Search results: Corn sugar

Michael Siegel, MD, MPH, a Professor at the Boston University School of Public Health (whom I do not know), has been mailing me copies of his recent blog posts on partnerships between food corporations and health organizations, particularly the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP) (see my previous posts), and the American Dietetic Association (ADA) (see my previous posts on this one too).

Dr. Siegel’s current post discusses two reasons why these partnerships do more for the food companies than they do for the organizations:

1. Coca-Cola and other Big Food companies are using these partnerships to enhance their corporate image, and therefore, their bottom line: sales of unhealthy products that are contributing towards the nation’s obesity epidemic.

In its 2010 annual report, Coca-Cola writes: “…researchers, health advocates and dietary guidelines are encouraging consumers to reduce consumption of sugar-sweetened beverages, including those sweetened with HFCS or other nutritive sweeteners. Increasing public concern about these issues…may reduce demand for our beverages, which could affect our profitability.”

…Pepsico, in its 2010 annual report, also makes clear the connection between the company’s public image and its bottom line: “Damage to our reputation or loss of consumer confidence in our products for any of these or other reasons could result in decreased demand for our products and could have a material adverse effect on our business, financial condition and results of operations, as well as require additional resources to rebuild our reputation.”

2. The American Dietetic Association, American Academy of Pediatrics, and American Academy of Family Physicians are supporting companies that oppose virtually every state-specific public health policy related to improvement of school nutrition, reduction of junk food and soda consumption, and environmental health and safety.

…Through its contributions to the Grocers Manufacturers Association (GMA), Coca-Cola is opposing any and all taxes on sugar-sweetened beverages (soft drinks), opposing the removal of BPA from bottles containing liquids consumed by infants, opposing legislation to simply require the disclosure of product ingredients, opposing taxes on candy, opposing bottle bills, opposing all restrictions on BPA-containing packaging, opposing standards for food processing, and opposing school nutrition standards.

…That the AAP, AAFP, and ADA have fallen for Coca-Cola’s tricks is one possibility. The other, which I find more likely, is that they have been bought off. In other words, that the receipt of large amounts of money has caused them to look the other way. It’s amazing what a little financial support will do. And of course, this is precisely the reason why companies like Coca-Cola and Pepsico include the sponsorship of public health organizations in their marketing plans.

I’m just back from the American Society of Nutrition meetings in Washington, DC, where the daily newsletter put out by the society included full-page advertisements from Coca-Cola, the beef industry, and the Corn Refiners Association (see yesterday’s post).  And then there is the astonishing example of Coca-Cola’s $10 million gift to Children’s Hospital of Philadelphia to head off a potential city soda tax.

It is completely understandable why food and beverage companies would want to buy silence from health professionals.  It is much less understandable why health organizations would risk their credibility to accept such funding.  Professor Siegel’s analyses of these issues are worth close attention.

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.

Over the holidays, Pepsi announced two changes to its products.

“All Natural” Frito-Lay: First, the company announced that half its Frito-Lay chips would now be made with “all natural” ingredients.

“Natural,” you may recall, has no regulatory meaning.  Companies pretty much get to define for themselves what the word means, provided what they say is “truthful and not misleading.”

By “natural,” Pepsi means removing MSG, artificial colors, and other chemical additives from some—but by no means all—chips and other snacks.  This is a good start, but Cheetos and Doritos?  Not a chance.

As to worries that the word “natural” is a calorie distractor and might encourage overeating, a Pepsi spokesperson said: “It’s meant to say: made with natural ingredients….It’s not meant to say: eat more.”  Really?  I’m not convinced.

Tropolis Squeezable Fruit: Next, Pepsi announced the latest innovation in kids’ products: Tropolis pouches of squeezable fruit.

I learned about Tropolis from a reporter at the Wall Street Journal, Valerie Bauerlein, who forwarded Pepsi’s press release:

Each fun-flavored 3.17 fl oz (90g) pouch provides a smooth blend of real squeezable fruit, is a good source of fiber, and offers 100 percent of the recommended daily value of vitamin C – all for less than 100 calories.

Tropicana Tropolis is made with no added sugars, artificial sweeteners or high fructose corn syrup; and no artificial flavors, colors or preservatives.

“Fun-flavored” is a euphemism for sugar.  The press release explains what’s not in the product.  So, what does it contain? It took some doing to find out, but it arrived eventually along with some further background information from Pepsi:

The issue is kids aren’t getting enough fruit, so Tropicana Tropolis is trying to help solve that problem in a fun, nutritious way…Studies show that families are not getting enough fruit and vegetables in their diets, and the health experts we talked to (registered dietitians and pediatricians) when developing Tropolis also raised this issue.

As you might imagine, I was not one of the experts they talked to.  Here are the ingredients:

• Grape World: Apple puree, filtered water, banana puree concentrate, fibersol-2 fiber (maltodextrin), grape juice concentrate, apple juice concentrate, lemon juice concentrate, natural flavor and ascorbic acid (vitamin C).
• Cherry World: Apple puree, filtered water, banana puree concentrate, fibersol-2 fiber (maltodextrin), apple juice concentrate, cherry juice concentrate, lemon juice concentrate, natural flavor and ascorbic acid (vitamin C).
• Apple World: Apple puree, filtered water, banana puree concentrate, fibersol-2 fiber (maltodextrin), apple juice concentrate, lemon juice concentrate, natural flavor and ascorbic acid (vitamin C).

Translation: “Juice concentrates” is another euphemism for sugar.  You don’t believe me?  See the list of sugar euphemisms in the 2005 Dietary Guidelines (Table 14).

My translation: this is watery apple and banana sauce, artificially thickened, sweetened with fruit sugars, flavored with additives, and with added vitamin C.

As Valerie Bauerlein’s Wall Street Journal account explains,  this product is about expanding Pepsi’s profits in the “better-for-you” category as captured in a quotation that is sure to become a classic.

Ms. Nooyi [Pepsi’s CEO] has said she wants to build the nutrition business to $30 billion from $10 billion by 2020.…We see the emerging opportunity to ‘snackify’ beverages and ‘drinkify’ snacks as the next frontier in food and beverage convenience,” Ms. Nooyi said.

I ’m also quoted in her article (I did the interview while stranded in Miami trying to get back to snowbound New York):

Marion Nestle, a professor of nutrition at New York University, said that the fruit concentrates are simply sugar. “They start out with real food, so let’s give them credit for applesauce and mashed-up bananas,” but “the rest of it is sugar,” she said. “Kids would be better off eating an apple or a banana.”

PepsiCo said Tropolis should get kids to eat more fruit, which is what’s most important.

Tropolis raises my favorite food philosophy question: Is a “better-for-you” product necessarily a good choice?  Is this a good way to get kids to eat more fruit?

You decide.

My first San Francisco Chronicle “Food Matters” column for the new year deals with some predictions:

Q: Whatever you used as a crystal ball last year turned out to be a pretty good predictor of the most prominent food issues of 2010. How about trying again: What food matters will we be hearing about in 2011?

A: It doesn’t take a crystal ball to figure out what’s coming up with food issues. I’m happy to make predictions, especially since most seem fairly safe.

Dietary guidelines will be released this month. By law, they were due last year and are already late. What will they say? The 2010 guidelines advisory committee recommended eating more fruits, vegetables and whole grains, but introduced a new euphemism – SOFAs, or Solid Fats and Added Sugars – for the “eat less” advice. SOFAs really mean “cut down on fatty meat and dairy products” and “avoid sugary sodas.”

Will government agencies have the nerve to say so? Let’s hope.

The U.S. Department of Agriculture will issue a new food guide. The 2005 pyramid’s rainbow stripes proved impossible to teach and useless to anyone without a computer. I’ve heard a rumor that I will love the new design. I’m skeptical. I liked the original 1992 pyramid. It showed that bottom-of-the-pyramid foods were healthiest, making it unpopular with companies selling top-of-the-pyramid products. But it is healthier to eat some foods than others (see: dietary guidelines).

Will the USDA improve on the 1992 design? We will soon find out.

The fights over food safety will continue. At the last possible moment, Congress passed the food safety bill by a large majority. Now the fights really begin.

Funding will be most contentious, with the actual regulations not far behind. The Congressional Budget Office absurdly considered the bill’s provisions to be “budget neutral.” They are anything but.

The bill’s provisions require the Food and Drug Administration to hire more inspectors just at a time when Republican lawmakers have sworn to cut domestic spending. The FDA also must translate the bill’s requirements and exemptions for small farmers into regulations.

Rule-making is a lengthy process subject to public comment and, therefore, political maneuvering. Watch the lobbying efforts ratchet up as food producers, large and small, attempt to head off safety rules they think they won’t like.

Expect more lawsuits over the scientific basis of health claims. The Federal Trade Commission just settled a $21 million claim against Dannon for advertising that yogurt protects against the flu. The agency also has gone after scientifically unsubstantiated claims that omega-3s in kiddie supplements promote brain development and that pomegranate juice protects against prostate problems. POM Wonderful has already countersued the FTC on grounds that the First Amendment protects commercial speech. I’ll be watching this case carefully.

The FDA will issue new front-of-package label regulations. The FDA has promised to propose an at-a-glance symbol to indicate the overall nutritional value of food products. Food companies like the Guideline Daily Amount spots they are using in the upper corners of food packages because the symbols are factual but nonjudgmental. The FDA, however, is considering red, yellow and green traffic-light symbols that do convey judgments. Food companies say they will not voluntarily use a symbol that tells people to eat less of their products.

Will the FDA have the courage to make traffic lights mandatory? It will need courage. The new British government dealt with the traffic-light idea by summarily dismantling the food agency that suggested it.

Corporations will seek new ways to co-opt critics. Under the guise of corporate social responsibility, food companies have been making large donations to organizations that might otherwise criticize their products. The most recent example is the decision by Save the Children, formerly a staunch advocate of soda taxes, to drop that cause coincidentally at a time when its executives were negotiating funding from Coca-Cola.

Such strategies remind me of how the Philip Morris cigarette company distributed grants to leading arts groups. Expect food companies to use generosity to neutralize critics and buy silence.

School meals will make front-page news. Congress passed the Healthy, Hunger-Free Kids Act last month. Now the USDA must implement it by setting nutrition standards, adding fresh fruits and vegetables (some locally grown) and expanding eligibility.

President Obama has promised to restore the $4.5 billion “borrowed” from the SNAP (food stamp) program to fund this act. The scrambling over the regulations and financing should make excellent spectator sport.

Farm bill advocates will be mobilizing. You might think it too early to be worrying about the 2012 Farm Bill, but I’ve already gotten position papers analyzing commodity and food-assistance issues from groups gearing up to lobby Congress to bring agricultural policy in line with nutrition and public health policy.

I have a personal interest in such papers. I will be teaching a course on the Farm Bill at New York University next fall. Please get busy and write more of them!

Happy new year, and let’s see how my guesses play out.

In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes “The big issue is ultra-processing.”  Because his Commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.

The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.

Monteiro makes it clear that all foods and drinks are processed to some extent.  Fresh apples are washed and, sometimes, waxed.  Drinking water is filtered.  Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:

• Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
• Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt.  These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
• Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).

The purpose of Type 3 ultra-processing is to create:

durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration (‘long shelf life’), to be transportable for long distances, to be extremely palatable (‘high organoleptic quality’) and often to be habit-forming. Typically they are designed to be consumed anywhere – in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.

Monteiro argues: “the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world.”

As evidence, he notes that ultra-processed products as a group are:

• Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
• [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
• Relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy.
• Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
• Available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
• The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.
• Promoted by lightly regulated or practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being of children.

Overall, he says:

Their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.

His groups the main points of his argument in three theses:

• Diets mainly made up from combinations of processed ingredients and unprocessed and minimally processed foods, are superior to diets including substantial amounts of ultra-processed products.
• Almost all types of ultra-processed product, including those advertised as ‘light’, ‘premium’, supplemented, ‘fortified’, or healthy in other ways, are intrinsically unhealthy.
• Significant improvement and maintenance of public health always requires the use of law. The swamping of food systems by ultra-processed products can be controlled and prevented only by statutory regulation.

Lest there be any confusion about the significance of this proposal for public health nutrition, an accompanying editorial (unsigned but assumed to be by Geoffrey Cannon) poses a serious challenge: “Nutrition science: time to start again.”

This editorial is about the significance of food processing, and in particular of ‘ultra-processed’ food and drink products. It is also about the nature, purpose, scope and value of nutrition science, which as conventionally taught and practiced, is now widely perceived to have run into the buffers or, to change metaphor, to have painted itself into a corner.

The editorial argues that nutritionists’ focus on nutrients, rather than foods, has led to the assumption that if foods contain the same nutrients, they are the same—even though it is never possible to replicate the nutritional content of foods because too much about their chemical composition is still unknown.

This notion is an exquisite combination of stupidity and arrogance, or else of intelligence and cunning. For a start, similar results can only be of those chemical constituents that are at the time known, and actually measured.

These are important ideas, well worth consideration and debate.  I am struck by their relevance to the latest survey of soft drink availability in American elementary schools.  Despite the efforts of the Clinton Foundation and the voluntary actions of Coca-Cola and Pepsi-Cola, the availability of soft drinks to young school children increased from 49.% to 61% just in the year from 2006-07 to 2008-09.  Soft drinks, in Monteiro’s terms, are ultra-processed.  Doing something about them requires statutory regulation.

Consideration of the effects of ultra-processing might help us look at what we feed our kids in a more constructive way.  This is important work.

Addition: I should have mentioned that Monteiro’s approach is consistent with that of the people (including me) who worked with the Strategic Alliance in Oakland, CA to write Setting the Record Straight: Nutritionists and Health Professionals ” Define Healthful Food.

The Alliance is California’s network of food and activity advocates, we’ve developed a definition of healthy food that asserts that truly healthful food comes from a food system where food is produced, processed, transported, and marketed in ways that are environmentally sound, sustainable, and just.

If you agree with Setting the Record Straight, you can endorse it on the Strategic Alliance’s website.

I’ve been saying for ages that the sugar composition of high fructose corn syrup (HFCS) is no different from that of table sugar (sucrose).

Oops.  A new study in the journal, Obesity, actually measured the amounts and kinds of sugars in 23 kinds of HFCS-sweetened drinks.

The findings are summarized in a fact sheet:

• The sugar content varied widely from amounts stated on labels.  Some drinks had 15% less sugar than labeled, but others had as much as 30% more.
• On average, the drinks had 18% more fructose than expected.
• Several brands of sodas seemed to be made with HFCS that is 65% fructose, not 55%.
• The average amount of fructose in the drinks was 59%.

The press release points out one other finding.  You know how everyone thinks Mexican Coca-Cola is so much more delicious than American Coke because it is made with table sugar (sucrose), not HFCS?  Oops again.  The investigators could not find any sucrose in the Coke, but did find plenty of glucose and fructose.  This suggests that Mexican Coke is also made with HFCS (or it could also mean that the sucrose had been split into its constituent glucose and fructose).

To review the biochemistry: sucrose is a double sugar of glucose and fructose bonded together.  HFCS is glucose and fructose, separated.  The sucrose bond is quickly split in the intestine and its glucose and fructose are the same as those in HFCS.

The metabolic problems that result from sugar intake are mostly due to the fructose content.  Less is better for health.  More is better for the soft drink industry, however.  Fructose is sweeter than either glucose or sucrose, and sweet is what sells sodas.

At most, HFCS is supposed to be 55% fructose, as compared to the 50% in table sugar.  Most foods and drinks are supposed to be  using HFCS that is 42% fructose.  A percentage of 55 is not much different biologically than 50, which is why the assumption has been that there is no biologically meaningful difference between HFCS and table sugar.   This study, if confirmed, means that this supposition may need some rethinking.

The study names the beverages that contain 65% fructose: Coke, Pepsi, Sprite. It identifies Dr. Pepper, Gatorade, and Arizona Ice Tea as containing close to 60% fructose.

If, in fact, the percentage of fructose is higher than advertised, it’s another good reason to avoid sugar-sweetened beverages.

Addition and possible caution:  I’ve now heard separately from two experts on measuring sugars in beverages who point out serious flaws in the methods used in this study:

• The results are based on one beverage sample, analyzed once.   Analytical methods invariably produce ranges of values and require multiple samples and analyses.
• Measuring sugars in beverages is technically challenging and there are several possible methods, some of which give more accurate results than others.  Although the paper says the investigators used standard methods, it does not specify which.
• The methods used did not seem to detect the small starches or maltose that are always present in HFCS.  If the methods “read” the little starches as fructose, the percentage could easily have been 59 rather than 55.
• The drinks that contained 65% fructose were bottled drinks, and that is a concern.  The fountain drinks are mixed by the company–McDonald’s or Burger King–and could have been made too concentrated by whoever did the mixing.
• The failure to find sucrose in Mexican Coca-Cola could be two to two reasons: the Coke is old and the sucrose “inverted” (split into glucose and fructose), or the company used HFCS instead of sucrose.

The bottom line remains the same: it’s best not to eat too much sugar or any kind.

Addition, October 27: Cara Wilking, an attorney with the Public Health Advocacy Institute in Boston, notes that this study raises the possibility that HFCS violates federal prohibitions against:

• False and misleading food labeling
• Food adulteration
• False and misleading advertising

It will be interesting to follow how the lawyers deal with these issues.

The most thoughtful comments I’ve seen on the proposal to block food stamp recipients from buying sodas come from Andy Fisher’s post on Civil Eats.

Mr. Fisher is currently a Kellogg Food and Society Fellow with the Institute for Agriculture and Trade Policy in Minneapolis.  He is the Co-Founder/Executive Director of the Community Food Security Coalition (CFSC).

I have added the red-highlighted emphases:

Banning Soda for Food Stamps’ Recipients Raises Tough Questions

October 8th, 2010  By Andy Fisher

On Thursday, New York City Mayor Michael Bloomberg announced that he had asked the US Department of Agriculture to allow the city to exempt soda from the permitted list of items its 1.7 million food stamp recipients can purchase with their benefits. This ban would last for two years, enough time to assess its effects and determine whether the ban should be continued on a permanent basis. New York City food stamp recipients spend an estimated $75 million to $135 million of their $2.7 billion in food stamps annually on soda, according to AP.

Anti-hunger and public health advocates at odds over proposal

Public health advocates contend the obesity epidemic is costing the US hundreds of billions of dollars per year in increased health care costs, and sugar sweetened drinks are a major factor.   They correctly note that low income persons tend to have higher rates of diet related diseases than the general public: poor New Yorkers have twice the rate of adult-onset diabetes than compared to the wealthiest. Mayor Bloomberg noted, “Sugar-sweetened drinks are not worth the cost to our health, and government shouldn’t be promoting or subsidizing them.”

On the other hand, anti-hunger advocates argue that food stamp recipients should have the same freedom of choice at the supermarket checkout counter as any middle class person. Exercising that freedom is a matter of personal dignity that the poor all too often are not afforded. Restricting soda is the first step in a slippery slope toward further demeaning regulations on what food stamp recipients can buy.  They correctly point out that poor people often can’t afford produce, as nutritious foods tend to be more expensive per calorie than less healthy food.

The anti-hunger community is correct that historically, as a nation, we have treated the poor paternalistically. American social, educational and health policy is littered with countless examples of this failed approach. Regulating what food stamp recipients can and can’t buy with their benefits puts forth the message that they are not capable of making good decisions, and the government needs to set forth boundaries to protect them from their own poor choices. To the contrary, some studies have shown that food stamp recipients actually buy more nutritious food per dollar than non-food stamp recipients.

Anti-hunger advocates are also right that poor people typically can’t afford nutritious foods. Highly processed foods, such as ramen, fill up a belly more cheaply than broccoli and whole wheat pasta.  In our food system, high calorie foods with low nutritional value are cheaper than nutrient dense foods. For example, a 12 pack of 12 ounce cans of Coke (144 oz) at Kroger’s costs $2.79 on sale, while a half gallon (64 ounces) of Minute Maid orange juice (also a Coca Cola Inc. product) is $2.49. The bad choice is the cheap choice.

On the other hand, public health groups are dead-on accurate that it is irresponsible public policy to be subsidizing with tax dollars the purchase of unhealthy products that will burden society with increased health care costs in the future.  As a nation, we’re subsidizing soda companies $4 billion annually through the food stamp program. In return, decades later, the public will be stiffed with the hospital bill for billions of dollars more for extra health care costs from these poor dietary choices.

Thorny issue raises questions

Why are anti-hunger advocates in the absurdly precarious position of protecting the right of poor people to drink soda? Do I have a right as an American to poison myself with “soft” drinks that can dissolve the rust off a car? Does it matter whether I use my own money or tax dollars?  Should freedom of choice apply to products of marginal utility if not harmful products?

Why does it cost Coca-Cola more to produce a half-gallon of orange juice than a half gallon of Coke? How do we reverse this situation, such that healthful products are more affordable and unhealthy products are more costly?

Are food stamps an income support program- or as the program’s new name indicates, a Supplemental Nutrition Assistance Program? If it is a “supplemental nutrition” program, then shouldn’t USDA define which products are nutritious based on Institute of Medicine standards, and limit purchases to these products? USDA does this with the Women Infants and Children (WIC) program, which is widely touted for saving billions in health care costs.

If food stamps are an income support program, and anti-hunger advocates want to maximize poor people’s freedom of choice, then why shouldn’t food stamps be distributed as cash rather than as a debit card good for food purchases? Doesn’t receiving cash maximize a person’s dignity as it bestows trust upon that person that he or she will make the right choice with their money?  Would food stamps not then become a welfare program, and be subject to the negative public perception of welfare?

The real story behind food stamps is that it is neither a nutrition program nor an income support program. It is a massive subsidy for the food retailers, grocery manufacturers, and industrial growers. That is why commodity groups, the Grocery Manufacturers of America and the Food Marketing Institute all line up behind the food stamp program every five years when the Farm Bill is being debated. They know the extra buying power food stamps provides to low income Americans will end up in their pockets.

In their noble effort to reduce human suffering and to improve the livelihood of the 41 million Americans on food stamps, anti-hunger advocates are caught in an ever-tightening bind. They frame food stamps as a nutrition program, because a nutrition program has more public support and more powerful allies in Congress than a welfare or income support program. Yet, burgeoning rates of chronic diseases and the growing presence of the public health community as a player in federal food and farm policy, translates into increased accountability for the nutritional impact of the food stamp program.

What boat are both camps missing?

There is one very important point neither the anti-hunger nor the public health advocates are making. Our tax dollars, especially the $80-90 billion spent annually on federal food programs, are a powerful force in shaping the food system. Food stamps, like school meals and WIC, should be the cornerstone of a food system that is grounded in principles of environmental sustainability, social justice, and health. Directed toward the small farm economy, community-oriented retailers, brokers, and processors, even a modest percentage of these funds could ignite a transformation of our food system.

Consider this. While nationally food stamp recipients are spending $4 BILLION per year on soda, in 2009, only $4 MILLION of food stamps were redeemed at farmers markets. This difference is shaped by the fact that USDA has not equipped farmers markets with free debit card terminals (which are needed to accept food stamp benefits), and prohibited federal nutrition education programs to promote farmers markets. Does this mean the Department of Agriculture values soft drinks one thousand times more than farmers markets?

Mayor Bloomberg has proposed only half the solution. USDA should grant him the waiver he requests if and only if New York City agrees to redirect the $75-$135 million that would have otherwise been spent on soda to programs that encourage food stamp recipients to purchase locally grown foods at farmers markets, community supported agriculture farms, and other community-oriented venues.

A reader writes that the discussion over genetically modified foods makes no sense because: “virtually every food we consume today  has been genetically  modified.”

The accuracy of this statement depends, of course, on how you define “genetically modified.”  If you include traditional genetic crosses done through plant and animal breeding, the statement is correct.

If, however, you restrict the definition of GM foods to those involving actual manipulations of DNA (rather than eggs and sperm), and the insertion of DNA from one organism into the DNA of another, then the number of GM foods approved for production in the United States is quite limited.

The FDA provides a list of such foods in its inventory of completed consultations on bioengineered foods.

The list includes GM corn, soybeans, cotton, cotton, alfalfa, canola, and sugarbeets, most of which are fed to animals or used as ingredients in processed foods.

But what about supermarket fruits and vegetables?  To answer this question requires a clear separation between approval of production and actual production.

To date, the FDA has approved production of GM varieties of plums, cantaloupe, papaya, squash, radicchio, tomatoes, and potatoes.  Note: sweet corn–the kind you eat off the cob–is not on the list.

Even if approved, the GM varieties may not be in your supermarket.  GM varieties, it turns out, are difficult to produce under field conditions.

When I was doing the research for What to Eat in 2005 or so I tried hard to find out which supermarket foods might be GM.  This was not easy.  Basically, nobody knew.  Unless you test for GM, you can’t tell, and nobody was testing.

So I did some testing.  The foods most highly suspected of being GM were papayas from Hawaii engineered to resist ringspot virus.  I sent samples of seeds from several varieties of supermarket papayas to GeneticID, a company that does such testing (at, alas, great expense).   As I recount in the book, the only papaya that tested positive was the one from Hawaii.  The one labeled organic did not and neither did any of the others.

I believe that the public has a right to know whether supermarket foods are GM varieties.  Without labeling, you can’t tell.  That is why we need GM labeling.

As I explained a year ago, the U.K. requires labeling of GM ingredients and companies making products with GM ingredients do so.  We could do this too, and we should.

Addition: The Associated Press writes about the significance of these discussions (I’m quoted).