by Marion Nestle

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Feb 23 2015

Dietary guidelines shouldn’t be this controversial

The uproar caused by the release of the Scientific Report of the 2015 Dietary Guidelines Advisory Committee (DGAC) has been even noisier than I predicted, so noisy that USDA Secretary Vilsack appears to have pulled back on it.  He told Jerry Hagstrom (HagstromReport.com) that:

He wants people to realize that the process of writing the dietary guidelines “is just beginning today,” and that he and [HHS Secretary] Burwell will consider input from federal agencies and the general public. He said he wants to be sure that people “know that I know my responsibility.”

In this, Vilsack was referring to the directive by Congress in the 2015 appropriations bill blocking him from considering sustainability in the guidelines.

As for the DGAC report: It concluded:

…the U.S. population should be encouraged and guided to consume dietary patterns that are rich in vegetables, fruit, whole grains, seafood, legumes, and nuts; moderate in low- and non-fat dairy products and alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and beverages and refined grains.

Predictably, this did not go over well with the meat industry or, for that matter, other industries affected by such advice or groups funded by such industries.

Less predictably, the New York Times published an Op-Ed by Nina Teicholz, the journalist author of “The Big Fat Surprise,” a work based on her own review of the science of fat.  In her view, mainstream nutritionists have badly misinterpreted this science to the great detriment of public health.

Her conclusion:

…we would be wise to return to what worked better for previous generations: a diet that included fewer grains, less sugar and more animal foods like meat, full-fat dairy and eggs.

But Teicholz’ book has been the subject of a line-by-line analysis by Seth Yoder (whom I do not know personally).  Mr. Yoder did what graduate students in science are trained to do: read the references.

He looked up and examined the references Teicholz cites in the book as the basis of her views.  He documents an astonishing number of situations in which the references say something quite different from what Teicholz gets out of them.  At the very least, his analysis raises serious questions about the credibility of her views on the science of fat.

Let’s grant that the science of nutrition is difficult to do and complicated.  The New York Times should know this, which is why I’m surprised that it would give Teicholz so prominent a platform without countering them with point-counterpoint views of a respected nutrition scientist.

It does little to foster the health of the public to make nutrition science appear more controversial than it really is.

The basic advice offered by 2015 Dietary Guidelines Advisory Committee boils down to plain common sense:

  • Eat plenty of foods from plant sources
  • Eat foods from animal sources in moderation
  • Balance calories
  • Avoid overeating junk food

Unfortunately, this kind of advice doesn’t make headlines or, apparently, merit op-ed space in the New York Times.

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Feb 20 2015

The 2015 Dietary Guidelines Advisory Committee releases its courageous report

The 2015 Dietary Guidelines Advisory Committee (DGAC) issued its more than 500-page report yesterday.

Before I say anything about it, please note that this report informs, but does not constitute, the Dietary Guidelines. The agencies—USDA and HHS—write the actual Guidelines and are not expected to do so until the end of this year.

Here are what I see as the highlights (these are direct quotes)

  • A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.
  • A diet higher in plant-based foods…and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet.
  • It will take concerted, bold actions…to achieve and maintain the healthy diet patterns, and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative.

Some facts and statements from the report (not direct quotes).

  • Half the energy intake in U.S. diets comes from a combination of burgers and sandwiches (~14%), desserts and sweet snacks (8.5%), sugary beverages (6.5%), mixed dished made with rice, pasta, and other grains (5.5%, savory snacks (~5%), pizza (4.3%), and meat, poultry and seafood mixed dishes (~4%).
  • Nearly half of total sugar intake comes from beverages other than milk and 100% fruit juice

The report comments on issues under current debate.

  • Saturated fat: “replacing SFA with unsaturated fats…significantly reduces total and LDL cholesterol…Strong and consistent evidence…shows that replacing SFA [saturated fatty acids] with PUFA [polyunsaturated fatty acids] reduces the risk of CVD [cardiovascular] events and coronary mortality…For every 1 percent of energy intake from SFA replaced with PUFA, incidence of CHD [coronary heart disease] is reduced by 2 to 3 percent. However, reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD risk.”
  • Sugars: “Strong and consistent evidence shows that intake of added sugars from food and/or sugar sweetened beverages are associated with excess body weight in children and adults…Strong evidence shows that higher consumption of added sugars, especially sugar-sweetened beverages, increases the risk of type 2 diabetes among adults and this relationship is not fully explained by body weight.[Theae findings are] compatible with a recommendation to keep added sugars intake below 10 percent of total energy intake.”
  • Food labels: “Consumers would benefit from a standardized, easily understood front-of-package (FOP) label on all food and beverage products to give clear guidance about a food’s healthfulness.” [This refers to the recommendations of the Institute of Medicine that I’ve written about previously; they disappeared without a trace.]
  • Soda taxes: “Economic and pricing approaches, using incentives and disincentives should be explored to promote the purchase of healthier foods and beverages. For example, higher sugar-sweetened beverage taxes may encourage consumers to reduce sugar-sweetened beverage consumption.”
  • SNAP: “Policy changes within the federal Supplemental Nutrition Assistance Program (SNAP), similar to policies in place for the WIC program, should be considered to encourage purchase of healthier options, including foods and beverages low in added sugars. Pilot studies using incentives and restrictions should be tested and evaluated.”

The DGAC recommends (these are direct quotes but not necessarily complete):

  • Establish local, state, and Federal policies to make healthy foods accessible and affordable and to limit access to high-calorie, nutrient-poor foods and sugar-sweetened beverages in public buildings and facilities.
  • Set nutrition standards for foods and beverages offered in public places.
  • Improve retail food environments and make healthy foods accessible and affordable in underserved neighborhoods and communities.
  • Implement the comprehensive school meal guidelines (National School Lunch Program) from the USDA that increase intakes of vegetables (without added salt), fruits (without added sugars), and whole grains.
  • Limit marketing unhealthy foods to children.
  • Make drinking water freely available to students throughout the day.
  • Ensure competitive foods meet the national nutrition standards (e.g., Dietary Guidelines for Americans).
  • Eliminate sugar-sweetened beverages [from schools].
  • Nutrition Facts label should include added sugars (in grams and teaspoons).

And for all federal nutrition programs, the DGAC recommends:

  • Align program standards with the Dietary Guidelines for Americans so as to achieve the 2015 DGAC recommendations and promote a “culture of health.”

Congratulations to this committee for its courageous recommendations.

Why courageous?  See my previous comments on the objections to such advice.

The next step: public comment:

The public is encouraged to view the independent advisory group’s report and provide written comments at www.DietaryGuidelines.gov for a period of 45 days after publication in the Federal Register. The public will also have an opportunity to offer oral comments at a public meeting in Bethesda, Maryland, on March 24, 2015. Those interested in providing oral comments at the March 24, 2015, public meeting can register at www.DietaryGuidelines.gov. Capacity is limited, so participants will be accepted on a first-come, first-served basis.

Here’s your chance to support this committee’s excellent ideas and demonstrate public approval for diets that promote the health of people and the planet.

Note: the reactions to the report are pouring in and I will deal with them next week.  Enjoy the weekend!

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Feb 19 2015

Nestlé USA says its chocolates won’t have artificial colors or flavors by the end of this year

Nestlé (the giant food company, not me) announces that it is removing all artificial flavors and colors from its chocolate candies this year.

Nestlé USA announced today its commitment to removing artificial flavors and FDA-certified colors, like Red 40 and Yellow 5, from all of its chocolate candy products. By the end of 2015, more than 250 products and 10 brands including NESTLÉ® BUTTERFINGER®, CRUNCH® and BABY RUTH® will be free of artificial flavors and certified colors. Products will begin appearing on store shelves by mid-2015, and will be identified by a “No Artificial Flavors or Colors” claim featured on-pack.

Just to put this in perspective.  According to figures in Advertising Age (June 2014), this company took in revenues exceeding $99 billion in 2013, with a profit of more than $11 billion.  The U.S. accounted for $25 billion of that amount.

If  Nestlé USA does this, the rest of Nestlé is likely to follow.

And “No Artificial Flavors or Colors” ought to encourage other companies to do the same.

Artificial flavors and colors are totally unnecessary in food products.  Think of them as cosmetics.

Whether they do or do not induce behavioral problems in kids—a problem not easily resolved—getting rid of them makes good sense.

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Feb 18 2015

And now a word from our sponsors: The Dietitians Association of Australia

Michele Simon’s latest investigative report deals with sponsorship by food corporations of the Australian Dietetics Association.


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Consistent with her previous report on corporate sponsorship of the American dietetic association (now The Academy of Nutrition and Dietetics), this one finds that the Dietitians Association of Australia (DAA):

  • Is sponsored by Meat and Livestock Australia, Nestlé, Unilever, Dairy Australia, and the Egg Nutrition Council
  • Is a partner in the “Nestlé Choose Wellness Roadshow”
  • Has important members who work for Kellogg and PepsiCo
  • Has a spokesperson who is paid by Coca-Cola to present his research denying a connection between sugars and obesity
  • Displays recipes from corporate sponsors with branded products despite policies against such things
  • Is believed to have stripped a dietitian of her earned credential for speaking out against such conflicts of interest [*but see additional comments below].

The DAA offers its corporate sponsors the following benefits:

  • Credible, independent, expert partner for nutrition communications
  • Unparalleled opportunity to inform the Australian public through members and the DAA profile
  • Access to members and interest groups for advice
  • Information and expert advice on all nutrition and health issues
  • Opportunities to sponsor DAA programs

This is a good deal for food and beverage corporate sponsors.

It’s not such a good deal for DAA members.  At best:

  • They appear in conflict of interest.
  • Their advice appears bought.
  • They lose credibility.

As Simon concludes:

The health of all Australians depends upon the independence of the nutrition profession and its leadership’s ability to operate free of conflicts of interest and be the nutrition leaders they claim to be, free from sponsorship money.

*Additions:

February 19:  Dr. Sara Grafenauer APD PhD of the DAA wrote me an e-mail detailing charges of error in this account.  She also wrote to Michele Simon.   Food company sponsorship of nutrition professional societies deserves far more critical attention than it usually gets and I am glad to see this debate.

February 20: Dr. Grafenauer writes again: “Thank you for considering our concerns however, with all due respect, the following statement is factually incorrect and should be removed:

  • Is believed to have stripped a dietitian of her earned credential for speaking out against such conflicts of interest.

DAA’s credential, Accredited Practising Dietitian (APD) is very important to the association and its members. It has rigorous processes around its maintenance and integrity and would never be used for purposes other than it is designed (for such as ‘gagging’ a member as is suggested here). There is no basis for this potentially defamatory statement and DAA will take whatever steps are necessary to defend the credential.”

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Feb 12 2015

What’s up with the cholesterol guideline?

The Washington Post says that the 2015 Dietary Guidelines Advisory Committee is about to drop the long-standing guideline about restricting dietary cholesterol.

The 2010 Dietary Guidelines said “Consume less than 300 mg per day of dietary cholesterol.”

This is about the amount in one egg.

I have no idea what’s going on.  The Advisory Committee report has not yet been released so I don’t know what it says (I’ve heard rumors that it is to be released this week, which could mean late Friday afternoon on a holiday weekend).

Recall: no matter what the Advisory Committee says in its report, it does not write the Dietary Guidelines.  The agencies—USDA and HHS—do whatever they choose with the committee’s research report.

If the Committee really is dropping the guideline, I’d like to see its research rationale.

I’m wondering if research sponsored by the egg industry could have anything to do with this.

See, for example, this recent study concluding that people with coronary heart disease don’t have to worry about eating eggs.

We found no evidence of adverse effects of daily egg ingestion on any cardiac risk factors in adults with CAD over a span of 6 weeks.

You have to read the study carefully to find the funding source (these are usually at the end of articles, but this one is in the middle):

Disclosures. This study was conducted with funding from the Egg Nutrition Center/American Egg Board and the Centers for Disease Control and Prevention (Grant
No. 5U48DP001945-05).

And you have to read the tables carefully to find out that 90.6% of the subjects in this study were taking statins, nearly 90% were taking drugs to lower blood pressure, and nearly 80% were taking aspirin.  The discussion, however, does not mention this point making this study a classic example of the problems with conflicts of interest in research.

If the Advisory Committee is dropping the cholesterol recommendation, could it be because so many people are taking statins that dietary cholesterol doesn’t appear to matter so much anymore?

This story is getting a lot of press.  Here’s one from USA Today that quotes me and changes my name as it goes along (they have now fixed that).

Can’t wait to see what the report really says.

 

 

 

 

 

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Feb 9 2015

Red meat politics

I was interested to read Clare Foran’s piece in The National Journal on The Political Battle Over Red Meat.   It nicely summarizes the lobbying to stop the 2015 Dietary Guidelines Advisory Committee from saying that diets would be healthier and more sustainable if they included less red meat.

Her piece includes this illustration of why the meat industry objects to such ideas.

Infographic

Since 2000, the meat industry has been relatively quiet over the Dietary Guidelines, mainly because—as I discussed in Food Politics—this industry had won most of the political battles.

The 2000 Dietary Guidelines recommended 2-3 servings a day of 2-3 ounces of meat for a total of 4-9 ounces a day—an increase over previous recommendations.

But then:

  • The 2005 Guidelines folded meat in with other sources of protein: “When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.”
  • The 2010 Guidelines said “Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.”

If current trends in Guidelines continue, the meat recommendation might disappear entirely.

Meat industry lobbyists want to make sure meat maintains its historic place in the center of American plates.

What will the Dietary Guidelines Advisory Committee say?  Its report is due out soon.  Stay tuned.

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Feb 3 2015

Obama’s budget calls for a single food safety agency!

Starting on page 82 of President Obama’s 150-page, $4 trillion 2016 federal budget is a section on food safety calling for creation of a single food safety agency.

The Budget proposes to consolidate the FSIS [the Food Safety and Inspection Service of USDA] and the food safety related components of the FDA to create a single new agency within HHS…A single Federal food safety agency would provide focused, centralized leadership, a primary voice on food safety standards and compliance with those standards, and clear lines of responsibility and accountability that will enhance both prevention of and responses to outbreaks of food borne illnesses.  It would rationalize the food safety regulatory regime and allow the Federal government to better allocate resources and responsibilities.

Wow!  Food safety advocates in and out of government have been pushing for something like this since the early 1990s.

Food safety lawyer Bill Marler says:

The budget proposes an additional $301 million for the FDA to implement that law, though part of the money would come from user fees imposed on the food industry.

Where do I apply?

Is this a good idea?  It sure could be but the devil is in the details.

Does it have a chance in this Congress?  I’m not holding my breath.

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Feb 2 2015

Food Politics 101: The School Nutrition Association vs. Fruits & Vegetables

The School Nutrition Association (SNA) is the organization that ostensibly represents the interests of school food service personnel.

I say ostensibly because the SNA has moved in a quite different direction.  It now fully represents the interests of its corporate food industry donors.

In the recent past, it supported federal efforts to improve the nutritional quality of school meals.  Now it fights all efforts to do so.

Recent events illustrate these points.

1.  Nancy Huehnergarth reports on the SNA meeting in Phoenix:

The annual conference, which this year ran from January 11 through 13, is “where school nutrition directors and industry representatives [came] together to build successful partnerships to better serve the nation’s children,” according to the SNA’s website. But a review of the conference agenda, speakers, educational sessions and sponsors paint a far different picture — one of an overwhelmingly industry-driven event heavy on the promotion of food and beverage offerings from major processed food corporations.

2.  The SNA has just issued a Position Paper on school meals.

It calls for more funding for school meals (good idea).

But then it insists on some very bad ideas:

  • Stop requiring fruits and vegetables to be served with every meal.
  • Don’t require so much whole grain.
  • Back off on lower sodium.
  • Allow any junk food to be part of the reimbursable meal.
  • Allow any junk food to be sold in competition with school meals.

In other words, return to the junk food school environment that flourished before the Institute of Medicine wrote two reports on improving the nutritional quality of school meals, Michelle Obama instituted Let’s Move!, Congress passed the Healthy, Hunger-Free Kids Act of 2010 authorizing USDA to set nutritional standards, USDA wrote those standards, and most schools in the United States went right ahead and implemented them.

The ostensible reason for the pushback?  Prevent waste.

3.  The Food Research and Action Center (FRAC) did an analysis of trends in student participation in school meals.

This  research firmly counters the idea that students are turning away from school meals in droves in order to avoid having to eat fruits and vegetables.  It cites the recession and the increased price of the lunches as the reasons for the decline in participation.

Writing in Politico, Helena Bottemiller Evich points to the politics:

Student rejection of fruits, vegetables and whole-grain products and declining participation has been a key part of the political debate over the push to relax some of the new standards. The move has sparked a battle that is expected to intensify this year as Congress looks to reauthorize the law governing school nutrition programs.

4.  Tom Stenzel, president and CEO of United Fresh Produce Association issued a response to SNA.

While we agree with many recommendations in the School Nutrition Association’s (SNA) 2015 Position Paper, we are deeply disappointed that SNA has chosen to continue its ill-advised fight against serving kids more fruits and vegetables in schools. The requirement that kids receive one-half cup of fruits or vegetables in school meals is being successfully met by tens of thousands of schools across the country. This is a modest step for the health of our children, especially in these critical learning years. When health classes teach students to make Half Their Plate consist of fruits and vegetables, it would be unconscionable for the school cafeteria to undercut that message by not serving at least one-half cup in school meals.

With friends like the SNA, school food advocates don’t need enemies.

Chalk this one up to food industry divide-and-conquer strategies.  Food companies pay SNA’s bills.  They get what they pay for.

The SNA ought to be the strongest advocate for healthier school meals.  It’s a tragedy that this organization has become the leading defender of junk food.

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