Search results: sugar policy

Thanks to Courtney Scott, a doctoral student at University of North Carolina, for sending me this account of the fate of Britain’s salt reduction strategies, published in the BMJ (British Medical Journal).

The lead author on the article is Dr. Graham MacGregor, Britain’s leading advocate for diets lower in salt.  It is about the derailing of Britain’s remarkable successful salt reduction strategy.

Under the auspices of Britain’s Food Standards Agency (FSA), the salt reduction program initiated in the early 2000s—getting companies to slowly but steadily reduce the salt in their products—was working well.

Most impressive: salt intake, blood pressure, heart disease, and stroke declined in parallel with the decline in salt in the food supply.

But in 2010, Britain elected a more conservative government.

Andrew Lansley was appointed secretary of state for health, and he moved the responsibility for nutrition from the FSA to the Department of Health. This disrupted the salt reduction programme, making it unclear who would be responsible for the policy. In 2011 Lansley launched the responsibility deal, whereby he made the alcohol and food industries responsible for reducing alcohol consumption and improving nutrition, respectively. As a result, salt reduction lost momentum.

The key points of the article:

• Most of the foods that industry currently provide are very high in salt, fat, and sugars and are therefore more likely to cause cardiovascular disease and predispose to cancer than healthier alternatives.

• The UK’s salt reduction programme…led to a significant reduction in population salt intake, accompanied by reductions in blood pressure and cardiovascular mortality.

• The programme has been set back by the coalition government’s decision to hand power back to the food industry as part of the responsibility deal.

• An independent agency for nutrition with a transparent monitoring programme is urgently needed to improve the food that we eat.

As I’ve explained previously, most salt—80% or more—in American diets is already in processed and prepared foods when they are presented to us.  That’s where the salt reduction has to come from.  As the authors explain,

Members of the food industry have said that they are keen to reformulate their foods to make them healthier. All they require is to be on a “level playing field” with the other major companies, so that they can make their foods healthier in a structured, incremental way. They need to be assured that there are proper reporting mechanisms in place and that all of the companies are being monitored equally. Enforcement is required, and if it doesn’t work, regulation or legislation must be enacted.

The debates over salt may be the most contentious in the field of nutrition (as the Washington Post puts it), but the parallels between the British decline in salt intake and in salt-related disease are impressive.

On a population basis, eating less salt is healthier.

This is something you can’t easily do on your own.  The food industry has to do it.  And food companies don’t want to, for obvious reasons.

Hence: the need for regulation.

PoliticoPro Morning Agriculture reports on USDA Secretary Tom Vilsack’s speech to the Consumer Federation of America’s National Food Policy Conference in Washington, DC.

About changing the rules so that SNAP benefits could not be used to buy unhealthy foods, Vilsack said:

[recipients] may buy a little bit more soda, but they might buy less salty snacks than we do.  They might purchase a little more of this than we do, than non-SNAP families, but we purchase a lot more sugary stuff than they do in other categories, so it’s kind of a wash…It’s also extremely difficult to set up a system that distinguishes between various items.  You set that system up, what’s going to happen is that people won’t be able to buy apple juice, they won’t be able to buy orange juice… Our thinking is that a better way to approach this is to educate people so they make the right choice, they make the healthy choice [my emphasis].

Ah yes.  Education.  As an educator, I’m all for it, but let’s get real.

For this analysis, I am indebted to Daniel Bowman Simon, who does the math:

• SNAP benefits =  $70 billion in 2014, for about 46 million participants.
• Therefore, the average SNAP participant received about $1504 per year in SNAP benefits.
• The USDA provides Nutrition Education and Obesity Prevention Grants for SNAP (see section 241)= $375 million.
• Therefore, the average SNAP participant received about $8 per year in nutrition education.
• The USDA also provides double-value awards ($31 million) to help SNAP participants buy fruits and vegetables.
• This adds an average of 66 cents per year for each SNAP participant to make healthy choices.

Thought for today:  How much nutrition education does $8.66 buy?

This is why regulation of the SNAP package is a better approach—once we get past congressional attempts to cut the program out of existance (an exaggeration, but you know what I mean).

• ‘Big Food’: taking a critical perspective on a global public health problem, by Simon N. Williams & Marion Nestle. 

• The transitional dynamics of caloric ecosystems: changes in the food supply around the world, by Sanjay Basu.
• Big Food without big diets? Food regimes and Kenyan diets, by K. O’Neill.
• Density of outdoor food and beverage advertising around schools in Ulaanbaatar (Mongolia) and Manila (The Philippines) and implications for policy, by Bridget Kelly, Lesley King, Batjargal Jamiyan, Nyamragchaa Chimedtseren, Bolorchimeg Bold, Victoria M. Medina, Sarah J. De los Reyes, Nichel V. Marquez, Anna Christine P. Rome, Ariane Margareth O. Cabanes,John Juliard Go, Tsogzolmaa Bayandorj, Marie Clem B. Carlos & Cherian Varghese. 
• Snack food advertising in stores around public schools in Guatemala, by Violeta Chacon, Paola Letona, Eduardo Villamor & Joaquin Barnoya.  
• Comparison of food industry policies and commitments on marketing to children and product (re)formulation in Australia, New Zealand and Fiji, by Gary Sacks, Melissa Mialon, Stefanie Vandevijvere, Helen Trevena, Wendy Snowdon, Michelle Crino & Boyd Swinburn.  
• Encouraging big food to do the right thing for children’s health: a case study on using research to improve marketing of sugary cereals, by Jennifer L. Harris, Megan E. LoDolce & Marlene B. Schwartz.  
• Big Soda’s long shadow: news coverage of local proposals to tax sugar-sweetened beverages in Richmond, El Monte and Telluride.  Laura Nixon, Pamela Mejia, Andrew Cheyne & Lori Dorfman.  

Commentaries

• Big Food’ and ‘gamified’ products: promotion, packaging, and the promise of fun, by Charlene Elliott.
• Food as pharma: marketing nutraceuticals to India’s rural poor, by Alice Street.

Thanks to Simon Williams for initiating (and doing the heavy lifting on) this project, and to all the terrific contributors.

Enjoy!

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!

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

Joel Leftwich has left his job as senior director for PepsiCo’s public policy and government affairs team (since March 2013) to become staff director for the Senate Agriculture Committee now led by Pat Roberts (R-Kansas).

In some ways, it’s a perfectly logical appointment.  Before joining PepsiCo, Leftwich worked for Roberts as a legislative aide from 2005 to 2010 and as deputy staff director for the Ag Committee from 2011 to 2013.

But his connection to PepsiCo raises concerns.  The Ag committee will be dealing with several issues involving sodas and snack foods opposed by some members of Congress:

• Reauthorization of WIC, the Women, Infants and Children nutrition program (its requirements for healthy foods are always under pressure).
• Preservation of the school nutrition standards authorized by the Healthy, Hunger-Free Kids Act (under attack by the food industry and its friends in Congress).
• SNAP nutrition standards (there is a movement to make sodas ineligible for SNAP-EBT purchases).
• Issuance of the 2015 dietary guidelines, always under pressure not to say anything direct about not drinking sodas.
• Issuance of the new food labels.  The soda industry opposes putting in “added sugars.”   While this is FDA’s purview, not USDA’s, the Ag Appropriations Committee governs FDA’s appropriations.

And on the state level, it’s worth taking a look at what the Texas Commissioner of Agriculture is up to, courtesy of Bettina Siegel’s The Lunch Tray: “cupcake amnesty.”

Clearly, agricultural policies affect public health in highly prominent ways.

That’s why we need to do a much better job of connecting food policy to health policy.

And that’s why having a leading PepsiCo lobbyist in charge of agricultural committee staff raises serious concerns about conflict of interest.

Food Politics will mourn the passing of the Colbert Report.

What, you might ask, did the Colbert Report have to do with Food Politics?

Plenty.

For one thing, I was lucky (well, nonplussed) to appear on the show in August 2009.

The topic?  Sugar trade policy.

Oh.  Of course.

I explained what this was about in a blog post.

Better, Colbert did occasional pieces: Thought for Food.

Eater has collected them all in one place (thanks to Eleanor Talbot West for sending).

Or, if you want to watch them separately…

• Thought for Food – Domino’s Smart Slice & Doritos Jacked …
• Thought for Food – Fairlife Milk & Pizza Hut’s Subconscious …
• Thought for Food – Ban on Trans Fats & McDonald’s McRib …
• Thought for Food – Kentucky Tuna & Grilled Cheese Burger …
• Thought for Food – Spreadable Sharia & Buddy Cup – The ...
• Thought for Food – Bug Food Coloring, Hot-Dog-Stuffed …
• Thought for Food – KFC’s Go Cup & Powerful Yogurt – The …
• Thought for Food – Responsible Snacking & Second Breakfast
• http://www.feedyourheaddiet.com/the-western-diet-can-be-funny.html

It was great while it lasted.  I will miss the brilliant satire.

Addition: A reader just sent this link to Colbert’s in-character testimony to Congress on agricultural labor issues (from the expressions on the faces of the people sitting behind him, they must have been taking him seriously).

This is my week to be talking about the Dietary Guidelines, apparently.  Yesterday’s Politico Morning Agriculture, a news source on which I greatly depend, noted yet another attack on the Dietary Guidelines, this one from a group called  The Healthy Nation Coalition.

The Coalition wrote a letter to the secretaries of USDA and HHS, the agencies sponsoring the Guidelines, with many complaints about process and ineffectiveness.

I had never heard of this group, so I went to its website and laughed when I saw this graph—a terrific example of why epidemiologists insist that association does not necessarily say anything about causation.

The implication here is that the Dietary Guidelines either cause obesity (something patently absurd) or have had no effect on its prevalence (something only to be expected given the other changes in society that predisposed to obesity beginning in the early 1980s).

If anything, the Dietary Guidelines are a result of those forces in society, not their cause.

I have my own issues with Dietary Guidelines (see Fo0d Politics), mainly about the use of advice that is euphemistic (“choose lean meats”) or incomprehensible (reduce SoFAS—solid fats and added sugars), and their focus on nutrients (fat, sugar, salt) rather than foods.

But I can’t understand what this Coalition is about or what it wants.

Its website says the Coalition formed because

A sense of community has arisen around questioning our current approach to food and nutrition. Healthy Nation Coalition has its beginnings in the ancestral health, Weston A. Price Foundation, and low-carbohydrate nutrition communities.

I understand what the Coalition does not want.  It

suggests that the 2010 Guidelines are not appropriate for population-wide diet recommendations, especially with regard to restrictions on dietary fat, saturated fat, cholesterol and salt.

indicates that the 2010 Guidelines may lead to increased risk of weight gain, diabetes, and chronic disease in many populations.

indicates that reducing intake of sugars and starches has health benefits.

indicates that adequate, complete protein is a critical part of the adult diet and that many adults benefit from intakes above current minimum recommendations.

Here’s what it says it wants

the Healthy Nation Coalition proposes that this process be removed from the USDA and HHS and given to one or more independent agencies, offices, or entities that can create dietary guidance that is without bias and responsive to the needs of the people of America.

Really?  Like what?

The “ask” in the letter is this:

It is the duty of USDA and DHHS leadership to end the use of controversial, unsuccessful and discriminatory dietary recommendations. USDA and DHHS leadership must refuse to accept any DGA that fail to establish federal nutrition policy based on the foundation of good health: adequate essential nutrition from wholesome, nourishing foods. It is time to create DGA that work for all Americans.

But what would they look like?

I don’t recognize any of the names of the individuals listed as part of the Coalition.

Can anyone explain to me what this group wants and is about?