by Marion Nestle

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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.

Nov 30 2023

FoodNavigator–Asia on product reformulation

FoodNavigator–Asia, a newsletter I subscribe to, publishes articles on reformulation and has now collected them in one place.

Reformulation is what happens when companies change the mix of food product ingredients to make them healthier—or at least to appear healthier-.  This is a highly effective sales strategy.

But reformulation raises philosophical questions:

  • Is a slightly better-for-you food product necessarily a good choice?
  • Does reformulation convert an unhealthy ultra-processed food product into a healthy one?
  • Is a food product with a gram or two less of sugar or salt likely to make any difference to your health?

Never mind.  Here’s what food companies are doing these days, at least in Asia.

Special Edition: Reformulation: Sugar, Salts, Fats and Oils

Governments across the region are continuing to enforce policies to reduce sugar, salts, fats, and certain oils. In this special edition, we’ll showcase the companies providing the most innovative solutions and brands at the forefront of this charge.

Nov 29 2023

RIP Brominated Vegetable Oil (BVO), maybe for good this time?

The FDA says it is proposing to revoke the regulation authorizing the use of brominated vegetable oil (BVO) in food.  In  transslation from FDA-speak, the agendy now intends to ban BVO.

This is the second time I have written an RIP for BVO.  The first was in 2013—ten years ago!— when PepsiCo said it no longer use BVO in Gatorade in response to a petition from a teenage influencer.

BVO, a flame retardent, is made by adding bromine to vegetable oil.  Studies for years have found BVO to cause neurological and other health problems.  The FDA says:

In our 2014 review, we identified four unresolved safety questions with respect to the use of BVO in food: the potential for thyroid toxicity, bioaccumulation, developmental neurotoxicity, and reproductive toxicity. We determined that the safety data and information available did not provide evidence of a health threat resulting from the limited permitted use of BVO as a flavoring stabilizer in fruit-flavored beverages,…We concluded that high-quality data from contemporary studies, performed under current guideline standards, were needed to address the knowledge gaps regarding the safety of BVO …. The rodent safety studies…confirmed previous reports that dietary exposure to BVO is toxic to the thyroid and results in bioaccumulation of lipid-bound bromine in the body at doses relevant to human exposure.

OK, but this FDA action has an even longer history, and shockingly so.

In 1970, the FDA ruled that BVO could no longer be considered “Generally Recognized as Safe” (GRAS), but took no further action saying removing it was not much of a priority.

The UK banned it isoon after; the European Union got rid of it in 2008.  But the FDA did not.

In summary, the FDA has been worried about BVO since 1970 but is only just now getting around to banning it.

Why?  I can only speculate.

  • The soft drink industry is losing power now that people view it as producing unhealthy products.
  • California recently took the lead and banned BVO along with three other questionably safe additives.
  • Or maybe it just didn’t judge the evidence for harm as adequate.

Better now than never.

Resources

Nov 28 2023

The hazards of feeding babies and young children: What to do?

I’ve been collecting items on feeding kids.  Here are four.

I.  FDA Warning Letters: The FDA has sent warning letters to ByHeart, Mead Johnson Nutrition (Reckitt), & Perrigo Wisconsin for violating basic food safety standards in manufacture of infant formula.

They [letters] reflect findings from FDA inspections of these facilities over the last several months. At the time of each inspection, the FDA issued inspectional observations and exercised oversight of each firm as they initiated recalls (in December 2022February 2023 and March 2023) to remove product potentially contaminated with Cronobacter sakazakii from the marketplace…The FDA is issuing these letters now as part of its normal regulatory process and to reinforce to these firms the importance of instituting and maintaining appropriate corrective actions when they detect pathogens to ensure compliance with the FDA’s laws and regulations. As part of this, the firms must, among other things, thoroughly conduct root cause investigations and perform subsequent cleaning and sanitation activities. Notably, firms also need to properly evaluate their cleaning and sanitation practices, schedules, and procedures before releasing product. 

Comment: What shocks me is the implication that the companies are not already doing this as part of their normal routines.

II.  Baby food pouches with lead sicken children.   

At least 18 more children have been sickened by the recently recalled applesauce fruit pouches due to dangerous lead contamination, the Food and Drug Administration said, in a recent update.  That brings the total number of affected children to 52. Applesauce pouches recall timeline:From recalls to poisoned kids in multiple states

Comment: Yes, I know self-feeding pouches are convenient, but I sure don’t like them much.  They are usually loaded with sugar and they don’t teach kids about diverse food flavors and textures.  Quality control, apparently, is a big issue.  My vote: avoid.

III. Environmental Working Group study finds 40% of commercial baby foods to contain toxic pesticides.

  • EWG sampled 73 products from three popular brands: 58 non-organic, or conventional, baby foods and 15 organic.
  • At least one pesticide was detected in 22 of the conventional baby foods.
  • No pesticides were detected in any of the 15 organic products.

Comment: Pesticides may be in all foods but they get concentrated in baby foods.  The moral here is clear; if you want baby foods free of harmful pesticides, buy organic.  For more on this, see article in The Guardian.

IV. The marketing of ultra-processed foods especially targets infants and young children.   A study done in the UK provides ample documentation of anything you would want to know about this practice.

Comment: Food companies say they have to market to young children in order to meet sales growth targets.  Ethics is not a consideration here.

Given that situation, what to do?

Understand: commercial infant and baby foods are convenient, but enormously profitable to manufacturers.  Profits induce corporations to cut safety and health cautions.  This tension should make you think twice about using commercial infant and child feeding products.

To the extent you can:

  • Breast feed when possible, for as long as possible
  • If you use infant formula, switch around the brands (they are all the same, nutritionally); buy organic if you can afford it.
  • Make your own baby foods (put whatever healthy foods you are eating or have around in a tiny blender).; buy organic foods if you can afford them.
  • Feed kids real foods as soon as they can grab, chew, and swallow them without choking.

If you eat a generally healthy diet, get your kids eating it as soon as they can.