by Marion Nestle

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Jan 1 2024

Welcome to 2024: Annals of research

I want to start off the new year with a week of cheery postings.  IHow’s this for an irresistable beginning!

The study:  Could sharing chocolate cake increase engagement with research on intermittent fasting?   BMJ2023383 doi: https://doi.org/10.1136/bmj.p2585 (Published 20 December 2023).

Rationale: “Food and the festive season are heavily intertwined, and for us one sweet treat stands out: the chocolate brownie. Whether it’s the fudgy centre or the crinkled crust, brownies’ irresistibly rich deliciousness evokes comfort and delight. And isn’t chocolate good for you?…We wanted to know whether offering brownies affects how recipients respond to research findings on intermittent or short-term fasting.”

Method: “We completed two multicentre studies—a randomised controlled trial and a cross-sectional study—to seek understanding of the effects of offering brownies on healthcare professionals’ engagement with, and perception of, research findings on fasting.”

Results: “Preliminary results indicate that brownies did not influence their views—but many saw value in short term fasting to improve wellbeing.”

Conclusion: “Sharing brownies may not affect perceptions of presented evidence, but we remain convinced that they are the best treat to offer while discussing calorie restriction.”

Conflicts of interest:  “We have,,,no relevant interests to declare.”

Comment: This study produced a negative result, but who cares?  I’ll bet participants had a great time.  Check out the recipe; it is designed to produce enough brownies for one research meeting.

No, I am not making this up.

Happy new year!

Dec 21 2023

Bird flu causing big trouble

Avian influenza of the highly pathogenic kind (HPAI, H5N1) is now everywhere.

The CDC says bird flu, caused by avian influenza viruses,

naturally spread among wild aquatic birds worldwide and can infect domestic poultry and other bird and animal species. Bird flu viruses do not normally infect humans. However, sporadic human infections with  bird flu viruses have occurred.

The CDC also has much to say about the current status of H5N1: it has infected 72.5 million poultry so far this year.  These had to be destroyed.

One egg producer, Michael Foods, said it “lost” 4.2 million laying hens to HPAI.

“Lost?”

According to Vox, 

The 2022-2023 spread of bird flu has been the most catastrophic on record in the US. In less than two years, it’s hit hundreds of poultry factory farms across nearly every state in the country, costing the federal government $757 million and counting to manage, and the poultry industry more than $1 billion in lost revenue and other costs (experts also fear that the disease could spark an outbreak in humans).

To help stamp out the disease’s spread, all of the more than 72 million chickens, turkeys, and other birds raised for meat and eggs on affected farms have been killed and disposed of, whether or not they actually had the virus, which can spread rapidly and has a very high mortality rate for poultry birds.

Vox explains the killing method (consider what killing millions of chickens entails): basically shutting down the ventilation.

This seems catastrophic, even though 72 million is just a small fraction of the 1.2 billion chicken alive at any time.

Surely, industrially crowded housing has something to do with the rapid spread of H5N1.  Another downside of industrial egg production.

Expect egg prices to rise.

Happy new year.

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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.

Dec 14 2023

Insects as food: a roundup

I like following what’s happening with insect foods, and much is.  Here are some recent examples from the press but also from academic journals.

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Dec 12 2023

Food iS Medicine (FIM): the latest food movement (of sorts)

I subscribe to Jerry Hagstrom’s Hagstrom Report because he gets to go to things in Washington, D.C. and elsewere that I can’t get to but wish I could.

He reported last week (December 7) on the Food As Medicine Summit, and wrote about it in the National Journal — “Food as medicine’ on the table”.  This notes, among other things, that the minimum fee for attending was $399.

So what is the food-as-medicine movement? Advocates believe changing Americans’ diets away from the fat, sodium, and added sugars that have led to high levels of obesity and instead toward fruits, vegetables, fiber, and lean protein can reduce the need for prescription drugs and hospitalizations. The advocates want Medicare, Medicaid, and private insurers to pay for diet interventions like produce prescriptions.

He also reported on the accompanying Trade Show.

Food as Medicine is still an emerging concept, but there was a small trade show on the sidelines of the Food as Medicine Policy Summit that showed the range of companies that believe the food and health care industries need their products.

I was particularly interested in the trade show because the monetization of Food Is Medicine is a big concern.

Also last week, JAMA published a critique of the concept: “A “Food Is Medicine” Approach to Disease PreventionLimitations and Alternatives,” arguing that “the medical and public health communities’ enthusiasm for food is medicine seems unjustified by its likely benefit.”

The authors argue (my paraphrasing):

  • Evidence in support of FIM’s ability to improve health is weak.
  • Existing studies do not differential FIM from the effects of standard care.
  • FIM requires enrollment in the health care system (overburdened, dysfunctional, difficult to access).
  • Patient adherence to interventions is low (unless they are provided intact and paid for).
  • Existing federal food and nutrition programs are already known to work; they deserve more support.
  • The main beneficiary is the food industry, which gets to shift responsibility to the health care system.
  • Food companies will also benefit from sales of FIM products [hence the Summit Trade Show].

Count me as an FIM skeptic.  It’s nice for people who can get it; it is not likely to scale up enough to address chronic disease in any significant way.

Hagstrom lists these resources:▪
USDA National Institute of Food and Agriculture — Gus Schumacher Nutrition Incentive Program
Grey Green Media — Events
Food is Medicine Coalition

Dec 11 2023

Conflicted interests: obesity drugs, alcohol, clinical trials

DRUGS

Here’s the headline: Maker of Wegovy, Ozempic showers money on U.S. obesity doctors

Drugmaker Novo Nordisk paid U.S. medical professionals at least $25.8 million over a decade in fees and expenses related to its weight-loss drugs, a Reuters analysis found. It concentrated that money on an elite group of obesity specialists who advocate giving its powerful and expensive drugs to tens of millions of Americans.

What’s extraordinary about this situation is the amounts.  Some doctors got millions.

This account follows one about similar efforts in the UK: Revealed: experts who praised new ‘skinny jab’ received payments from drug maker.

The drug giant behind weight loss injections newly approved for NHS use spent millions in just three years on an “orchestrated PR campaign” to boost its UK influence.  As part of its strategy, Novo Nordisk paid £21.7m to health organisations and professionals who in some cases went on to praise the treatment without always making clear their links to the firm, an Observer investigation has found.

Novo Nordisk knew what it was doing, and its efforts (presumably legal) are certainly paying off.

ALCOHOL

The headline: Scientists in Discredited Alcohol Study Will Not Advise U.S. on Drinking Guidelines: Two researchers with ties to beer and liquor companies had been named to a panel that will review the health evidence on alcohol consumption. But after a New York Times story was published, the panel’s organizers decided to drop them.

Five years ago, the National Institutes of Health abruptly pulled the plug on an ambitious study about the health effects of moderate drinking. The reason: The trial’s principal scientist and officials from the federal agency’s own alcohol division had solicited $60 million for the research from alcohol manufacturers, a conflict of interest and a violation of federal policy.

I wrote about that in a previous post.

I’m told by people in the know that I should not be too hard on the scientists.  NIH told them it would not fund the study and they should get the funding from industry.  If true, that is unfortunate.

For sure, NIH is not interested in nutrition research except for genetically based “Precision” nutrition aimed at individuals.  That leaves population studies out of the picture.  Unfortunate, indeed.

CLINICAL TRIALS

The study: Industry Involvement and Transparency in the Most Cited Clinical Trials, 2019-2022

Among 600 clinical trials with a median sample size of 415  participants:

  • 409 (68.2%) had industry funding
  • 303 (50.5%) were exclusively industry-funded
  • 354 (59.0%) had industry authors
  • 280 (46.6%) involved industry analysts
  • 125 (20.8%) were analyzed exclusively by industry analysts.

Among industry-funded trials:

  • 364 (89.0%) reached conclusions favoring the sponsor.

Industry involvement in research in general and in nutrition research in particular deserves close scrutiny and much skepticism.

Drug companies are required to do research and to find their own funding.  That is not true of nutrition.

Everyone should be lobbying for more independent funding for nutrition research.

Dec 5 2023

The COP-28 UN Climate Change Conference in Dubai—items

COP-28, the UN’s climate change conference is happening in Dubai, right now.

I’m trying to make sense of it.  For starters, the irony:

But food—the effects of agriculture on climate change (and vice versa) is on its agenda this year—a major big deal.

That’s why a coalition of farmers, communities, business, and philanthropy has issued a call to transform food systems.

Here’s my collection of food-related items.

I.  Food Tank’s Danielle Nierenberg is on the job: more than 30 Food Tank partnered events are scheduled.

Once again, four pavilions will be devoted to food systems: Food and Agriculture, led by our partners and friends at FAO, CGIAR, International Fund for Agricultural Development, and The Rockefeller Foundation; Food Systems, spearheaded by the European Union-backed program EIT Food and a variety of other groups including the Food and Land Use Coalition; Food4Climate, organized by a variety of partners—including youth voices—pushing for a more humane and sustainable food system; and the Sustainable Agriculture of the Americas Pavilion facilitated by IICA, bringing together the global north and south across the hemisphere.  You can read Food Tank’s coverage of the roadmap, which was announced last year, here.

IIFoodDive: Food system transformation on the menu at COP28

III.  Reuters: Countries urged to curb factory farming to meet climate goals

IV.  The lunch menu: The summit is featuries roughly two-thirds plant-based menu to highlight the link between greenhouse gas emissions and livestock.  But the meat industry is fighting  back.

V.  DeSmog: Big Meat Unveils Battle Plans for COP28

VI.  The Guardian: Plans to present meat as ‘sustainable nutrition’ at Cop28 revealed: Documents show industry intends to go ‘full force’ in arguing meat is beneficial to the environment at climate summit.

VII.  The Meat Institute

The Meat Institute and the Protein PACT for the People, Animals & Climate of Tomorrow will highlight animal agriculture’s commitments and progress toward global goals in multiple high-level engagements at the UN Climate Change Conference (COP28) in Dubai November 30-December 12. The Protein PACT has organized or assisted with inviting expert speakers for six panels across five COP28 pavilions, including:

  • December 5 panel in the Food Pavilion, co-organized by IICA and the International Livestock Research Institute (ILRI) on the topic of sustainable and healthy livestock production systems
  • December 6 panel in the IICA pavilion, organized by the ​​Canadian Alliance for Net-Zero Agri-food on the topic of achieving net zero in agrifood systems
  • December 8 panel in the IICA pavilion, organized by the Protein PACT on the topic of principles, practices, and proof for animal agriculture driving climate and food security solutions
  • December 9 panel in the IICA pavilion, co-organized by IICA and ILRI on the topic of innovation and investment in livestock systems for climate change adaptation and  mitigation

VIII.  International Dairy Federation & European Dairy Association side event: How Animal Source Food Nourishes The World In Times of Climate Change.

IX. Vox: There’s less meat at this year’s climate talks. But there’s plenty of bull.  Meat and dairy are driving the climate crisis. Why won’t world leaders at COP28 do anything about it?

X.  Food Navigator: on The Emirates Declaration.  Food is finally at the top table but measurable targets are missing.  Over 130 prime ministers and presidents have today signed the Emirates Declaration at COP28 – a first of its kind commitment to adapt and ‘transform’ food systems as part of action on the climate crisis…. Read more

Comment: The Emirates Declaration on Sustainable Agriculture, Resilient Food Systems and Climate Action is the firsr statement out of this meeting.  It doesn’t mention fossil fuels (the elephant in this particular room) or meat.  But it does propose:

1. Financial and technical support for sustainable solutions, capacity building, infrastructure, and innovations for farmers, fisherfolk, and other food producers.while conserving, protecting and restoring nature.

2. Promoting food security and nutrition.

3. Supporting workers in agriculture and food systems whose livelihoods are threatened by climate change.

4. Strengthening water management .

5. Conserving, protecting and restoring land and natural ecosystems, enhancing soil health, and biodiversity, and shifting from higher greenhouse
gas-emitting practices to more sustainable production and consumption approaches, including by reducing food loss and waste and promoting sustainable aquatic blue foods.

As for how and when?

To achieve these aims – according to our own national circumstances – we commit to expedite the integration of agriculture and food systems into our climate action and, simultaneously, to mainstream climate action across our policy agendas and actions related to agriculture and food
systems.

In the meantime, consider these:

What will it take to stop the impending disaster?  This has to be #1 on the advocacy agenda.

Dec 4 2023

Why I care about conflicts of interest

For years now I have been posting on Mondays something about conflicts of interest in nutrition research and practice on this site .

My goal in doing so is to raise awareness of practices that give the nutrition profession the appearance of undue food industry influence at the expense of public health.

Occasionally someone involved with something I post requests a correction or clarification.

Most recently, I heard from Gunter Kuhnle, a researcher in the UK whom I do not know personally.   He wrote:

In your blog (https://www.foodpolitics.com/2023/11/chocolate-an-update-on-the-food-politics-thereof/), you comment about my article in “The Conversation” on flavanols. This comment concludes with a statement that could be interpreted as if I was paid to write this piece. I would like to make clear that I was not paid to write this article – it was conceived and written in order to address a number of misunderstandings in the reporting of various studies concerning flavanols.  I would appreciate if you could correct this.

Since that was not at all my intention, I clarified the post immediately.

But I also requested his permission to reprint his note so I could do some more explaining about why this issue so concerns me.

I want to start by emphasizing that I do not see this as a personal matter.  My original post did not mention the author’s name and in general I try to avoid mentioning names of authors of industry-funded research unless they report financial ties to companies with vested interests in the outcome of that research.

I see this as a systemic issue.

But to summarize the arguments—and the research—I make and summarize in my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat:

An enormous body of evidence, most of it derived from studies of tobacco, chemical, or pharmaceutical drug industry-sponsored research, consistently shows:

  • Industry-funded research generally yields results that favor the sponsor’s interests.
  • Industry funding of research influences its outcome.
  • The influence of industry funding usually shows up in the framing of the research question or in the interpretation of results.
  • Recipients of industry funding do not recognize the influence, do not intend to be influenced, and deny the influence (“science is science”).
  • Denial of influence contradicts an enormous body of evidence to the contrary.
  • Disclosure of funding source or relationships is necessary but not sufficient; considerable evidence exists to show that the statement “the sponsor had nothing to do with the design, conduct, or publication of the study” is often misleading or false.
  • Exceptions do exist, but they are rare.

That researchers do not recognize the risks of industry funding is disturbing.  At the very least, when nutrition researchers accept funding from food companies, they give the appearance of conflict of interest.

And that is all it takes to reduce public trust in nutrition research, nutrition professionals, and nutrition professional societies.

I think there is something seriously wrong when I can look at the title of a nutrition research article and make a good guess about what company or industry trade association funded it.

I think there is something seriously wrong when I can look at the funder of a study and guess what the outcome is.

One more point: an argument I hear often is that all nutrition researchers are biased because they have dietary or ideological preferences.  There is research on this point too.  It argues that all researchers have personal or ideological biases—that’s what motivates them to do studies to test their hypotheses.  Personal biases, therefore, are universal and do not cause conflicts of interest.

Industry funding introduces a quite different motive: proving the health benefits or safety of a food product for commercial—not scientific—purposes.

Unsavory Truth provides references for all of this.

Also see Science in the Private Interest:  Has the Lure of Profits Corrupted Biomedical Research? by the late Sheldon Krimsky (I miss him terribly).

Professor Kuhnle, I thank you for writing and for the opportunity to respond.