Search results: dietary guidelines

As it promised in response to a petition from the KIND fruit-and-nut bar company (as I discussed in a previous post), the FDA is now asking for public comment on what “healthy” means on food package labels.

You might think that any food minimally processed from the plant, tree, animal, bird, or fish would qualify.

But “healthy” is a marketing term for processed food products (not foods).  

As Politico Morning Agriculture reminds us, things got complicated when KIND, which makes products from whole nuts, said its bars deserved to be called “healthy.”

In 2015, KIND received a warning letter from FDA arguing the company violated federal rules by using “healthy” on its packages. KIND then petitioned the agency, and, after an exchange about why the current definition is outdated, FDA decided to reverse course. For example, it requires that a food be low-fat to be labeled “healthy,” a standard that a nut-based bar doesn’t meet, while products like fat-free puddings do.

The FDA’s rules now say:

The term “healthy” and related terms (“health,” “healthful,” “healthfully,” “healthfulness,” “healthier,” “healthiest,” “healthily” and “healthiness”) may be used if the food meets the following requirements: 21 CFR 101.65(d)(2)

OK.  I know you can’t read this (you can look for it here). The point is that to qualify as “healthy,” a product has to be low in fat, saturated fat, and cholesterol; relatively low in sodium; and contain at least 10% of the Daily Value per serving for vitamins A or C, calcium, iron, protein, or fiber (with some exceptions).  There are also rules for levels of nutrients added in fortification.

The FDA wants input on whether all of this makes sense in the light of the 2015 Dietary Guidelines and the KIND petition.

In its inimitable FDA-speak:

While FDA is considering how to redefine the term “healthy” as a nutrient content claim, food manufacturers can continue to use the term “healthy” on foods that meet the current regulatory definition. FDA is also issuing a guidance document stating that FDA does not intend to enforce the regulatory requirements for products that use the term if certain criteria described in the guidance document are met.

If I correctly understand the meaning of “does not intend to enforce the regulatory requirements,” the FDA, while waiting for your comments, will allow manufacturers to call products “healthy” as long as the products:

(1) Predominantly contain mono and polyunsaturated fats regardless of total fat content; or

(2) Contain at least ten percent of the Daily Value (DV) per serving of potassium or vitamin D.

In other words, if your food product is made with a low saturated fat oil and contains potassium or vitamin D, it is by definition “healthy.”

Correction, September 29: An FDA official wrote to say that I didn’t quite get this right.  

Actually, if a food exceeds the low fat requirement currently in our definition, we will not take any enforcement or compliance action as long as the food meets all of the other requirements in the definition, namely that it is low in saturated fat, cannot exceed the specified levels of cholesterol and sodium, and contains at least 10 percent of the daily value for beneficial nutrients.  

Second, we are not saying that foods must contain potassium or vitamin D to be labeled as “healthy.”  We are simply indicating that potassium and vitamin D can be substituted for the beneficial nutrients now listed in the current regulations, in line with the new Nutrition Facts label regulations.

My apologies to the FDA for misunderstanding the notice.

The FDA’s request is good news for KIND bars.

But it smacks of “nutritionism”—the use of these two single nutrients (as well as others on the short list of beneficial nutrients) as indicators of quality in processed food products (and don’t get me started on vitamin D, which is a hormone, not a vitamin, and best obtained by getting outside in the sun once in a while).

Understand: this effort is not about semantics; it is about marketing.

Would you like to weigh in on what you think qualifies a food as “healthy?”  Here’s how:

• Federal Register Notice for the Guidance for Industry 
• Federal Register Notice for the Request for Information
• Guidance for Industry: Use of the Term “Healthy” in the Labeling of Human Food Products
• Blog: Making Sure ‘Healthy’ Means What It Says on Food Packages
• “Healthy” on Food Labeling 

Food Navigator is an industry newsletter with articles about topics of interest to food companies.  This is one of its occasional collections of columns on a particular topic, in this case, beans, seeds, and grains.

Beans, chickpeas, peas and lentils are now appearing as added value ingredients in every part of the store, from chips and snacks to salads, soups, pastas, dips and baked goods. Non-GMO, gluten-free, high in protein, fiber and micronutrients, and low in fat, beans in particular are undergoing a PR renaissance among consumers, who have been eating them for years in tacos and burritos, but now see them as a more wholesome alternative to soy, rice, corn and potatoes in their snacks. So where will they go next, and who is driving innovation, both from a formulation, and branding perspective? We also take a look at ancient and ‘heirloom’ beans and grains.

•  Manufacturers answer FAO’s call to increase pulse consumption in 2016 with new bean-based snacks: In declaring 2016 the year of the pulse, the Food and Agriculture Organization of the UN issued a call to action to increase the consumption and popularity of legumes such as chickpeas, lentils and beans which are under used in the US… Watch now
• How consumer demand is resurrecting ancient grains from the past: Data from SPINS reveals that sales of products featuring ‘ancient grains’ grew 16.6% year-over-year to $198,884,358 in 2016… Read
• Rancho Gordo brings heirloom beans to American doorsteps: Working with farmers from Central California, Oregon, Washington, New Mexico, and Mexico, Napa-based Rancho Gordo is resurrecting long-forgotten beans and bringing them back to the American table…Read
• Modern Table Meals serves up bean pasta as meal kits or plain: The team of moms is cornering the category with a double whammy-pulse-based pasta for both the time-strapped parent and the aspiring chef with more time on their hands… Read
• The Good Bean rides bean-based snacking wave in the Year of the Pulse: The Good Bean – a Berkley-based snack brand built around the garbanzo bean (chickpea) – more than doubled its sales in 2015 and expects to do so again in 2016 as pulse-based snacking (beans, peas, lentils) gains momentum. .. Read
• US volumes of pulses surge 8% in 2015, outpacing overall fresh food growth of 1%: Volumes of pulses (defined as leguminous crops – beans, peas, chickpeas, lentils – harvested for dry grains) surged 8% in the US in 2015, while overall volumes of fresh food (retail, foodservice, institutional channels combined) grew by a more modest 1%, according to Euromonitor International… Read
• Beans, peas, lentils, chickpeas: The hottest ingredients in the snack developer’s toolbox? North American pulse growers still export a lot of their wares, but domestic demand has ramped up significantly in recent years as beans, peas, chickpeas, and lentils have started to infiltrate every aisle in the grocery store, from hummus, bean dips, pasta and salads, to chips, brownies and nutrition bars, according to pulse processor AGT Food and Ingredients…Read
• Inclusion of pulses in processed food grew the fastest, says Pulse Canada: Of the many culinary ways pulses can be used, inclusion as an ingredient in snack foods or pasta really ramped up, Pulse Canada data says. We chatted with the industry association to learn more about the state of pulses… Read
•  Full of beans: Banza chickpea pasta now in 2,000+ stores… ‘It’s been a wild ride!’: Unlike some of the more esoteric products at Expo West, Banza chickpea pasta is aimed squarely at mainstream consumers who are looking for more protein and fiber in their pasta, but are not prepared to compromise on taste or texture (no mush). .. Watch now
•  Bean pasta category emerges to meet demand for high-protein, fiber-packed and gluten free options: Ongoing interest in products that are gluten free and better for you are colliding with the international push to celebrate 2016 as the year of the pulse to create a burgeoning category of pasta created from legumes rather than more traditional wheat or rice… Display
• Whole grains consumption increases thanks to plant-forward diet, focus on new flavors: Once shunned for their distinct taste and texture, whole grains are gaining acceptance among more Americans for these same attributes thanks in part to innovative restaurateurs and chefs who are using them to round-out increasingly popular plant-forward dishes, according to the Whole Grains Council… Read
•  Taste Test Friday: Banza chickpea pasta with One Hop Kitchen Bolognese offers a twist on a classic: On the menu for this edition of Taste Test Friday is a blind sampling of a classic American-Italian meal: pasta with Bolognese sauce – but with a twist. .. Watch now
• World Peas acquired by Snack it Forward: Austin based World Peas – best known for its coated peas and fava bean snacks, has been acquired by L.A. based Snack it Forward LLC – which makes freeze-dried fruit snacks (Sunkist Fruit Chips) and trail mix… Read
• NY start-up unveils the ultimate plant-based protein snack: BRAMI lupini beans: Lupini beans have a nutritional profile to die for. The problem is, most Americans have never heard of them. But that could change rapidly if the New York based entrepreneur behind BRAMI snacking beans gets his way… Read
•  Soup-To-Nuts Podcast: Quinoa’s rise to superfood superstar status and the challenges it must address: Quinoa was one of the first superfoods to take America by storm more than a decade ago, and one of the few such stars to sustain its reign long enough to push past being a fad food to become a staple on restaurant menus and households across the country, but the popular grain faces challenges as it become commoditized. .. Listen now
•  Whole grains 101: Highlights from the 2015 Whole Grain Summit: The 2010 Dietary Guidelines for Americans say half of our grains should be whole. So how are we doing? FoodNavigator-USA headed to Portland, Oregon, for the 2015 Whole Grain Summit  – organized by Oregon State University and the Grains for Health Foundation – to find out….. Display
• Eating more whole grains could reduce risk of chronic diseases, study finds: New research that demonstrates a clear association between eating whole grains and the reduced risk of chronic diseases supports the 2015 dietary guideline’s recommendation that Americans “shift” their diet by making at least half their grains whole grains. .. Read
•  Selling complex carbs in a post Grain Brain world: Do grains really make us fat and sick? Grains, according to the author of best-selling book Grain Brain, are “silent killers”. Not only are they making us fat, says Dr David Perlmutter, “but even healthy ones like whole grains can cause dementia, ADHD, anxiety, chronic headaches, depression, and much more…” But is there any truth behind these assertions, and if not, what can the grain chain do to fight back?.. Watch now

Bridget Huber of The Food and Environment Reporting Network (FERN) has produced a don’t-miss” article in The Nation: “Welcome to Brazil, where a food revolution Is changing the way people eat: How the country challenged the junk-food industry and became a global leader in the battle against obesity.”

As she explains, Latin America is leading worldwide opposition to food industry marketing, and much is happening in Brazil.

She writes about the advocacy work of Carlos Monteiro, Professor of Nutrition in the School of Public Health, University of Sao Paolo, who says:

The local food system is being replaced by a food system that is controlled by transnational corporations…this dietary deterioration doesn’t just harm bodily health but also the environment, local economies, and Brazil’s rich food traditions. We are seeing a battle for the consumer.

She further explains:

Over the last 30 years, big transnational food companies have aggressively expanded into Latin America. Taking advantage of economic reforms that opened markets, they’ve courted a consumer class that has grown in size due to generally increasing prosperity and to antipoverty efforts like minimum-wage increases and cash transfers for poor families. And as sales of highly processed foods and drinks have plateaued (and even fallen, in the case of soda) in the United States and other rich countries, Latin America has become a key market…In recent years, Brazil has inscribed the right to food in its Constitution and reformed its federal school-lunch program to broaden its reach while bolstering local farms.

And in 2014, the Ministry of Health released new dietary guidelines that made healthy-food advocates across the world swoon [I did a post on them when they were released].  Monteiro helped lead the team that wrote them; the guidelines transcend a traditional nutrition-science frame to consider the social, cultural, and ecological dimensions of what people eat. They also focus on the pleasure that comes from cooking and sharing meals and frankly address the connections between what we eat and the environment.

Huber’s investigative report is long and detailed, and well worth the read.

And it comes with a great graphic comparing the situation in Brazil with that of the U.S. (this is just an excerpt):

Those of us advocating for food systems that are healthier for people and the planet have much to learn from our colleagues in the South.

Brazilian researchers have published a study clearly aimed at countering Brazil’s dietary guidelines, which the authors say, include advice to “avoid fast food.”

The study, which looked at the nutritional quality of children’s lunches, comes to three conclusions:

1. The nutrition quality of lunch in fast food restaurants is similar to a typical Brazilian meal [Really?  Who paid for this?].
2. The restaurant meals could fit into a balanced diet from time to time [Of course.  Anything can].
3. Every meal observed here could be improved with regard to sodium and fiber to promote children’s health in adulthood [Ditto].

Did you guess?

The authors acknowledge Equilibrium Consultancy which led this study. Funding by McDonald’s Corporation for the project was primarily to Equilibrium.

This is yet another industry-funded study with results favorable to the sponsor’s interests.  These especially require scrutiny of hypotheses, methods, and interpretation and repetition by independently funded investigators.

The Los Angeles Times has reprinted a story about Big Sugar’s hold on Florida politics.  The story appeared first in the Miami Herald (but don’t even try to read it there; the ads make the site impenetrable).

The LA Times version is worth a look.

Between 1994 and 2016, a review of state Division of Elections records by The Miami Herald/Tampa Bay Times Tallahassee bureau shows, the sugar industry led by United States Sugar and Florida Crystals has steered a whopping $57.8 million in direct and in-kind contributions to state and local political campaigns. (The total does not include federal contributions.)

It appears to be money well spent. On issue after issue, regulators, legislators and governors have erred on the side of softening the impact of adverse rules and regulations on cane growers and other powerful and polluting agriculture interests, including cattle operations north of Lake Okeechobee.

The sugar industry beat back a voter-approved amendment that would have forced it to pay for cleaning up its own nutrient-rich runoff into the Everglades, instead shifting much of the cost to taxpayers. It won repeated delays of strict water quality standards. It has fended off calls for buyouts even after one of the largest companies, U.S. Sugar, offered to sell itself to the state. And it has undermined attempts to use a second constitutional amendment, Amendment 1, to be used to buy farmland for Everglades cleanup.

I like butter as much as you do—and definitely more than margarine—but Time Magazine took it to an extreme with its cover story last year on how scientists (they are so dumb) got it wrong.

Hype alert: any time you read that science got it wrong, be skeptical.  Maybe they did, but it’s more likely that the science is still incomplete.

Time Magazine is really dug in on the butter issue.  It continues to insist that scientists were wrong about saturated fats.  Indeed, Time says, its case against saturated fats has just gotten even stronger.

On what basis?  A new study with the provocative title, “Is butter back?”   The study concludes:

This systematic review and meta-analysis suggests relatively small or neutral overall associations of butter with mortality, CVD, and diabetes.

It comes as no surprise that a single food like butter is not linked to a higher risk of heart disease. The highly respected Cochrane Collaboration’s meta-analysis of 15 randomized clinical trials concluded that replacing saturated fat (from all sources) with polyunsaturated fats lowers the risk of heart attacks and other cardiovascular events. (That finding is consistent with clinical studies on blood cholesterol levels and well-designed analyses of observational studies). One would not expect any single food to matter, since people who eat butter don’t necessarily eat an overall diet that is high in saturated fat.

No, butter is not back says the Harvard School of Public Health:

What the headlines miss is that in a meta-analysis such as this, there is no specific comparison (i.e. butter vs. olive oil), so the default comparison becomes butter vs. the rest of the diet. That means butter is being compared to a largely unhealthy mix of refined grains, soda, other sources of sugar, potatoes, and red meat…Here is the most important takeaway from this study not making headlines: Butter, a concentrated source of saturated fat, is still a worse choice than sources of healthy unsaturated fats such as extra virgin olive, soybean, or canola oils.

And just published is the Harvard group’s latest report on the diet and health of tens of thousands of nurses:

Different types of dietary fats have divergent associations with total and cause-specific mortality. These findings support current dietary recommendations to replace saturated fat and trans-fat with unsaturated fats.

Even the “Is butter back?” investigators temper their conclusions:

These findings do not support a need for major emphasis in dietary guidelines on either increasing or decreasing butter consumption, in comparison to other better established dietary priorities; while also highlighting the need for additional investigation of health and metabolic effects of butter and dairy fat.

Time Magazine:  Your science writers need to do a better job of reading the literature and putting new studies in context.

Readers: consider “scientists are wrong” (and, by implication, “we are right”) to be a red flag.  Saturated fat is one nutrient in diets that contain many, and studies that examine the effects of one nutrient without considering the total diet—and calorie balance—are highly likely to require further research.   In the meantime, enjoy butter—in moderation, of course.

First the good news

The USDA is applying its school-food rules  to child and adult care programs.  It has just released its final rule for these programs.  These go into effect in October 2017.

Previously, the USDA released standards for the Women, Infants and Children program and for the National School Lunch Program.

Now all three food assistance programs are more or less aligned with the Dietary Guidelines.

The child and adult feeding programs will specify more fruits and vegetables, less sugar and fat, but have reduce the standards for whole grain-rich products and sodium.  Presumably, this will make the rules more acceptable to people who don’t like them, of which there are many (see below).

And now the bad news

The House has released its child nutrition reauthorization bill, with the Orwellian title: “Improving Child Nutrition and Education Act.”  Like all such titles, this one means the opposite of what it says.

The House bill increases reimbursements for school breakfasts (good), but then lowers the nutrition standards for school meals and makes it harder for schools to qualify for universal free meals.  Here’s the committee’s bill summary.  And here is what the House Education and Workforce Committee says in its fact sheet.

The Hagstrom Report quotes Margo Wootan of Center for Science in the Public Interest saying that the House bill will:

• Freeze sodium reduction for at least three years.
• Require yet another scientific review of sodium.
• Weaken the whole grain standards.
• Let junk food back into schools
• Allow schools to replace fresh produce with dried (without a sugar limit), canned (without a sodium or sugar limit), and frozen fruits and vegetables, thereby allowing schools to replace fresh apples and carrots with sugary fruit snacks, potato chips, jam, or trail mix containing candy.

The Center on Budget and Policy Priorities says this bill will increase food insecurity among children.

Fortunately, not everyone in the House loves this bill.  A letter signed by 111 House members details objections.

The House will be working on this bill tomorrow.  What will the Senate do?

School food advocates: it’s time to get busy.  Here’s the list of House members.  Write to yours today!

A couple of weeks ago, I mentioned several new studies that elicited much media attention.  I am now getting around to them.

Let’s start with the article in the BMJ about newly discovered data from the Minnesota Heart Study purportedly casting doubt on the risks of saturated fat (here’s what the Washington Post said about it).

The BMJ article concluded:

Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.

I’ve been at this game long enough to guess that any statement suggesting that everything you thought you knew about nutrition is wrong ought to raise red flags and call for more than the usual degree of skepticism.

Here are some sensible and, yes, skeptical comments about this study:

From Julia Belluz of Vox

But there were a few major problems with the research. The study involved men and women of an average age of 52 who had been admitted to a nursing home and six state mental health hospitals because they were sick. The researchers who conducted the meta-analysis note the “results are not necessarily generalizable to populations without mental illnesses or living outside nursing homes.”

Another issue: The study followed 9,423 women and men, but only a quarter of the participants followed the diets for more than a year. Altering one’s diet for a short period of time — especially in old age — would not necessarily affect one’s long-term health risks….

…Some of the biggest controversies surround saturated fats. Scientists disagree about the extent to which saturated fats contribute to important health outcomes like heart disease, stroke, and cancer. The available research does suggest, however, that there are health benefits from replacing saturated fats with unsaturated fats in the diet, and that eating lots of nutrient-poor carbs (like sugary cereals, soda, and white bread) instead of fat is a bad idea.

From David Katz, to whom I am often grateful for taking on such things, writes that this study

tested something that nobody expert in nutrition is recommending: an extremely high dose of omega-6, linoleic acid…we already got the memo that this is a dubious proposition.

With all due respect to the BMJ authors, I personally found it a bit odd that they stated the following: “A key component of dietary guidelines has long been to replace saturated fat with oils rich in linoleic acid…” The current Dietary Guidelines for Americans, let alone the far better 2015 Dietary Guidelines Advisory Committee Report, make no such recommendation. Searching for any mention of linoleic acid, I found it only in the appendices in the context of descriptions and definitions, not in any of the actionable guidance. While the current Dietary Guidelines do recommend limiting saturated fat intake, the replacement encouraged is a balance of healthful oils, such as olive, and the fats found natively in, as noted, nuts, seeds, avocado, and fish.

From Martijn Katan, the Dutch lipid biochemist who did the original work demonstrating the cholesterol-raising effects of trans fats, writes in an e-mail:

I have not had time to study the BMJ article on the Minnesota Heart Study in detail. However, some of my colleagues did, and I think that their conclusions are correct:

1. The randomized trial itself showed no effect on disease or death
2. This was to be expected because most subjects were on the diet for less than 1 year. This was due to the change in regime for psychiatric patients that took place during that period, which essentially caused the trial to fail. Lowering cholesterol by 14% for one year does not noticably affect CVD risk.
3. The relation of a larger fall in cholesterol with a larger risk of mortality did not emerge from the randomized study; subjects were not randomized to various levels of cholesterol lowering. It is an observational association. The question than arises which causes which. Various occult diseases, notably cancer, cause cholesterol to fall as the disease progresses. This also explains the association seen in observational studies between low cholesterol and cancer. That observation led me to think up in 1985 the technique now known as ‘Mendelian Randomization’ [1]. Application of that technique showed that the association of low cholesterol and cancer is indeed spurious [2].

The only new thing about the present study is that they revived the long disproved hypothesis that lowering cholesterol causes various diseases. Hundreds of thousands of patients in statin trials have proven this wrong….

[1] Katan, M.B., 1986. Apolipoprotein E isoforms, serum cholesterol, and cancer. Lancet 1, 507–8.

[2] Trompet, S.,et al ., 2009. Apolipoprotein E genotype, plasma cholesterol, and cancer: a Mendelian randomization study. Am J Epidemiol 170, 1415–21.

My bottom line on this one

It confirms the value of basic dietary advice: Eat a variety of relatively unprocessed foods, mostly plants (fruits, vegetables, grains, beans, nuts), balance calories, and enjoy what you eat!

Do this and food fatty acids will balance out too and you won’t need to give them another thought.

The moral

Whenever you read a headline suggesting that everything you know about nutrition is wrong, roll your eyes, eat something delicious, and wait for confirming studies to come along before deciding to ignore that basic advice.