Search results: added sugar

The annual meeting of the Academy for Nutrition and Dietetics, formerly the American Dietetic Association, always provides an incredible exhibit of products from food companies—the latest in dietetic junk food and food company nutritional spin.

Knowing how much I enjoy these things, and that I am working on a book about food advocates and the soft drink industry (Oxford University Press, September 2015), several of my colleagues brought back souvenirs.

Functional foods (with “healthy” ingredients above and beyond what occurs naturally)

• For Keurig brewing machines, a container of Fibersol Cran-Raspberry flavored instant tea mix, with soluble fiber added (is tea really a significant source of soluble fiber?).
• MealEnders.com’s chocolate mint signaling lozenges, “an antidote to overeating.”  If you feel that you are overeating, suck on one: “take control, curb appetite, get results” (if only).
• A 6-ounce can of Kao Nutrition’s black coffee with 270 mg polyphenol (coffee chlorogenic acid), naturally present because the coffee was not brewed at high temperature (well, coffee is a plant extract, after all).

Swag

• A pen with a pull-out section that gives the potassium content of commonly consumed foods (these come in other versions too, apparently).

Soda company propaganda

• A brochure from PepsiCo’s Nutrition Team, HydrateNow.  Gatorade, it points out, is 93% water (and the other 7%, pray tell?.
• A pamphlet from PepsiCo on Calorie Balance: “many things influence your everyday nutrition.  For maintaining a healthy weight, the most important factors are how many calories you eat and the total calories you use up”  (but if those calories happen to be empty?).
• A PepsiCo brochure on Diet Beverages for People with Diabetes (but it still is advertising Pepsi).
• A list of PepsiCo drinks that meet the USDA’s nutrition standards for schools (a long list, alas).
• A scientific paper, “What is causing the worldwide rise in body weight,” sponsored by Coca-Cola (Coke’s answer: lack of physical activity, of course.)
• A poster from the American College of Cardiology, “Striking an energy balance,” sponsored in part by Coca-Cola.   It says: “Drink water or no- or low-calorie beverages” (it does not say you should “Drink less soda”).
• A pamphlet on National School Beverage Guidelines sponsored by Coca-Cola, PepsiCo, Dr Pepper Snapple, and the American Beverage Association:  “The beverage industry committed to bold change and then made it happen.  Working with our school partners, we transformed the beverages available to students” (yes, but it doesn’t explain that public pressure forced them to do this).
• A Coca-Cola pamphlet, Balancing Act.  This gives five easy ways to burn 100 calories: playing soccer 13 minutes, briskly walking 15 minutes, climbing stairs 10 minutes, jumping rope 9 minutes, gardening 19 minutes (based on a 150 lb person).  Funny, it doesn’t mention that one 12-ounce Coke is 140 calories.
• A FamilyDoctor.org pamphlet, Healthy Eating for Kids, from the American Academy of Family Physicians and the American Dietetic Association, distributed with a grant from Coca-Cola.  It lists healthy eating habits—family meals, be active, limit screen time, stay positive, etc (but—surprise—does not suggest that your kid might be healthier not drinking sugar-sweetened beverages).

Treasures, all.  I really love this stuff.  Thanks.

The big nutrition scare last week was the study in Nature finding that in mice and, maybe, humans, artificial sweeteners mess up the microbiome and make some people even more intolerant of glucose.

The authors conclude that their results call for a reassessment of massive use of artificial sweeteners.

The study is complicated and difficult to read but the Wall Street Journal has a nice summary.  It explains why the study is getting so much attention:

The new Nature study marks a significant advance because it brings together two separate areas of research—the role of sweeteners in raising blood sugar levels, and the complex workings of the vast colonies of bacteria that inhabit the gut. Individuals can have differing bacterial colonies in their gut, meaning people respond differently to what they consume.

The study involved several experiments.  These found:

• Mice fed saccharin, sucralose, or aspartame had significantly higher blood-glucose levels than mice whose diet included sugar, or just water.
• Mice with sterilized digestive tracts, who were given bacterial transplants from artificial-sweetener-fed mice, displayed higher blood sugar levels than those receiving bacterial transplants from sugar-fed mice.
• People who typically use artificial sweeteners have different kinds of bacteria in their intestines than those who do not.  They also are more glucose intolerant.
• Seven volunteers fed artificial sweeteners for four days displayed higher blood-sugar levels as well as altered populations of bacteria in their gut.

The Wall Street Journal quotes the Calorie Control Council (the trade association of makers of artificial sweeteners).  The CCC said:

The results from the mouse experiments may not apply to humans, while the human experiments had a small sample size. It said further research was needed.

Despite my lack of enthusiasm for artificial sweeteners, I think the Calorie Control Council has a point.

The excellent report by Kenneth Chang in the New York Times explains why.

At present, the scientists cannot explain how the sweeteners affect the bacteria or why the three different molecules of saccharin, aspartame and sucralose result in similar changes in the glucose metabolism.

Chang ends with this:

Dr. Frank Hu, a professor of nutrition and immunology at the Harvard School of Public Health who did not take part in the study, called it interesting but far from conclusive and added that given the number of participants, “I think the validity of the human study is questionable.”

Here’s why I’m not fond of artificial sweeteners:

• They taste bad (to me)
• They have no demonstrated effectiveness in helping people lose or maintain weight.
• They are artificial, and violate my rule to “never eat anything artificial.”

Do they mess up the microbiome and cause glucose intolerance, insulin resistance, and metabolic syndrome?

That would be fascinating, but I’m reserving judgment pending further research.

In the meantime, I’ll take sugar—in moderation, of course.

The FDA is taking comments on label proposals until August 1 (see info at end of post).  Here’s mine on voluntary vitamin D labeling.

July 17, 2014

TO:  FDA

FROM:  Marion Nestle, Professor, New York University

RE:  Proposed revision to Nutrition Facts Panel: VITAMIN D

This is to argue against permitting food companies to voluntarily label added “Vitamin” D on the Nutrition Facts panel.  Doing so will not promote—and may possibly harm–public health.

Rationale

• “Vitamin” D is not a vitamin; it is a hormone synthesized by the action of sunlight on skin.  For this reason alone, it does not belong on the food label.
• Vitamin D fortification must be understood as a form of hormone replacement therapy.   As such, it raises questions about efficacy, dose, and side effects that should be asked about all such therapies.
• Fortification and supplementation provide hormone Vitamin D by the oral route.  This is not physiological.  Active vitamin D is synthesized in the body through a series of reactions that begin with the action of sunlight on skin.  Sunlight on skin produces ample Vitamin D, is regulated to promote synthesis as needed and avoid toxicity, and may lead to synthesis of other useful biological components; the unphysiologic oral route does not produce the same benefits.[i]
• As a hormone, Vitamin D is found naturally in very few foods (e.g., fish); in them, it is present in small amounts.  It is present in most foods as a result of fortification.
• Permitting Vitamin D to be listed on food labels will encourage fortification, undoubtedly of foods that would not otherwise necessarily be recommended.  To cite just one example: Yum Bunny Caramel Milk Spread fortified with vitamin D at 10% of the DV.  This product is half sugars by weight, marketed as “a good source of calcium and vitamin D,” and clearly aimed at children. See: http://www.yumbunny.com/about-us.   Whether such products should be considered “good sources” also deserves scrutiny.
• The U.S. Preventive Services Task Force concludes that evidence is insufficient to determine how Vitamin D supplementation (and, therefore, fortification) affects fracture incidence.[ii]^,[iii],[iv] 
• Data from the Women’s Health Initiative also are consistent with largely inconclusive findings about hormone Vitamin D supplements and bone health.[v]
• The Institute of Medicine (IOM) does not consider deficiency of Vitamin D to be a serious problem in the United States, except among certain population groups.  Instead, because of widespread fortification and supplementation, it is concerned about the possibility of adverse consequences from overconsumption through supplementation or fortification.[vi]
• Many scientific debates about hormone Vitamin D are as yet unresolved.[vii]^,[viii]  
• The lack of compelling research has permitted Vitamin D to become “trendy.”  It is advertised on boxes of fortified cereals, has its own pro-supplement advocacy group, and generates millions in annual supplement sales.[ix]

In the absence of stronger evidence for benefit from fortification, and some evidence for possible adverse consequences, the FDA should not contribute to further commercialization of this misnamed hormone by permitting it to be listed on food labels.

References

[i] Wacker M, Holick MF.  Sunlight and Vitamin D: A global perspective for health. Dermato-Endocrinology 2013;5(1):51–108.

[ii] Cranney A, Horsley T, O’Donnell S, Weiler H, Puil L, Ooi D, et al.  Effectiveness and safety of vitamin D in relation to bone health. Evidence Report/Technology Assessment No. 158. Rockville, MD: Agency for Healthcare Research and Quality. 2007.  http://www.ncbi.nlm.nih.gov/books/NBK38410. Accessed February 5, 2013.

[iii] Chung M, Balk EM, Brendel M, Ip S, Lau J, Lee J, et al  Vitamin D and calcium: a systematic review of health outcomes. Evidence Report/Technology Assessment No. 183. Rockville, MD: Agency for Healthcare Research and Quality. 2009.  http://www.ncbi.nlm.nih.gov/books/NBK32603/. Accessed February 5, 2013.

[iv] Chung M, Lee J, Terasawa T, Lau J, Trikalinos T. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155(12):827-38.

[v] Prentice RL, Pettinger MB, Jackson RD, Wactawski-Wende J, LaCroix AZ, Anderson GL, et al.  Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study.  Osteoporosis Int.  2013;24(2):567-580.

[vi] Institute of Medicine.  Dietary Reference Intakes: Calcium, Vitamin D.  Washington, DC: National Academies Press, 2011.

[vii] Rosen, Clifford J,  Abrams, Steven A,  Aloia John F. et al.  IOM Committee members respond to endocrine society vitamin D guideline. J Clin Endocrinol Metab. 2012;97:1146-1152.

[viii] Holick, Michael F,  Brinkley Neil C, Heike, A et al  Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited.  J Clin Endocrinol Metab. 2012;97:1153-1158.

[ix] Much growth in vitamin sales driven by vitamin D.  Nutr Business J. 2009;14(6/7):5.

Here’s how to file comments:

The proposed revisions are to:

• Nutrition and Supplement Facts Labels
• Serving Sizes 

The FDA makes it very easy to file comments. It provides:

• All necessary information in one place.
• A short guide and checklist

File comments here

• Nutrition and Supplement Facts Label: Docket FDA-2012-N-1210  Comment here now
• Serving Sizes: Docket FDA-2004-N-0258  Comment here now

Hoping to cash in on the current protein craze, General Mills has come up with this (thanks to Kasandra Griffin of  Upstream Public Health in Portland, OR,  for sending):

Cheerios Protein has 7 grams of protein per serving.  But it also has 17 grams of sugars.

I use sugars, plural, for good reason.  Here’s the ingredient list:

In case you can’t read this: Whole grain oats, cluster (whole grain oats, brown sugar, soy protein, lentils, sugar, corn syrup, natural flavor, molasses, rice starch, caramel (sugar, caramelized sugar syrup), salt, calcium carbonate, baking soda, color added, BHT added to preserve freshness), sugar, corn starch, honey, salt, refiner’s syrup, tripotassium phosphate, rice bran and/or canola oil, color added, natural flabor, brown sugar, vitamin E (mixed tocopherols) and BHT added to preserve freshness.

A trip to the supermarket also turned up these:

This one has 16 grams of sugars.

And here’s another.  This one only has 7 grams of sugar per serving.  How come?  Sucralose!

Really, you can’t make this stuff up.

And just a reminder about protein: American consume roughly twice as much as needed.  Protein is not an issue in U.S. diets.

This is about marketing, not health.

I guess Cheerios SUGARS, Fiber One SUGARS, or Special K SUGARS PLUS ARTIFICIAL SWEETENERS wouldn’t go over nearly as well.

This ad was in last Sunday’s New York Times.  It appears again today with blurbs added.

Full disclosure: I’m one of the many people interviewed for the film and appear in three 10-second clips.

Fed Up! is a stunningly hard-hitting exposé of the food industry’s role in promoting unhealthy diets and childhood obesity.  It spares nothing in showing the devastating effects of obesity on kids (I found those parts painful to watch).

The film’s main message is that the food industry, in collaboration with government, is responsible for creating a food environment that promotes poor health.

It is especially tough on food company marketing and industry-sponsored research.

It is also—I think, unfortunately—tough on Michelle Obama and her Let’s Move! campaign.

Mrs. Obama is not the problem.  The food industry’s marketing and co-opting practices are the problem.

We can debate whether it was wise or useful for Let’s Move! to partner with the food industry, but the campaign has done much to bring issues of childhood obesity to public attention.

It’s ironic that the accomplishments of Let’s Move!—the White House garden, the Healthy Hunger-Free Act of 2010, the new school food nutrition standards, the new nutrition standards for WIC, and the new food label, for example—are at this very moment under fierce attack by food companies, their trade associations, and their friends in Congress.

With that said, the film is well worth seeing.  Don’t miss it.  Get your friends to see it.  Let the debates begin.

How to see Fed Up!

• Watch the trailer here.
• Find out where it’s playing here.
• Share it on social media here.
• See Katie Couric’s excellent ABC News interview here.
• Read the New York Times review here.

As for the debate, please enjoy:

• The Grocery Manufacturers Association statement about Fed Up! and its Q and A in response to the film
• International Food Information Council review
• The National Confectioners Association statement

Additions

• Jerry Hagstrom on the lack of “policy muscle”
• Nancy Huenegarth’s review in Food Safety News
• The food industry’s stealth campaign against the film
• Michele Simon’s take on the film.
• IFIC’s new point-by-point rebuttal of scientific statements in the film.
• Mark Bittman on the most important movie ever made.
• Food Policy Action — Real Fed Up Facts (in response to GMA)

You might think that the Supreme Court of the United States would have more important things to do than to weigh in on which of two beverage companies puts less misleading labels on its products, but apparently not.

The highest court in the land takes POM Wonderful’s accusation against Coca-Cola seriously.  Coke’s Minute Maid juice, POM says, is advertised in ways that mislead the public.

POM should know.   It’s been under fire from the Federal Trade Commission for equally absurd label claims.

Here’s the Coca-Cola product at issue.

And here’s what the label says, in case you can’t read it (with emphasis added):

Enhanced Juice/Minute Maid/100% Fruit Juice Blend

Omega-3/DHA/HELP NOURISH YOUR BRAIN

5 Nutrients to Support Brain and Body

Pomegranate  Blueberry Flavored Blend of 5 Juices

From concentrate with added ingredients and other natural flavors

Never mind the nutritional quality or the ridiculous structure/function claims on this particular product (here’s Fooducate’s analysis from 2009—it has 29 grams of sugars, among other things).

POM doesn’t want Coke getting away with selling cheap grape and apple juices as pomengranate juice and undercutting their prices.  Coke’s drink is 99% apple and grape juice; it contains less than 1% pomegranate or blueberry juice.  You would never know that from looking at the label.

Why is the court interested?  The Minute Maid label is legal by FDA standards.  Therefore, can the label be considered misleading?

Coca-Cola won in the lower court, but the Supreme Court seems sympathetic to POM (here’s the transcript of the hearing).

The New York Times account has the best quotes:

Kathleen M. Sullivan, a lawyer for Coca-Cola, said consumers were not misled.

“We don’t think that consumers are quite as unintelligent as Pom must think they are,” she said. “They know when something is a flavored blend of five juices and the nonpredominant juices are just a flavor.”

Justice Kennedy frowned. “Don’t make me feel bad,” he said, “because I thought that this was pomegranate juice.”

It also quotes from Justice Alito:

You don’t think there are a lot of people who buy pomegranate juice because they think it has health benefits, and they would be very surprised to find when they bring home this bottle that’s got a big picture of a pomegranate on it, and it says ‘pomegranate’ on it, that it is — what is it — less than one half of 1 percent pomegranate juice?”

Where is the FDA on all this?  Blame its inaction on the Dietary Supplement Health and Education Act of 1994, which allowed ridiculous health claims on food labels and forced the FDA to keep hands off.

This outcome of this case, silly as it is, will be fun to watch.

I read about General Mills’s introduction of non-GMO Cheerios back in January, but didn’t get around to looking for them until this weekend.

I was expecting to see something like this (thanks Fooducate):

Instead, the information is tucked into a side panel. 

This may explain why General Mills is complaining that the non-GMO is not doing a thing to boost sales of Cheerios.  If anything, sales are “down somewhat.”

And here’s a good one: According to one professor, the non-GMO Grape Nuts and Cheerios are going to be less nutritious than the GMO versions.

Post Foods’ new non-GMO Grape Nuts (click here ) no longer include Vitamin A, vitamin D, vitamin B12 or vitamin B2 (Riboflavin)*, while the new non-GMO Original Cheerios no longer have Riboflavin on the ingredients list (the old version has 25% of the daily value in a 28 g serving while the new version has 2% of the DV).

How come?  It’s hard to find non-GMO vitamins (who knew?).  Vitamins, it seems are often produced from genetically engineered microorganisms, or from microbes growing in fermentation tanks that are fed a nutrient mix that contains ingredients from GM sugar beets or corn.

Should we be worried about nutritional deprivation among Cheerios eaters?

Cheerios are essentially a vitamin pill wrapped in rapidly absorbable starch.

The ingredients: whole grain oats, corn starch, sugar, salt, tripotassium phosphate, wheat starch.

Everything else is added vitamins.

Personally, I prefer my cereals with no added vitamins (they taste bad).  And I doubt they make much difference to health.

Whether non-GMO will have a noticeable effect on sales of Cheerios remains to be seen.

If General Mills doesn’t advertise the change, it can’t expect non-GMO to boost sales.

Curious, no?

Rumors are flying that Let’s Move! will announce significant accomplishments this week.

From what I can piece together from ProPolitico and press conference announcements, they go on all week.

• Tuesday: School wellness policies
• Wednesday: Food assistance programs other than SNAP
• Thursday:  The Nutrition Facts label

These promise to be more useful than Mrs. Obama’s visit to the New Museum in New York to celebrate a pop-up exhibit organized by WAT-AAH!, a company that makes bottled water—marketed specifically to kids.

The company is a supporter of Let’s Move!’s Drink Up! campaign.

Its bottled waters are “functional,” meaning ostensibly nutritionally enhanced in some way.

For example, its “Power” product says it is:

Ultra pure water!

Bone-building magnesium!

Absolutely NO SUGAR!

Taste like pure clean water!

Sounds like plain, ordinary water to me (unless the amount of magnesium is substantial, which seems unlikely—I can’t find a Nutrition Facts label for it).

The idea here is to get kids who won’t drink water to drink bottled water aimed specifically at them—at $1.50 a pop.

This was great publicity for the company, but I sure wish Drink Up! would emphasize how terrific tap water is, especially in New York City, where it really is terrific.

Added comments:  A reader points out that WAT-AAH!’s health claims are difficult to substantiate (e.g., boosted oxygen level, brain function), and are just the kinds of claims that concern the FTC.  

And, despite Drink Up!’s public stance on how tap water is just fine, WAT-AAH! puts down tap water.  To check both the claims and the put down, go to the website, click on WAT-AAH! Drinks!, then on Just the Facts, and scroll on down.  

You will find plenty of highly iffy health claims, along with this:

OK, so this is about marketing so what’s the big deal?  I can think of several reasons for concern:

• It’s marketing bottled water.
• It’s marketing directly to kids.
• It’s marketed with absurd health claims.
• It claims to be substantially better for kids than tap water.
• It’s endorsed by the First Lady.

The FTC has gone after health claims just like these.  Can it go after WAT-AAH!’s claims and, thereby, take on the First Lady?

This is what happens—all too often—when health programs try to partner with private industry.  The private industry invariably wins, and the health partner loses credibility.