by Marion Nestle

Search results: dietary guidelines

Aug 26 2015

Five more industry-funded studies with expected results. Score: 47 to 1

The Inadmissibility of What We Eat in America and NHANES Dietary Data in Nutrition and Obesity Research and the Scientific Formulation of National Dietary Guidelines. Archer E, Pavela G, Lavie CJ. Mayo Clin Proc. 2015 Jul;90(7):911-26. doi: 10.1016/j.mayocp.2015.04.009. Epub 2015 Jun 9.

  • Conclusion: we conclude that M-BM [memory-based dietary assessment methods] data cannot be used to inform national dietary guidelines and that the continued funding of M-BMs constitutes an unscientific and major misuse of research resources.
  • Funding: National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.
  • Potential Competing Interests: Dr Archer has received honoraria from the International Life Sciences Institute and The Coca Cola Company. Dr Lavie reports receiving consulting fees and speaking fees from The Coca-Cola Company….
  • Comment: This is part of what appears to be a concerted effort by Coca-Cola to discredit NHANES, the national survey of dietary intake and disease risk that consistently associates soda intake to poor health.

A high-protein breakfast prevents body fat gain, through reductions in daily intake and hunger, in “Breakfast skipping” adolescents.  Heather J. Leidy, Heather A. Hoertel, Steve M. Douglas, Kelly A. Higgins and Rebecca S. Shafer.  Obesity.  Article first published online: 4 AUG 2015.  DOI: 10.1002/oby.21185

  • Conclusions: The daily addition of a HP [high-protein] breakfast improved indices of weight management as illustrated by the prevention of body fat gain, voluntary reductions in daily intake, and reductions in daily hunger in breakfast skipping adolescents with overweight/obesity.
  • Funding: The Pork Checkoff supplied the funds to complete the study.
  • Disclosure: The authors declared no conflict of interest.
  • Comment: Industry-funded investigators typically state that funding does not introduce conflicts of interest.

Breakfasts Higher in Protein Increase Postprandial Energy Expenditure, Increase Fat Oxidation, and Reduce Hunger in Overweight Children from 8 to 12 Years of Age.  Jamie I Baum, Michelle Gray, and Ashley Binns.  J. Nutrition.  First published August 12, 2015, doi: 10.3945/jn.115.214551  J. Nutr. jn214551

  • Conclusion: This study indicates that breakfast macronutrient composition affects postprandial responses in both NW [normal weight] and OW [overweight] children. A PRO [protein-rich breakfast] increases postprandial EE [energy expendititure] and fat oxidation, reduces hunger, and increases satiety when compared with a carbohydrate-based breakfast.
  • Funding: Supported by a grant from the Egg Nutrition Center/American Egg Board, Chicago, IL. The Egg Nutrition Center/American Egg Board was not involved in the design, implementation, analysis, or interpretation of the data.
  • Author disclosures: JI Baum, M Gray, and A Binns, no conflicts of interest.
  • Comment: These industry-funded investigators also deny that funding introduces conflicts of interest.

The Effect of Breakfast vs. No Breakfast on Brain Activity in Adolescents when Performing Cognitive Tasks, as Assessed by fMRI [functional magnetic resonance imaging].  Jonathan Fulford1, Joanna L Varley2 and Craig A Williams.   Nutritional Neuroscience 2015 epub ahead of print.

  • Conclusion: Although no statistically significant (P > 0.05) improvement in task performance was determined, significantly higher activation was recorded in the frontal, premotor, and primary visual cortex areas in the breakfast trial relative to the fasting condition…Such a finding may have important implications in the examination of the role of diet, and specifically breakfast, in determining children’s performance within the school environment.
  • Funding: A grant was received of £18,678.08 from Kellogg Marketing & Sales Company (UK) Ltd to cover MRI scanning costs. Otherwise the research was conducted with the support of internal institutional funds and the authors received no other direct or indirect support, with no further competing interests.
  • Comment: Ordinarily I’m not concerned about food companies’ donating products to be tested but £18,678.08 seems noteworthy, especially since the only point of this study is to demonstrate that breakfast-eaters do better (higher brain activation even though no significant gain in task performance).

Suboptimal Serum α-Tocopherol Concentrations Observed among Younger Adults and Those Depending Exclusively upon Food Sources, NHANES 2003-2006. McBurney MI, Yu EA, Ciappio ED, Bird JK, Eggersdorfer M, Mehta S (2015). PLoS ONE 10(8): e0135510. doi:10.1371/journal.pone.0135510

  • Conclusion: The prevalence of inadequate vitamin E levels is significantly higher among non-users of dietary supplements…Our findings provide evidence that most Americans have serum α-tocopherol levels below 30 μmol/L. The EAR [Estimated Average Requirement], epidemiological and randomized controlled studies all indicate that maintaining a serum α-tocopherol concentration of 30 μmol/L may have beneficial effects on mortality, cognitive function and reproduction [Note: “may” indicates that what follows is speculative].
  • Funding: This statistical analysis of data collected by the Centers for Disease Control (CDC)…was supported by DSM Nutritional Products, a manufacturer of vitamin E. MM, EC, JB and ME are employees of DSM Nutritional Products. DSM Nutritional Products provided support in the form of salaries for authors MM, EC, JB, and ME and as an unencumbered gift to Cornell University that was used to support EY as a graduate research assistant.
  • Competing interests: This study was supported by DSM Nutritional Products, a manufacturer of vitamins, including vitamin E, for food, dietary supplement, and pharmaceutical use. MM, EC, JB, and ME are employees of DSM Nutritional Products.
  • Comment: Inadequate vitamin E in this study is defined as a serum level below a certain cut-point with uncertain clinical significance.  According to the Dietary Reference Intakes, clinical signs of vitamin E deficiency have not been observed in healthy populations.

Note: Since mid-March, I have posted 47 industry-funded studies with results favorable to food companies or trade associations, vs. 1 study with unfavorable results.

If you see industry-funded studies with results that must have made the sponsor unhappy, please send.

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Aug 25 2015

Update on the school meal situation

School is starting and the school food debates will no doubt be starting up again.

The USDA has a new report on what’s happening with adoption of the new nutrition standards.

  • A national study of elementary school principals and foodservice managers finds the majority (63%) to agree or strongly agree (7%) that students seem to like the new lunches.
  • The participation rate for paid school lunches declined from FY 2008 through FY 2014, with steeper declines during FY 2012-2014.  This could be do to the changes in standards but is more likely the result of higher prices charged for meals.
  • Smaller, more rural, and wealthier districts had the most difficulty adopting the new meal standards. Higher meal prices affected smaller and more rural districts.

The 2015 School Food Poll conducted by the Kellogg Foundation just reported:

  • 90% of respondents support the national school nutrition standards.
  • 86% say the school nutrition standards should stay the same or be strengthened.
  • 91% say kids need access to safe drinking water in schools.
  • 88% support increased government funding to expand farm to school programs.
  • 84% believe sustainable agriculture should be part of the Dietary Guidelines for Americans.

The Kellogg Foundation provides

My interpretation: The nutrition standards are working well enough but it’s time to advocate even more strongly for universal school meals.  It’s absurd and unconscionable that poor kids are getting priced out of school meals.

Addition: The School Nutrition Association, the group doing everything it can to undermine the new nutrition standards, has just issued a report finding that the standards have caused severe financial harm to 70% of schools.  The reason?

There is strong consensus as to the leading reason for the decline in lunch ADP: decreased student acceptance of meals [.underlined in report].

The report does, however, provide a table of reasons for increased costs:

  • Increased per meal food costs — 70.1%
  • Decreased lunch participation — 56.8%
  • Decreased a la carte revenue — 53.0%
  • Increased labor/benefits costs — 48.5%
  • Declining student enrollment — 20.6%

Given these results, you might think the SNA would be lobbying night and day for higher reimbursement rates, but no such luck.  The SNA is lobbying for weaker standards.  Pity.

Addition, August 25:  A study from the University of Vermont finds school kids to be consuming slightly fewer servings of fruits and vegetables since the nutrition standards were implemented and to be producing 56% more plate waste.  This is not good news.

Addition, August 28:  But a CDC study finds that in 2014, schools were making significant progress:

  • Almost all schools offered whole grain foods each day for breakfast (97.2%) and lunch (94.4%)
  • Most schools offered two or more vegetables (79.4%) and two or more fruits (78.0%) each day for lunch.
  • Approximately one third (30.5%) of schools offered self-serve salad bars.
  • Among the 55.0% of schools that prepared food at the school, about half were trying hard to reduce salt.
  • Overall, 97.5% of schools used at least one of the nine school nutrition services practices examined, with 23.9% using one to three of the practices, 48.3% using four to six of the practices, and 25.3% using seven or more of the practices.

My interpretation: Schools are moving to adopt the new nutrition standards.  Some are succeeding better than others.  The outcome of studies therefore depends on whether you see the glass as half full, or empty.

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Jul 30 2015

More industry-sponsored research with predictable results 

Once again, I am posting five food industry-sponsored studies with results that come out just the way the sponsor wants them to.  Coincidence?  Or something more serious?  I am trying to remain open-minded.  If you know of food industry-sponsored research that does not favor the sponsor’s interests, please send.  As soon as I collect five, I will post.

Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women: a randomized crossover trial. Am J Clin Nutr ajcn109116, 2015.  doi:10.3945/ajcn.115.109116.  Thorning, T.K., Raziani, F., Bendsen, N.T., Astrup, A., Tholstrup, T., Raben, A.

  • Conclusion: Diets with cheese and meat as primary sources of SFAs [saturated fatty acids] cause higher HDL cholesterol and apo A-I and, therefore, appear to be less atherogenic than is a low-fat, high-carbohydrate diet.  Also, our findings confirm that cheese increases fecal fat excretion.
  • Sponsor: Supported 50% by the Danish Dairy Research Foundation and the Danish Agriculture and Food Council (Denmark) and 50% by the Dairy Research Institute (United States), the Dairy Farmers of Canada (Canada), the Centre National Interprofessionel de l’Economie Laitie`re (France), Dairy Australia (Australia), and the Nederlandse Zuivel Organisatie (Netherlands).

Normal or High Polyphenol Concentration in Orange Juice Affects Antioxidant Activity, Blood Pressure, and Body Weight in Obese or Overweight Adults.  Oscar D Rangel-Huerta, Concepcion M Aguilera, Maria V Martin, Maria J Soto, Maria C Rico, Fernando Vallejo, Francisco Tomas-Barberan, Antonio J Perez-de-la-Cruz, Angel Gil, and Maria D Mesa,  J. Nutrition.  First published July 1, 2015, doi: 10.3945/​jn.115.213660.  jn213660

  • Conclusions: Our results show that the consumption of either NPJ [normal polyphenol juice] or HPJ [high polyphenol juice] protected against DNA damage and lipid peroxidation, modified several antioxidant enzymes, and reduced body weight in overweight or obese nonsmoking adults.
  • Sponsor: Supported by research contract 3345 between the University of Granada–Enterprise General Foundation and Coca-Cola Europe [Coca-Cola owns Minute Maid and Simply Orange].

Fructose-Containing Sugars and Cardiovascular Disease.    James M Rippe and Theodore J Angelopoulos.   Adv Nutr 2015; 6:430-439 doi:10.3945/an.114.008177.

  • Conclusion:  …although it appears prudent to avoid excessive consumption of fructose-containing sugars, levels within the normal range of human consumption are not uniquely related to CVD risk factors with the exception of triglycerides, which may rise when simple sugars exceed 20% of energy per day, particularly in hypercaloric settings.  [My translation: this implies it’s OK to eat sugars up to 20% of calories per day, even though health authorities typically recommend 10% or less].
  • Author’s disclosure: JM Rippe has received consulting fees from ConAgra Foods, Kraft Foods, Florida Department of Citrus, PepsiCo International, The Coca Cola Company, Dr. Pepper/Snapple Group, Corn Refiners Association, and Weight Watchers International.

Sugars and Health Controversies: What Does the Science Say?   James M Rippe and Theodore J Angelopoulos.   Adv Nutr 2015; 6:493S-503S doi:10.3945/an.114.007195

  • Conclusion: …there is little scientific justification for recommending restricting sugar consumption below the reasonable upper limit recommended by the Dietary Guidelines for Americans, 2010 of no more than 25% of calories.  [Note: health authorities routinely recommend no more than 10% of calories].
  • Sponsor: supported in part by an educational grant from the Corn Refiners Association. Publication costs for this supplement were defrayed in part by the payment of page charges. This publication must therefore be hereby marked “advertisement.”
  • Author’s disclosure:  JM Rippe’s research laboratory has received unrestricted grants and JM Rippe has received consulting fees from ConAgra Foods, Kraft Foods, the Florida Department of Citrus, PepsiCo International, The Coca-Cola Company, the Corn Refiners Association, Weight Watchers International, Dr. Pepper Snapple Group, and various publishers.

Do Fructose-Containing Sugars Lead to Adverse Health Consequences?  Results of Recent Systematic Reviews and Meta-analyses.   Vanessa Ha, Adrian I Cozma, Vivian LW Choo, Sonia Blanco Mejia, Russell J   de Souza, and John L Sievenpiper.   Adv Nutr 2015; 6:504S-511S doi:10.3945/an.114.007468.

  • Conclusion: it is difficult to separate the contribution of fructose-containing sugars from that of other sources of excess calories in the epidemic of obesity and cardiometabolic disease. Attention needs to remain focused on reducing the overconsumption of all caloric foods associated with obesity and cardiometabolic disease, including sugary beverages and foods, and promoting greater physical activity.
  • Sponsor: Aspects of this work were funded by…a research grant from the Calorie Control Council.   [Note: the Council promotes the benefits of fructose].
  • Authors’ disclosure: RJdS has received research support from the CIHR, Calorie Control Council, the Canadian Foundation for Dietetic Research, and The Coca-Cola Company (investigator-initiated unrestricted grant)… JLS has received research support from the CIHR, Calorie Control Council, The Coca-Cola Company (investigator-initiated unrestricted educational grant), Dr. Pepper Snapple Group (investigator-initiated unrestricted educational grant), Pulse Canada, and The International Tree Nut Council Nutrition Research & Education Foundation. He has received travel funding, speaker fees, and/or honoraria from [among many others]… International Life Sciences Institute (ILSI) North America, ILSI Brazil, Abbott Laboratories, Pulse Canada, Canadian Sugar Institute, Dr. Pepper Snapple Group, The Coca-Cola Company, Corn Refiners Association, World Sugar Research Organization, Dairy Farmers of Canada….
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Jul 24 2015

Good news: FDA proposes Daily Value for Added Sugars–10% of calories

The FDA announced this morning that it is proposing a Daily Value (the maximum) for Added Sugars on food labels—10% of calories.

Susan Mayne, FDA’s Director of the Center for Food Safety and Applied Nutrition, explains the rationale: this is the percentage recommended by the Dietary Guidelines and practically every other health authority that has examined the evidence on sugars and health.

Ten percent of calories means 200 calories on a 2000 calorie daily diet, or 50 grams, or 12 teaspoons—the amount in one 16-ounce soda.

If you drink a 16-ounce soda, you have done your added sugars for the day.

If this seems abstemious, consider that 10% of calories is more generous than the amount recommended by the UK’s Scientific Advisory Committee on Nutrition:

It is recommended that the average population intake of free sugars should not exceed 5% of total dietary energy for age groups from 2 years upwards.

The World Health Organization’s recent report on sugars and health also views 10% as the absolute maximum:

  • In both adults and children, WHO recommends reducing the intake of free sugars to less than 10% of total energy intake (strong recommendation).
  • WHO suggests a further reduction of the intake of free sugars to below 5% of total energy intake (conditional recommendation).

The WHO report explains:

The recommendation to further limit free sugars intake to less than 5% of total energy intake, which is also supported by other recent analyses, is based on the recognition that the negative health effects of dental caries are cumulative, tracking from childhood to adulthood…No evidence for harm associated with reducing the intake of free sugars to less than 5% of total energy intake was identified.

Americans, on average, consume way more than 10% of calories from added sugars, so this recommendation means a sharp restriction.

It means consuming less of sugary products: sodas, baked goods, and all those packaged foods with added sugars.

The proposal is up for comment.

You can bet that there will be plenty.

Congratulations to the FDA for this one.  Let’s hope it sticks.

How to Comment

To comment on the proposed changes to the Nutrition Facts Label:

  1. Read the proposed changes.
  2. Starting Monday, July 27, 2015, go to Regulations.gov to submit comments.
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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 5 2015

Food politics in action: Potatoes!

The National Academy of Sciences’ Institute of Medicine (IOM) has just recommended that white potatoes be included in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program.*

This recommendation contradicts previous policy, which excluded white potatoes from the WIC package on the grounds that starchy vegetables are not lacking in the diets of WIC recipients and it would be better to use WIC to encourage consumption of a broader range of vegetables.

As I’ve discussed in earlier posts, the potato lobby objected, insisted that white potatoes were just as healthy as other starchy vegetables, and that women weren’t eating enough of them.  It got Congress to overturn USDA’s restrictions on the number of times white potatoes (usually fried) could be served in the school lunch program.

And it got Congress to order USDA  to put potatoes back into WIC—unless it conducted a study demonstrating that potatoes should be excluded.  The USDA gave up and told state agencies to allow potatoes to be purchased by WIC recipients starting next summer.

In deciding in favor of potatoes, the committee said it is concerned that “”Current consumption of starchy vegetables does not meet 2010 DGA [Dietary Guidelines for Americans] recommendations for this food group.”

Really?  I have a hard time believing that WIC recipients are suffering from lack of potatoes in their diets.  Potatoes are fine foods, but highly caloric when prepared in the usual ways.  Encouraging WIC recipients to choose leafy greens and other vegetables seems like a good idea.

But the IOM committee took the 2010 Dietary Guidelines at face value and says this is what the rules are until changed.  So they effectively tossed this hot potato into lap of the 2015 Dietary Guidelines committee.

While waiting to see that committee’s report—expected soon—the take-home lesson is clear: lobbying works.

*The USDA has a new report out on WIC: The WIC Program: Background, Trends, and Economic Issues, 2015 Edition.

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Jan 26 2015

Some thoughts about the Revolving Door

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.

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