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Several readers wrote suggesting I take a look at the conflicts of interest statement on this paper.

It comes from the Harvard TH Chan School of Public Health, which issued a press release: Harvard study: ‘Portfolio diet’ may decrease risk of heart disease, stroke.

The portfolio diet—a plant-based diet designed to lower unhealthy cholesterol, emphasizing plant proteins (legumes), phytosterols (nuts and seeds), viscous fiber (oats, barley, berries, apples), and plant-based monounsaturated fatty acids (avocado)—may lower the risk of heart disease and stroke, according to a new study co-authored by researchers at Harvard T.H. Chan School of Public Health.

The study was published in Circulation, which also sent out a press release: Ever heard of the portfolio diet? It may lower risk for heart disease and stroke.

The study itself, Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies, produced results that should be expected from eating healthier diets.

Background: The plant-based Portfolio dietary pattern includes recognized cholesterol-lowering foods (ie, plant protein, nuts, viscous fiber, phytosterols, and plant monounsaturated fats) shown to improve several cardiovascular disease (CVD) risk factors in randomized controlled trials.

Objective: to examine the relationship between the Portfolio Diet Score (PDS) and the risk of total CVD, coronary heart disease (CHD), and stroke.

Methods: We prospectively followed 73924 women in the Nurses’ Health Study (1984–2016), 92346 women in the Nurses’ Health Study II (1991–2017), and 43970 men in the Health Professionals Follow-up Study (1986–2016) without CVD or cancer at baseline. Diet was assessed using validated food frequency questionnaires at baseline and every 4 years using a PDS that positively ranks plant protein (legumes), nuts and seeds, viscous fiber sources, phytosterols (mg/day), and plant monounsaturated fat sources, and negatively ranks foods high in saturated fat and cholesterol.

Conclusions: The PDS was associated with a lower risk of CVD, including CHD and stroke, and a more favorable blood lipid and inflammatory profile, in 3 large prospective cohorts.

This report was funded by Canadian and U.S. government research agencies.

Comment: The reason readers sent this to me had to do with the authors’ reported conflicts of interest.  These take up the equivalent of an entire page in the journal and refer to a curious mixture of financial support or connections, paid and unpaid, with government agencies and foundations, authors’ and sometimes their spouses’—in addition to long lists of financial ties to food trade associations for one or another plant food included in the Portfolio diet.

Muddying up disclosure statements like this is inappropriate.  Many connections listed do not in any way imply conflicted interests.  Mixing them up with those that do takes the focus away from financial ties that could have influenced the design or interpretation of the study.

Financial connections to food companies raise questions of credibility in nutrition research.  At the very least, they give the appearance of industry influence.

Disclosure lists like these either reflect ignorance of the significance and harm causes by conflicts of interest or deliberate disdain for its meanings.  If Circulation is requiring this mix of disclosures, it should reevaluate its policy.

Just because these disclosures come in a study from Harvard does not make them OK.

Fuchsia Dunlop.  Invitation to a Banquet.  The Story of Chinese Food.  Norton, 2023.  420 pages.

Fuchsia Dunlop, who has lived in China, went to cooking school there, and writes Chinese cookbooks, does something different here.  She writes about the history of Chinese Food using traditional dishes (stir-fried broccoli with ginger, Shandong guofu tofu, etc)  as starting points for exploring the how and why of each of them.

Chinese food is an inescapable cultural presence all over the world…As a brand, ‘Chinese food’ has global recognition.  Yet, from another perspective, Chinese food has also been the victim of its own success.  The resounding popularity of a simplified, adapted, even bastardized form of Cantonese cuisine, first developed in North America and then scattered like confetti all over with the world, with its childish predictability and limited range, its birght colours, sweet-sour and salty flavours, deep-fried snacks and stir-fried noodles, has clouded appreciation of the diversity and sophistication of Chinese gastronomic culture. (p.5)

The book makes up for these deficits.  Dunlop relates what she found on her travels throughout China about the origins of this cuisine (cuisines, really), the basic ingredients (animal and vegetable), the techniques (chopping, steaming, stir-frying), ending with a short dissertation on Chop Suey and scholarly apparatus: chronology, notes, bibliography.

Another quotation:

When it comes to Chinese food, I see myself increasingly as a small insect scaling a great mountain of human ingenuity.  It’s paradoxical, because in many ways modern China can seem sameish.  All over the country, the same identikit modern buildings, the same brands, the same clothes…Even after the destruction of the Cultural Revolution, Chinese food bounced back in a glittering kaleidoscope of colours.  All over the country, in nondescript little restaurants in concrete buildings, with nice calligraphy in a frames, people are tucking into remarkably delicious and locally distinctive foods.  At some profound level, this is how China expresses itself, from ancient times until now, from now until eternity (p.331).

As you should be able to tell from these brief excerpts, the book is an easy read.   I particularly enjoyed reading about Dunlop’s food adventures throughout China.  She now lives in the UK but used the pandemic to share them with us.

I’m trying to keep up with what’s happening with cultivated meat.  So far, the FDA has approved a couple of cultivated chicken cell companies, and these are selling “chicken” in a couple of restaurants, one in San Francisco and the other in Washington DC.

The big issue: scaling cell production up enough to have product to sell.  It takes lots of cells–billions? trillions?—to make a portion big enough to eat.

Here’s what’s going on in this area in the U.S. and U.K.

• • • ‘A defining feature of stem cells is that they can become other cells’: Strategies for the use of stem cells in cultivated meat productionThe production of cultivated meat will need stable cell lines from multiple different species to be successful. It is produced from stem cells, which are highly flexible and can create yields with the potential to be far greater in volume than the meat the cells originated from…. Read more.  
    • ‘Meating’ demand: Animal-based proteins versus cell-based agricultureAs demand for meat and poultry continues to grow, Food Manufacture explores what is driving sales of animal-based protein and whether or not the advent of cell-based meat is truly the herald of things to come, or a half-baked pipedream limited by a lack of resources…. Read more. How cultivated meat could be the key to avoiding the development of antimicrobial resistance: While the ‘routine use’ of antibiotics in animal agriculture is banned in the EU, increasing globalisation can make it difficult to avoid imported meat reared in this way. While the routine use of antibiotics can increase the risk of antimicrobial resistance, cultivated meat could provide a means of mitigating this…. Read more
      • • UK Government looking to fast-track legalisation of cultivated meat: The UK is set to fast-track the approval of cultivated meat as part of a partnership with Israel, the Telegraph has reported. Read more
        • Extracellular opens ‘Europe’s largest’ pilot plant for cultivated meat: Food tech firm Extracellular has opened ‘Europe’s largest’ contract pilot facility dedicated to cultivated meat and seafood production at its site in Bristol. Read more
        • Solving the mainstream adoption of alternative meats on a molecular level: Agilent Technologies global food segment director Lorna De Leoz explores the future of alternative proteins and how new advances in analytical tools can boost mainstream adoption of plant-based and cultured protein. Read more
        • Brazilian giant JBS begins construction on cultivated protein research centre: The JBS Biotech Innovation Centre is expected to open before the end of 2024 after construction work commenced this month (September 2023). Read more
        • ‘For the industry to succeed, there will need to be a ramping up of investment’: The past and future of the cultivated meat market: The number of deals in the cultivated meat market in the first eight months of 2023 has significantly declined since 2022, a report by financial advisory firm Oghma Partners shows. However, strong government investment and potential regulatory approval could provide a boost for the sector…. Read more
        • Episode 8: Alternative proteins: Tune in to this month’s Food Manufacture podcast, where we talk plant-based proteins and the future of the meat alternatives market. Read more. 

I’m always being asked what politics has to do with food.  My answer: everything.

Here is an example, courtesy of ProPublica and Oregon Public Broadcasting.

Enormous numbers of people depend on wild salmon for food and livelihoods.  If the salmon disappear or cannot be eaten, these people lose both.

• • This Billion-Dollar Plan to Save Salmon Depends on a Giant Fish Vacuum: Many endorse opening dams and letting fish coast the natural current as the best way to avoid extinction. The U.S. Army Corps of Engineers has other ideas. by Tony Schick, Oregon Public Broadcasting. View Story
  • The Fight of the Salmon People: Randy Settler’s family has spent generations fighting for their right to harvest salmon. But the federal government squandered its chance to recover the endangered fish before the onset of climate change. Now, Settler sees it all slipping away again. Tony Schick, Oregon Public Broadcasting, and Katie Campbell, ProPublica.
  • The U.S. Promised Tribes They Would Always Have Fish, but the Fish They Have Pose Toxic Risks: For decades, the U.S. government has failed to test for chemicals and metals in fish. So, we did. What we found was alarming for tribes. by Tony Schick, Oregon Public Broadcasting, and Maya Miller, ProPublica.
  • The Racism, and Resilience, Behind Today’s Salmon Crisis: Salmon have been endangered my entire life. Here’s what I didn’t realize until I started reporting. by Tony Schick, Oregon Public Broadcasting.
  • The Federal Government Is Finally Increasing Funding for Salmon Hatcheries. Tribes Say It’s Not Enough: Columbia River salmon hatcheries need billions of dollars’ worth of upgrades to withstand climate change. They’re getting $50 million. by Tony Schick, Oregon Public Broadcasting.
  • The U.S. Has Spent More Than $2 Billion on a Plan to Save Salmon. The Fish Are Vanishing Anyway: The U.S. government promised Native tribes in the Pacific Northwest that they could keep fishing as they’d always done. But instead of preserving wild salmon, it propped up a failing system of hatcheries. Now, that system is falling apart. by Tony Schick, Oregon Public Broadcasting, and Irena Hwang, ProPublica, photography by Kristyna Wentz-Graff, Oregon Public Broadcasting.

Salmon raise other issues besides their effects on indigenous populations.

• Salmon farming: see previous posts here and here.
• GMO salmon: here and here.

Nothing in food is simple.  Nothing in food is free of politics.

I am suddenly deluged with items about chocolate, which seems to raise any number of food politics issues.

For today, let’s deal with three: content of toxic heavy metals, research conflicts of interest, and claims of sustainability,

I.  Heavy metals. I learned about this one from Food Safety News (FSN): Consumer Reports finds one-third of chocolate is high in heavy metals: CR today released test results that have it urging Hershey’s to get harmful lead and cadmium out of its chocolate products.

FSN conveniently provided a link to the full CR report, which says.

When we tested dark chocolate bars last year, we found lead or cadmium levels above CR’s thresholds in 23 of 28 bars, or 82 percent of them. Our results this time were similar. Of the seven bars we tested, five, or 71 percent, were above our levels for lead, cadmium, or both…Eating an ounce of four others would put you over our limit for lead.

Food Safety News also reports: Chocolate makers say they have heavy metals issue under control: The National Confectioners Association (NCA) : “Chocolate and cocoa are safe to eat and can be enjoyed as treats as they have been for centuries,” NCA says. “Food safety and product quality remain our highest priorities,… Continue Reading

ConsumerLab does its own testing for toxins in Dark Chocolate, Cocoa & Cacao Products.

Which dark chocolate and cocoa products are best?  Be careful! Several cocoa powders, cacao nibs, and some dark chocolates failed to pass our review due to contamination with high levels of cadmium, a toxic heavy metal (see What CL Found).

II.  Conflicts of interest. ConsumerLab also commented on cocoa flavanols.

Furthermore, levels of potentially beneficial cocoa flavanols ranged from just 1 mg to 374 mg in cocoa powders and mixes, 2 mg to 351 mg in dark chocolates, and 2 mg to 993 mg in supplements. Products also vary widely in calories per serving.

This took me right to an e-mail from a reader, Thijs van Rens, Professor of Economics, University of Warwick,.  He wanted me to see something he had read in The Conversation: “Flavanols are linked to better memory and heart health – here’s what foods you can eat to get these benefits.”

He pointed out that the author “…received research funding from Mars, Inc., a company engaged in flavanol research and flavanol-related commercial activities.”  He added:

I got suspicious about the funding when I read this:  “This is why flavanols extracted from cocoa are an ideal model, as they contain the two main types of flavanols.”

In fact, I was going to comment and complain about The Conversation publishing something like this, until I noticed the one-but-last paragraph:

“It’s also important to note that while the flavanols used in many studies were extracted from cocoa, unfortunately chocolate (even dark chocolate) is a very poor source of flavanols – despite what some headlines might claim. This is because these flavanols are lost during processing.”

Not sure what to make of the article. On the one hand, the author clearly states not to eat chocolate for this reason and the funding is clearly disclosed. On the other hand, how many readers will get to the one-but-last paragraph and check the disclosure statement. On balance, I could imagine Mars Inc. would be quite happy about this article.

Indeed yes.  That’s why they paid for it (but see clarification below)

III.  Sustainability.  This also came in a e-mail, this time a press release from Chocolate Scorecard, a group that rates chocolate companies on practices related to traceability, wages, child labor, deforestation, agroecology, etc.  Its key messages:

• Sustainability claims of chocolate companies cannot necessarily be trusted.
• Only 11% of chocolate companies can fully trace where their cocoa comes from – without knowing they cannot claim sustainability.
• Farmers need to be paid more for their cocoa to ensure a sustainable life.

“100% sustainably sourced cocoa,” says the sign on the stand promoting a well-known chocolate brand in the supermarket. The message is not one you can necessarily trust.

…A recent report by Oxfam claims that the “net income of farmers decreased by an estimated 16.38% between the 2019/20 and 2021/22 harvesting season.” When the price of cocoa increases everything else a farmer purchases increases in price, leaving worse off in reality. This is associated with increases in profits in chocolate companies.

The Chocolate Scorecard is a collective of 37 NGO’s and Universities. They are calling on chocolate companies to commit to a ‘living income’ for cocoa farmers.

And you thought you were just eating candy.

Additions

Readers wrote to remind me to add:

• John Oliver’s brilliant piece on low wages and child labor among chocolate workers.
• Food Empowerment Project’s Chocolate List (of chocolate companies not using child labor)

Clarification

The author of the flavanol article wrote to say that my comment could be interpreted as suggesting he was paid to write it, which he was not.  That was not my intention and I apologize for giving that impression.  I do see research or commentary paid for by food companies, but such instances are rare. The “funding effect,” as I discuss in my book Unsavory Truth, gives the appearance of conflicted interest no matter what its actual level of influence.

Farm Action, an organization devoted to stopping corporate agrocultural monopolies and building fair competition in rural America, has issued a short report, Balancing the US Agricuiltural Trade Deficit with Higher Value Food Crops.  

Its point (you have heard this from me repeatedly): the U.S. food system focuses on feed for animals and fuel for automobiles.  It ought to focus on food for people.

The current situation:

• Most American farmland acreage is dedicated to animal feed and fuel production.
• Over the last 5 years, American consumption of chicken and exports of pork continued to climb, increasing demand for soy, a key feed crop for pork and poultry.
• Acreage of many key food crops including potatoes, sweet potatoes, sweet corn, tomatoes, apples, and oranges has fallen precipitously 20-90% from peaks in the 20th century.
• Exports fell and imports rose for vegetables, fruits, melons, and key food grains.
• Across produce items, the US was or became a net importer of all 5 of the top vegetables by 2021.

What can be done:

• At 2022 prices, just 3.5-4.4 million acres of higher value fruit, vegetables, and melons would be needed to generate $32.9B in sales, the 2022 size of the US produce trade deficit and more than the projected $27.5B
  overall ag deficit projected for 2024—this amounts to just 0.4% of US farmland.
• This could be accomplished by approximately doubling the amount of land currently harvested for these crops.

Policy (Legislative) recommendations for farmers who grow food for people:

• Improve crop insurance and risk management
• Expand market access

These analyses make these fixes look easy.  Make them happen!

Jerry Mande, a co-founder of Nourish Science wrote me to urge support for a national action plan to reduce obesity—and the chronic diseases for which it raises risks. (Note: he also has an op-ed in The Hill on NIH research and leadership needs).

Here is what we should do. It’s time for a new federal nutrition goal. For decades it’s been some variation of “access to healthier options and nutrition information.” Jim Jones [the new head of food and nutrition at FDA] used that last week in his vision for the new human foods program. It’s in USDA FNS’s mission too. The WaPo reporting on life expectancy, fatty liver disease, & Lunchables in school meals reveals that goal has failed and needs to be replaced.

The goal should be updated to: ensuring that every child reaches age 18 at a healthy weight and in good metabolic health. Cory Booker proposed making it the U.S. goal in his attached letter to Susan Rice on the WHC [White House Conference]. It’s part of the Nourish Science vision.

It’s doable.  USDA has the necessary power, reach, and resources. Over half of infants are on WIC, 1/3 of children in CACFP [Child and Adult Care Feeding Program], virtually all in school meals, and almost ½ of SNAP recipients are under 18. If we leveraged those programs to achieve the new goal and with FDA’s & CDC’s help, we could make substantial progress. For example, USDA was able to raise school meal HEI [Healthy Eating Index] scores from failing U.S. average of 58 to an acceptable 82 in just three years.

We have a successful blueprint in FDA regulation of tobacco. When we began our FDA investigation in 1993 1/3 of adults and ¼ of kids smoked cigarettes. Today we have a $700M FDA tobacco center and 11% of adults and only 2% of high school students smoke cigarettes.

We should set the new goal in the upcoming Farm Bill. We should change USDA’s name to the U.S. Department of Food and Agriculture and state the new goal.

The only needed ingredient to make this happen is an effective federal nutrition champion. That’s how tobacco happened.

I’m optimistic. We can do this.

I like the vision.  I’m glad he’s optimistic.  Plenty of work to do to get this on the agenda.

Some background

• The CDC on how nearly 70% of American adults are overweight or have obesity.
• My report on the White House Conference, a year ago
• Politico (Helena Bottemiller Evich, now at Food Fix)  on how diet- and obesity-related diseases are a huge public health problem, especially for COVID-19, but no government program exists to prevent them.
• Politico (Catherine Boudreau and Helena Bottemiller Evich) on how federal research on prevention of diet- and obesity-related diseases hardly exists.

José Tenorio.  School Food Politics in Mexico: The Corporatization of Obesity and Healthy Eating Policies.  Routledge, 2023.  

I was asked for a blurb for this one:

From first-hand observations and deep research, José Tenorio makes it clear that school food in Mexico is about much more than feeding hungry kids; it’s about how food corporations have taken advantage of social inequalities to replace native food traditions with less healthful but profitable products.  School food politics, indeed!

This book may seem specialized, but it is a useful case study in the politics of school food—not confined to the United States, apparently.

Mexico leads the way in efforts to promote healthier diets.  It has  excellent dietary guidelines.   It also has warning labels on food products (see my post on these), soda taxes, a ban on trans fats, and other measures.

Mexico’s schools do not provide meals for kids in schools.  They sell foods at canteens.

The country set nutrition standards for foods sold in schools in 2011, but compliance is not great.

Public health and food advocacy groups support laws to ban unhealthy foods and drinks from schools.  Despite formidible industry opposition, this may actually happen.

This book provides evidence for why it should.