by Marion Nestle

Search results: PURE study

Dec 20 2023

Lead in baby food pouches: not a pretty story

A few weeks ago,  the FDA announced  volunary recalls of  3 brands of baby pouches containing apple sauce with cinnamon, because they contained excess lead.

Lead is poisonous to children’s nervous systems and brain development; there is no safe level of lead intake.

DO NOT LET YOUR KIDS EAT THESE PRODUCTS!

 

 

 

 

 

 

 

 

The FDA inspected the plant in Ecuador where cinnamon apple sauce is made; the amounts of lead were shockingly high.  Food Safety News reports:

The applesauce, sold in pouches packaged for children, has been found to have a lead content of 5110 parts per million (ppm) and 2270 ppm. The international Codex body is considering adopting a maximum level of 2.5 ppm for lead in bark spices, including cinnamon.

What is even more shocking about this situation is how the FDA found out about the lead—not by testing but because

…a developing investigation by the North Carolina Department of Health and Human Services and the North Carolina Department of Agriculture & Consumer Services [found] about four children with elevated blood lead levels, indicating potential acute lead toxicity.

The state investigation identified WanaBana apple cinnamon fruit puree pouches as a potential shared source of exposure. As part of their investigation, the department of health and human services analyzed multiple lots of WanaBana apple cinnamon fruit puree, detecting extremely high concentrations of lead.

The FDA then announced it was investigating cinnamon as a source of the lead.

It traced the cinnamon to a supplier in Ecuador.

The FDA suspects that somewhere along the supply chain, someone deliberately added lead to the cinnamon to maintain its color and increase its weight.

This reminds me of the addition of Chinese melamine to pet food and infant formula in 2006 and 2007 (I wrote about the pet food scandal in Pet Food Politics: The Chihuahua in the Coal Mine).

This also points to the need for strengthening the FDA.  It is not required to test products for lead and neither are manufacturers.

The FDA has proposed action levels for lead in foods, but these are neither final nor implemented.

The New York Times quoted Tom Neltner, safety expert at the Environmental Defense Fund:

That the levels of lead in children’s blood tends to be the first line of detection for lead in food is “effectively using kids as canaries…What this shows is a breakdown in the agency, and an industry that needs to be fixed.”

By industry, I’m assuming he means baby food and I could not agree more.

Pouches may be convenient for parents, but they promote sweet tastes and don’t teach kids how to eat real foods.  One study concluded:

Squeeze pouch products available in Australia are nutritionally poor, high in sugars, not fortified with iron, and there is a clear risk of harm tothe health of infant and young children if these products are fed regularly. The marketing messages and labelling on squeeze pouches are misleading and do not support WHO or Australian NHMRC recommendations for breastfeeding or appropriate introduction of complementary foods and labelling of products. There is an urgent need for improved regulation of product composition, serving sizes and labelling to protect infants and young children aged 0–36 months and better inform parents.

That goes for U.S. products too.

Caveat emptor.

Jun 5 2023

Conflicted interest of the week: multivitamins and memory

Here’s another one that several readers have asked me about: Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial.  Authors: American Journal of Clinical Nutrition. DOI:https://doi.org/10.1016/j.ajcnut.2023.05.011

The study: “Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y.”  Primary outcome measure: change in episodic memory (immediate recall performance on the ModRey test, after 1 y of intervention).  Secondary outcome measures: changes in episodic memory over 3 y of follow-up,  and in performance on neuropsychological tasks of novel object recognition and executive function over 3 y.

Results: “Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes…we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change.”

Conlusion: “Daily multivitamin supplementation, compared with placebo, improves memory in older adults.”

Conflict of interest: HDS, JEM, and AMB received investigator-initiated grant support to their institutions from Mars Edge. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. HDS received investigator-initiated grants from Pure Encapsulations and Pfizer Inc and honoraria and/or travel for lectures from the Council for Responsible Nutrition, BASF, NIH, and the
American Society of Nutrition during the conduct of the study. No funding sources had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Funding: This work was supported by an investigator-initiated grant from Mars Edge, a segment of Mars Inc dedicated to nutrition research. Pfizer Consumer Healthcare (now Haleon) provided support through the
partial provision of study pills and packaging.

Comment:  This study continues to surprise me.  As I’ve written before, it is part of the COSMOS trial, which is also supported by grants from NIH and a private foundation.  In my previous post on it, I noted that despite being funded by Pfizer (which makes Centrum Silver multivitamin supplements), the study did not show benefits of the supplement for prevention of cardiovascular disease or cancer—a rare exception to the rule that industry-funded studies tend to favor the sponsor’s interests.  But here we go again, this time with an equally surprising result but for a different reason: most multivitamin studies have shown no benefits whereas this one says if you take Centrum Silver, it will give you another three years of no loss in memory.  Wow!  I’ll be Pfizer is thrilled.

Here’s what the NIH National Center for Complementary and Integrative Health says about multivitamins:

Multivitamins/multiminerals (MVMs) are the most frequently used dietary supplements, with close to half of American adults taking them. MVMs cannot take the place of eating a variety of foods that are important to a healthy diet. Foods provide more than vitamins and minerals. Many foods also have fiber and other substances that can provide health benefits. However, some people who don’t get enough vitamins and minerals from food alone, or who have certain medical conditions, might benefit from taking one or more of these nutrients found in single-nutrient supplements or in MVMs. However, evidence to support their use for overall health or disease prevention in the general population remains limited.

Some of its conclusions:

  • Most individuals can get all of the necessary vitamins and minerals through a healthy eating pattern of nutrient-dense foods.
  • Taking an MVM increases overall nutrient intake and helps some people get the recommended amounts of vitamins and minerals when they can’t or don’t get them from food alone.
  • There’s no standard or regulatory definition for MVMs, or any dietary supplement, as to what nutrients they must contain or at what levels. .
  • People with healthier diets and lifestyles are more likely to take dietary supplements, making it hard to identify any benefits from their use. There’s no convincing evidence that MVMs help prevent chronic disease.

We will see whether this study causes the Center to change any of this.

Mar 31 2022

Marketing works! A post stolen (OK, with permission) from ConscienHealth

I am a big fan and daily reader of ConscienHealth, mainly because its producer, Ted Kyle, invariably and consistently has something interesting to say about whatever he is writing about (obesity and health, usually).

I liked this one so much—it sounds just like something I would say—that I asked his permission to reproduce it.  He agreed.  Enjoy!

Controlled Study Shows How to Sell Less Easter Candy (if you click on the link, you can find the place to subscribe or comment)

Not every study in PLOS Medicine is thoroughly impressive, but this one is pure genius. Researchers at the University of Oxford have discovered that if grocers don’t promote Easter candy, they will sell less of it. But wait, there’s more. Those same researchers showed that promoting “healthy items” – like low fat potato chips – yields higher sales for those health-promoting snacks.

PLOS Academic Editor Jean Adams obviously recognized the genius of this research by Carmen Piernas, Georgina Harmer, and Susan Jebb. So she published an opinion paper alongside them, praising it. She says:

“Piernas and colleagues’ studies add to the accumulating evidence that restricting marketing on less healthy foods and encouraging marketing on healthier foods may be an effective way to support public health.”

But she also lamented the fact that implementation of tighter regulation of food marketing is slow to come. She calls it “a sad indictment of our collective inability to create a world that supports everyone to eat in the way they want to, rather than the way the marketers want for us.”

Easter Egg Hunts and a Trip to the Zoo

There’s a lot of great material in this trifecta of medical research and commentary. Adams tells us that supermarkets are out of control:

“The concentration of food marketing in grocery stores can feel particularly overwhelming with parents describing the ‘temptation’ as ‘like a trip to the zoo every week’ for their children.”

Seeing the brilliance of this research and commentary, headline writers got into the spirit. Our favorite:

Hiding Easter eggs better in supermarkets could rescue UK’s waistlines, Oxford study claims

Clearly, journalists understand how to capture the essence of serious public health science.

Actual Health Outcomes?

Crispy Fruit

Crispy Fruit, photo by Ted Kyle

There’s just one tiny gap in this beautiful story. None of this research offers any evidence of healthier waistlines. It presumes that selling less Easter candy and more low-fat chips will cause waistlines to shrink.

Good luck with that. For decades now, food marketers in the U.S. have been selling us all kinds of food with claims that it’s healthy stuff to eat. Sales boomed and obesity kept rising. Onward and upward.

So count us skeptical that selling more low-fat chips and a little less Easter candy will put a dent in the UK problem with obesity.

Click here for the Easter candy study and here for the study of merchandising for low-fat chips. For the commentary by Adams, click here. And if this screed hasn’t been enough, click here for our further thoughts on the quest for a sustainable, nourishing, food supply.

Mar 22 2022

Industry-funded trial with surprising results

Yesterday I reported about the COSMOS clinical trial demonstrating reductions in mortality among people taking cocoa flavanol supplements.

That trial had another arm: multivitamin supplements.

The study: Multivitamins in the Prevention of Cancer and Cardiovascular Disease: The COSMOS Randomized Clinical Trial.  Sesso HD et al.  The American Journal of Clinical Nutrition, nqac056, https://doi.org/10.1093/ajcn/nqac056

Conclusion: The supplements did not reduce cardiovascular disease, cancer, or all-cause mortality in older men and women.

Funding: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare (now part of GSK Consumer Healthcare) provided support through the partial provision of study pills and packaging.

Conflicts of interest: Drs. Sesso and Manson reported receiving investigatorinitiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, for infrastructure support and donation of COSMOS study pills and packaging,
Pfizer Consumer Healthcare (now part of GSK Consumer Healthcare) for donation of COSMOS study pills and packaging during the conduct of the study. Dr. Sesso additionally reported receiving investigator-initiated grants from Pure Encapsulations and Pfizer Inc. and honoraria
and/or travel for lectures from the Council for Responsible Nutrition, BASF, NIH, and American Society of Nutrition during the conduct of the study. No other authors reported any conflicts of interest.

Comment: Pfizer, of course, makes Centrum multivitamin supplements aimed at older adults.

I was surprised by this part of the trial because previous studies have also shown no consistently beneficial effect of supplementation of individual vitamins or multivitamins on disease risk.  Pfizer must have hoped to find benefits for Centrum.  This is a rare industry-supported study that showed no benefits and is, therefore, worth attention.

Nov 13 2020

Weekend reading (well, browsing): Harold McGee’s Nose Dive

Harold McGee.  Nose Dive: A Field Guide to the World’s Smells.  Penguin Press, 2020.Hardcover Nose Dive : A Field Guide to the World's Smells Book

Harold McGee, author of the astonishing On Food and Cooking, sent me a copy of his equally astonishing new book, this one an encyclopedia of the smells of everything—the “osmocosm.”

I am happy to have it.  He’s produced a life-changing book.  I will never think of smells in the same way again.

For starters, the book is brilliantly designed with elegant charts, key terms in bold, and chemical structures (yes!) right next to the terms in miniature on a light grey background, set off from the text but right there where they are needed.  Here’s an example from the pages that Amazon.com makes available.  This excerpt comes from a section on the smells of chemical compounds found in interstellar space (p. 19—and see my comment on the page number at the end of this post).

Interstellar space?  Well, yes.  Also animals, pets, and human armpits, along with flowers, spices, weeds, fungi, stones (they have bacteria and fungi on them), asphalt, perfumes, and everything else that smells or stinks—as well as foods, of course.

McGee must have had fun writing this.

It’s exactly becasue CAFOs [Concentrated Animal Feeding Operations] are offensive and harmful that the volatiles of animal excrement have been so well studied.  Crazily but appropriately, chemists borrow the terminology of top, middle, and base notes from the perfume worls (see page 477) to describe the smells of CAFOs.  The top notes, very volatile and quickly dispersed, are ammonia and hydrogen sulfide.  The more persistent middle notes include amines, thiols and sulfides, aldehydes and alcohols and ketones.  The constantly present base notes are the short-chain straight and branched acids, cfresol and other pehnolics, and skatole.  In a 2006 study of swine and beef cattle operations, barnyard cresol was identified as the primary offensive odor, and could be detected as far as ten miles (sixteen kilometers) downwind.  It’s probably the first long-distance hint I get of that I-5 Eau de Coalinga (p. 71).

But let me be clear: this is an encyclopedia, demanding close attention to the chemistry.  Sentences like this one come frequently: “The branched four-carbon chain (3-sulfanyl-2-methyl butanol) has its branch just one carbon atom over from the otherwise identical molecule in cat pee” (p.121).

But this blog is about food.  McGee’s discussion of food smells are riveting.  For example:

  • The standard basil varieties in the West today mainly produce varying proportions of a coupld of terpenoids, flowery linalook and fresh eucalyptol, and the clove- and anise-smelling benzenoids eugenol and estragole.  But when it comes to a dish in which basil stars—peto alla genovese, the Ligurian pasta sauce of pounded basil, garlic, nuts, and cheese—Italians are more particular (p. 255).
  • In 2014, I made a pilgrimage to a celebrated durian stall in the outskirts of Singapore and found that most of the half-dozen varieties I tried tasted of strawberries and a mix of fried onions and garlic.  I enjoyed them enough to smuggl one into my hotel room…After just an hour or two its royal presence filled the room and became unbearable.  I had no choice but regicide, and disposed of the body like coCanned sntraband drugs, flushing it in pieces down the toilet (p. 333).
  • The dominant note [in beef stews], described as “gravy-like,” came not from the meats, but from the onions and leeks!  The volatile responsible turned out to be a five-carbon, one-sulfur chain with a methyl decoration, a mercaptomethyl pentanol, MMP for short.  It is formed by a sequene of reactions, the first causaed by heat-sensitive onion enzymes, then ordinary chemical reactions that are accelerated by heat.  So its production is encouraged by chopping or pureeing these alliums (but not garlic) well before cooking them to let the enzymes do their work, the cooking slowly for several hours  (p. 513).
  • Canned sweet corn is dominated by seaside-vegetal dimethyl sulfide, acetyl pyrroline, and a corny thiazole (p. 519).
  • Swiss Appenzeller is notably strong in sweaty-foot branched acids (p. 567).

It should be clear from these excerpts that this is a reference work—a field guide—just as advertised.  If you read it, you will learn more than you ever dreamed possible about the volatile molecules that we can and do smell.

Nose Dive will go right next to On Food and Cooking on my reference shelf.

But uh oh.  How I wish it had a better index. 

For a book like this, the index needs to be meticulously complete—list every bold face term every time it appears—so readers can find what we are looking for.  This one is surprisingly unhelpful.

I found this out because I forgot to write down the page number for the fatty acid excerpt shown above.  I searched the index for most of the key words that appear in the clip: fatty acids, short and branched; butyric; methylbutyric; hexanoic; cheesy; intersteller space. No luck.  I had to check through all of the fatty acid listings and finally found it under “fatty acids, and molecules in asteroids, 19.”   Oh.  Asteroids.  Silly me.

I also forgot to note the page for the CAFO quote.  CAFO is not indexed at all, even though it appears in bold on the previous page, and neither does its definition, Concentrated Animal Feeding Operation.

McGee refers frequently to “Hero Carbon,” the atom basic to odiferous molecules.  I couldn’t remember where he first used “Hero” and tried to look it up.  Not a chance.

This book deserves better, alas.

Penguin Press:  this needs a fix, big time.

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May 24 2018

Pork (the meat, not goodies in the farm bill)

One of the industry newsletters I read regularly is GlobalMeatNews.com, which occasionally collects articles on specific topics into “special editions.”  This one is about pork.

Still the most-consumed meat in the world, the pork sector is shifting quickly with global markets opening for processors on a weekly basis. In this special newsletter, we look at the lucrative Chinese market that everyone is looking to break into, as well as work being done to tackle diseases in the pork sector.

A note on the pork study: it elicited a tirade in the New Food Economy about how so much of nutrition research is correlational and says little about causation.  The writer singles out the pork study as one of three examples of possible misuse of statistics.

Feeding infants puréed pork and increased body length? Trick question. P = 0.001—so something really seems to be happening. But does greater body length in infants actually matter? We’ll let the scientists pursue this one on their own until they come up with something that’s not just statistically significant but meaningful…The point isn’t to prevent you from snacking on prunes and chocolate while you shovel puréed pork into the baby. Do it if you want to, and given the marvelous powers of the placebo effect, you’ll probably be happy you did. But stop treating studies like these as if they contain the truth.

The study, no surprise, was sponsored by NIH but also by the National Pork Board, among other industry groups.  The Pork Board issued a press release: “New Study Finds Pureed Pork Supports Infant Growth.”

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Oct 5 2017

FoodNavigator-USA’s special edition on protein

Protein occurs in most foods but is especially abundant in meat, poultry, fish, dairy, eggs, grains, beans, nuts, and seeds.  Most of us get more than twice the amount we need on a daily basis.

But protein comes with a health aura.  It sells.

Hence: the food industry’s great interest in developing protein ingredients for food products.

FoodNavigator-USA, ever on top of current food trends, summarizes recent developments.

Special Edition: Protein in focus

While Americans typically get enough, there is no sign that the protein trend is going away, with growing numbers of food and beverage brands seeking to add additional protein to their wares or highlight the protein that’s always been there. We take a closer look…

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Jan 9 2017

FoodNavigator-USA’s Special Edition on Snack Foods

I always like to share FoodNaviagator-USA’s special editions—collections of articles on one theme, in this case, what’s happening with snacks from the industry’s perspective.

Special Edition: Snacking trends 

What’s hot in snacks? Sprouted grains? Posh jerky? Chickpeas? Gourmet marshmallows? What’s the difference between a meal and a snack, or are the lines becoming increasingly blurred? What’s a suitable portion-size? This FoodNavigator-USA special edition explores the hottest new trends and brands in the market.