A reader, Emma Calvert, a Senior Food Policy Officerfor the European Union in Brussels, sent me “this article.  She also pointed me to the article Food Navigator wrote about it: “Review hails health benefits of beer-gut alliance.”

Eager to find out what the “beer-gut alliance” might be, I went right to it.

The study: Beer-gut microbiome alliance: a discussion of beer-mediated immunomodulation via the gut microbiome.” Silu Zhang, Shuo Jin, Cui Zhang, Shumin Hu, Huajun Li.  Front. Nutr., 25 July 2023.  Volume 10. https://doi.org/10.3389/fnut.2023.1186927

Background: “As a long-established fermented beverage, beer is rich in many essential amino acids, vitamins, trace elements, and bioactive substances that are involved in the regulation of many human physiological functions.  The polyphenols in the malt and hops of beer are also important active compounds that interact in both directions with the gut microbiome.”

Methods: “This review summarizes the mechanisms by which polyphenols, fiber, and other beneficial components of beer are fermentatively broken down by the intestinal microbiome to initiate the mucosal immune barrier and thus participate in immune regulation.”

Conclusion: “Beer degradation products have anti-inflammatory, anticoagulant, antioxidant, and glucolipid metabolism-modulating potential. ..The positive effects of bioactive substances in beer in cancer prevention, reduction of cardiovascular events, and modulation of metabolic syndrome make it one of the candidates for microecological modulators.”

Funding: “This study was supported by the Open Research Fund of State Key Laboratory of Biological Fermentation Engineering of Beer, under grant no. K202101.”

Conflict of interest: “CZ and SH were employed by Tsingtao Brewery Co. Ltd.  The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.”

Comment: This seems like a lot to claim for beer.  Vested interest?  Yes.  The State Key Beer Lab is part of the Tsingtao Brewery Co. Ltd, Qingdao, 266100, China and two of the authors work for the company.  Why do this study?  To distract attention from the harmful effects of alcohol consumption (where do I begin?) and from its calories, and instead give beer a health aura.

Beer, alas, is not a health food, best consumed in moderation if at all.

Sorry.

One of the most viewed articles in The Guardian last week was this one on possible conflicts of interest among WHO panelists dealing with the health effects of the artificial sweetener, aspartame.

The headline: Revealed: WHO aspartame safety panel linked to alleged Coca-Cola front group

The article refers to the release last month of two somewhat contradictory reports on the potential carcinogenicity of the artificial sweetener, aspartame, a situation I referred to in this space as crazy-making.

To review:

• The WHO’s International Agency for Research on Cancer (IARC) classified aspartame as possibly carcinogenic to humans.
• But in the same report, the WHO and FAO Joint Expert Committee on Food Additives (JECFA) said a daily aspartame intake of 40 mg/kg body weight was acceptable.

A  report from US Right to Know poses a possible explanation: “Did a Coca-Cola front group sway a WHO review of aspartame?”

One possible answer: at least six out of 13 JECFA panel members have ties to ILSI, a longtime Coca-Cola front group. [In addition] Both the chair and vice chair of the JECFA panel have ties to ILSI.

I’ve written repeatedly about ILSI actions on behalf of the food industry, most recently about how it tracked responses to my book Unsavory Truth (in which I discuss the organization as a front group).

Just because committee members have affiliations with an industry front group does not mean they cannot be objective about the science of aspartame, and I have certainly heard arguments that anyone who has any stature in nutrition cannot avoid such ties (full disclosure: in the late 1980s, ILSI attempted—unsuccessfully, no surprise—to recruit me for a job).

But it is striking that 8 of 13 members had such an affiliation, a (perhaps) coincidence that got The Guardian’s attention.

At the very least, the membership gives the appearance of a conflict of interest, which is one reason why such things matter.

USDA’s Economic Research Service reports on trends in food consumption, with enlightening charts.  I thought this one was worth a close look.

The chart shows the proportion of income spent for total food—roughly 11% in 2022, a level last reached in 1991.  Food costs are going up—a lot.

The proportions spent inside and outside the home are roughly the same.

• At home: 5.6% of their income on food at supermarkets, convenience stores, warehouse club stores, supercenters, and other retailers.
• Away from home: 5.6% of their income on food at restaurants, fast-food establishments, schools, and other such places.

The drop in away-from-home eating in 2020 and 2021 was due to pandemic, restrictions of course, but is now recovering.

The decline in at-home eating is a long-term trend, reflecting major changes in American society.

The rise in away-from-home eating has health implications.

Away-from-home meals:

• Are served in larger portions than at-home meals
• Have more calories than at-home meals
• Encourage greater calorie consumption than at-home meals

Bring back home economics?

Last week, my industry-influenced study of the week involved kombucha, although the involvement appeared minimal.

All kombucha and placebo drinks were donated by Craft Kombucha. Craft Kombucha did not have any access to data reported in this study. No author has any financial ties with Craft Kombucha. SD was employed by MedStar Health. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

One of the authors of the study, Daniel Merenstein, wrote to object to the way I characterized it (quoted with his permission).

…But you do make it very clear in the article that all industry did was donate free drinks and had no access to data. Not sure how that really deserves being called influence. But my much larger point is this statement, ” It’s easy to find claims for its health benefits if you search for them, but much harder to find science to back them up.  IIf you can demonstrate benefits, you can sell more products.  Hence, this study.”

I think it is exactly the opposite. It is much easier to just say your product works or even better yet to get an influencer to drink your product.

But to actually put your product into scientist’s hands and have no access to data or publication is a huge step forward in food science. Look at JAMA every week, almost all the drug studies are -. The kombucha maker should be applauded for their bravery.

We didn’t going looking for a + outcome but registered our trial and stated a priori exactly what we would be looking at and reporting. This study has many limitations but not the ones you mentioned.

Dan

I appreciate thoughtful and respectful letters like this .  This one especially deserves a response.  Dr. Merenstein implies that this is an investigator-initiated study designed to test an investigator-initiated hypothesis.  Such things do happen.  Unfortunately, they are not the norm.

Here’ what concerned me about the study:

• It involved a kombucha company, even if lightly.  Much evidence demonstrates that company involvement in research ia highly correlated with positive outcomes, so much so that it has a name, the “funding effect.”
• Funding influence is thorougly demonstrated to occur at an unconscious level; investigators do not intend to be influenced, are unaware of the influence, do not recognize it, and deny it (even in the face of much research to the contrary).  The unconscious influence usually shows up in the way the research question is asked or in the interpretation of the results.
• Statements that funders have no involvement in the research have coften been shown to be false.  Exceptions do occur; this may well be one of them.
• This is a one-food study.  It is impossible to control such studies for dietary and other lifestyle confounders unless done in a locked metabolic ward.

On this last point, I am always suspicious of one-food studies because I find it hard to believe that a single food can make a measureable difference in chronic disease outcome.

I would like to know a lot more about how the microbiome works before being convinced that kombucha has any special health benefits (I do think it is delicious).

To their great credit, these authors fully disclose the limitations of their study (it was small) .

Dr. Merenstein says this study is really about the science.  In this case then, the bias is one shared by all scientists—a belief and the desire to prove it,–in this case that kombucha has particular health benefits .  If scientists didn’t have such beliefs and desires, no science would ever get done.

Such personal biases are indeed quite different from bias induced by financial interests with a company making a product.

Perhaps I misjudged this one.  If so, I owe Dr. Merenstein and his colleagues a sincere apology, here offered.

I thank him for writing and giving me the opportunity to discuss these issues again.

(For detailed discussion and references on issues related to industry research funding, see my book, Unsavory Truth: How the Food Industry Skews the Science of What We Eat).

Several readers have asked me to comment on legislative proposals to refocus SNAP on nutrition quality.

Their requests were triggered by an editorial in The Hill,  America’s food program for the poor should focus on nutrition, by two former USDA Secretaries, Dan Glickman and Ann Veneman, who co-chair the Bipartisan Policy Center’s Food and Nutrition Security Task Force.

They have several suggestions for improving SNAP:

To start, they should make diet quality a core, statutory focus of SNAP. Legislation from Sens. Cory Booker (D-N.J.) and Marco Rubio (R-Fla.) — the SNAP Nutrition Security Act of 2023 — would not only provide a statutory focus on nutrition within SNAP but craft a robust data collection strategy to identify opportunities to improve nutrition in the program.

The Booker/Rubio bill is clear about its purpose:

Food programs administered by the Department of Agriculture  should simultaneously combat food insufficiency and diet related chronic diseases, including obesity, diabetes, hypertension, heart disease, and cancer, which cause immense suffering, significantly increase already high health care spending, increase poverty, and undermine military readiness.

The bill calls for a report from the USDA Secretary that includes:

• An analysis of the food and nutrition security of participants and non-participants in SNAP
• Changes in SNAP aimed at improving food and nutrition security and diet quality
• An analysis of the effectiveness of those changes
• Recommendations for additional authority for the USDA Secretary to improve food and nutrition security and diet quality.

The core of this bill is store-level data collection.

The bill authorizes the USDA to study “the specific food items acquired with [SNAP] benefits by eligible households.”

Good idea, and about time too.  I was on the SNAP to Health commission which made similar recommendations in 2012.

I hope Congress passes it.  Here are the organizations that endorse the bill so far (as of July 14, 2023).

For the record: if we were starting from scratch on poverty reduction, my strong preference is for income support, not SNAP.  It worked splendedly during the pandemic.

Given that SNAP is what we’ve got, my preference is for the WIC model, or would be if all of these questions weren’t so politicized.

At least five readers recently sent me items about research funding by pecan trade associations and I especially thank Lisa Young and Matthew Rees.

But I will begin with Headline vs. Study from the weekly newsletter (invaluable) Obesity & Energetics Offerings (8-18-23).

• Headline: New Research: Regular Pecan Consumption Could Curb Obesity and Reduce Inflammation.
• University News Article: Adding Pecans to Your Diet Could Help Prevent Obesity and Reduce Inflammation.
• Press-Release: Pecans Give Obesity and Diabetes a Slim Chance: Study Shows the Health Benefits of Pecans, Which May Curb Obesity and Reduce Inflammation.
• Study: Pecans and Its Polyphenols Prevent Obesity, Hepatic Steatosis and Diabetes by Reducing Dysbiosis, Inflammation, and Increasing Energy Expenditure in Mice Fed a High-Fat Diet.

Guess who funded this:

• Funding: We acknowledge funding from the Texas Pecan Board and a grant from the Texas Department of Agriculture.
• Conflicts of Interest: The authors declare no conflict of interest.

Comment: Acknowledged or not, the funding establishes a conflicted interest.  Industry funding influences the outcome of research, whether the researchers recognize it or not.  I will say more about that this week in response to a comment from a reader.

In the meantime, here is another one.

• The study: McKay DL, Eliasziw M, Chen CYO, Blumberg JB. A Pecan-Rich Diet Improves Cardiometabolic Risk Factors in Overweight and Obese Adults: A Randomized Controlled Trial. Nutrients. 2018 Mar 11;10(3):339. doi: 10.3390/nu10030339.
• Acknowledgments: This work was supported by the U.S. Department of Agriculture (USDA) Agricultural Research Service under Cooperative Agreement No. 58-1950-014 and the National Pecan Shellers Association. The National Pecan Shellers Association provided the pecans for the intervention.
• Conflicts of Interest: The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Comment:  The role of the National Pecan Sheller sAssociation is not clear (to me) from these acknowledgments.  Did the trade association initiate or fund the study, or was its involvement strictly in providing pecans?   Is there a difference?  Perhaps.  It is possible for studies involving vested financial interests to be done objectively, but studies of the “funding effect”—a higher probability of favorable outcomes—to be the norm.  Again, I will speak to this point later this week.

In the meantime, for detailed discussion and references of this issue, see my book, Unsavory Truth: How the Food Industry Skews the Science of What We Eat.

I find it hard to keep up with everything USDA is doing in food assistance, because its programs go way beyond SNAP.  Every now and then, the USDA sends an update via email.

General Overview of Food Assistance and Nutrition Programs

USDA’s domestic food and nutrition assistance programs affect the daily lives of millions of people, with about one in four U.S. residents participating in at least one food assistance program at some point during a typical year.

Expenditures for food and nutrition assistance account for more than two-thirds of USDA’s budget.

USDA food and nutrition assistance programs, costs and participation, fiscal year 2022

USDA expenditures on food assistance programs, fiscal years 1970–2022

You may also be interested in charts on:

• Child Nutrition Programs 
• Supplemental Nutrition Assistance Program (SNAP)  
• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

The point: This is a huge amount of money.  These programs demonstrably relieve poverty, but are not nearly enough to solve it.  And the amounts are large enough to constitute a target for budget cutters, regardless of consequences.

Most of the attention focuses on SNAP, the most expensive program.  To the extent that the others stay off budget cutters radar, they can do plenty of good.

And these are basically what’s left of the safety net for the poor (except for the Earned Income Tax Credit).

These help, but not nearly enough.

My distant* but dearly loved cousin, Michael Kravit, sent this from Taiwan.  Seems like a really good idea.

I’m working on a book chapter on snack foods (for an updated edition of What to Eat) and I counted the number of feet of shelf space devoted to snacks—chips, crackers, cookies, toaster pastries, candies, etc—in the Ithaca Walmart: 4,100 linear feet, or 0.8 mile.

OK.  Some of them are nuts or dried fruit.  But the great majority?  Mostly ultra-processed and highly profitable to their makers.

*Definition of a distant cousin: he’s the grandson of my first cousin, which I think makes him twice removed.