participants were aware of melamine use by Shanghai Panda as early as April 2009. The paper, which didn’t identify its sources, said that in November China’s minister of health, Chen Zhu, referred to melamine tainting by the company during an internal meeting of Communist Party officials. Those comments, the newspaper reported, prompted Wenzhou-based Zhejiang Panda Dairy Products Co. in early December to announce on its Web site that, while its name was similar to Shagnhai Panda, the two companies aren’t related.

On November 13, the FDA announced indefinite postponement of rules requiring raw oysters from the Gulf of Mexico to undergo postharvest processing to destroy their content of Vibrio vulnificus, a particularly nasty “flesh-eating” bacterium.  According to accounts in the New York Times and in industry newsletters,  the FDA caved under pressure from the oyster industry and members of Congress representing oyster-harvesting regions in the Gulf.

The FDA has been trying for years to get the oyster industry to clean up its act and use post-harvest technologies to sterilize oysters in order to prevent the 15 or so deaths they cause every year.  The technologies include quick freezing, frozen storage, high hydrostatic pressure, mild heat, and low dose gamma irradiation.  When used, the methods reduce bacteria to undectable levels and deaths from Vibrio vulnificus infections to zero.  As the FDA puts it, “seldom is the evidence on a food safety problem and solution so unambiguous.”

The FDA took action on October 16.  It wrote a letter to the industry announcing the new rules.  It would expect oyster producers to use the techniques, especially on oysters harvested in summer months when bacteria levels are higher.  It also issued a background paper on why the techniques are needed, a fact sheet on oyster hazards, and a Q and A on the new policy.

On October 17, FDA official Michael Taylor gave a speech to the oyster industry outlining the policy.

Oops.  The oyster industry did not take well to the idea and went into organized action.

Now, the proposed rules are history.  As the FDA explains:

Since making its initial announcement, the FDA has heard from Gulf Coast oyster harvesters, state officials, and elected representatives from across the region about the feasibility of implementing post-harvest processing or other equivalent controls by the summer of 2011.  These are legitimate concerns.

It is clear to the FDA from our discussions to date that there is a need to further examine both the process and timing for large and small oyster harvesters to gain access to processing facilities or equivalent controls in order to address this important public health goal.  Therefore, before proceeding, we will conduct an independent study to assess how post-harvest processing or other equivalent controls can be feasibly implemented in the Gulf Coast in the fastest, safest and most economical way.

My interpretation: 15 or more preventable deaths a year, every year, from oyster Vibrio must not be enough to elicit industry responsibility or FDA action.  That the FDA was forced to back down so quickly is not reassuring about this administration’s commitment to food safety.  Make no mistake.  This is a major setback to developing a strong food safety system.

One of the ironies here is that the FDA’s approach to oyster safety mirrored the approach taken by the very same Michael Taylor when he worked for the USDA in the mid-1990s.  Then, the administration backed him up on requiring science-based food safety procedures for meat and poulty producers.  This time, it looks like the administration pulled the rug out from under him and forced the FDA to back down.

Note: Thanks to Mike Taylor, safety rules are in place for meat and poultry.  Unfortunately, the current USDA isn’t enforcing them.  I will have more to say on that point in tomorrow’s post.

Another note: Center for Science in the Public Interest, which has been pushing for oyster safety for years, has organized a protest campaign.  Sign up here.