On Friday, the University of Colorado School of Medicine announced that it was giving back the $1 million that Coca-Cola had donated to fund the Global Energy Balance Network.

This is the group of scientists funded by Coca-Cola who were promoting activity as the best way to prevent obesity, but playing down any contribution of soft drinks and junk food to weight gain (see my post on this).

This is the fourth impressive result of the investigative report by Anahad O’Connor in the New York Times in August that revealed Coca-Cola’s funding of such initiatives.

1. Coke’s chief executive, Muhtar Kent, disclosed that the company had spent almost $120 million since 2010 to pay for partnerships with medical and community health groups, and promised that the company would be more transparent.
2. Coca-Cola set up a transparency website where it revealed the list of funded organizations.
3. Coke ended its relationships with the Academy of Nutrition and Dietetics, the American Academy for Pediatrics, and the American Academy of Family Practice (or these groups pulled out—everyone seems to want to credit).
4. Now this. Coke says it will donate the returned money to the Boys & Girls Clubs of America.

I am quoted in this story:

Marion Nestle, a professor of nutrition, food studies and public health at New York University, called the network “a front group” for Coca-Cola intended to promote the message that obesity is primarily caused by a lack of exercise, not by overconsumption of junk food.

On Friday, Dr. Nestle, the author of “Soda Politics,” said she was pleased that the university had returned the money.

“Both deserve congratulations for making a difficult but necessary decision,” said Dr. Nestle. “Let’s hope other groups also decide to do the right thing and end such financial relationships.”

Next?

Yael Raviv.  Falafel Nation: Cuisine and the Making of National Identity in Israel.  University of Nebraska Press, 2015.

Yael Raviv is an adjunct instructor in my department at NYU and has been researching and working on this book since I have known her.

The cuisine of Israel is trendy right now, something that Raviv could not possibly have guessed when she began this project.

Although her book focuses on the years from the Zionist immigration wave beginning in 1905 (the Second Aliya) and the 1967 Six-Day War, it deals with older and more recent ways in which food affected and was affected by the complexities and contradictions of religion, ethnicity, nationalism, and subsequent waves of immigration in this country.

Raviv is not claiming that food can solve the political problems of the region, but her book demonstrates that food can help us understand them.

The Physicans Committee for Responsible Medicine (PCRM), a group advocating against use of animals in research but for vegetarian and vegan diets, has started a campaign to restore egg-and-cholesterol recommendations to the Dietary Guidelines for Americans.

Eggs are the largest source of cholesterol in American diets.

The campaign involves billboards like this one, in six locations in Texas:

It also involves a new organization (truthaboutegg.org) with an interactive website on a dozen issues related to egg production and consumption.

The one that particularly caught my eye was #5.

A 2013 review suggested that high-cholesterol foods have only a modest effect on blood cholesterol. Of the 12 studies it relied on, 11 were industry-funded.

In a letter to Congressman K. Michael Conaway (Rep-TX), Dr. Neal Barnard, PCRM’s president, wrote:

This week, billboards near your Texas offices will alert you to the dangers Americans face if cholesterol warnings are removed…Eggs are the leading source of cholesterol in the American diet.  A report (which I’ve included for your review) in the autumn 2015 Good Medicine magazine finds that this recommendation may have been influenced by egg-industry-funded cholesterol research. America’s heart disease and diabetes epidemics will continue unabated if the egg industry succeeds in its efforts to get cholesterol warnings out of the guidelines.

The 2015 Dietary Guidelines Advisory Committee (DGAC) said this about dietary cholesterol.

Cholesterol. Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol, consistent with the conclusions of the AHA/ACC report.^2,35.  Cholesterol is not a nutrient of concern for overconsumption.

The DGAC based its unconcern about dietary cholesterol on two references:

2.  Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S76-99. PMID: 24222015. Its conclusion:

There is insufficient evidence to determine whether lowering dietary cholesterol reduces LDL–C.

35.  Shin JY, Xun P, Nakamura Y, He K. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(1):146-59. PMID: 23676423. This study, which was also independently funded, concluded:

compared with those who never consume eggs, those who eat 1 egg per day or more are 42% more likely to develop type 2 diabetes. Among diabetic patients, frequent egg consumers (ie, > 1 egg/d) are 69% more likely to have CVD comorbidity…This meta-analysis suggests that egg consumption is not associated with the risk of CVD and cardiac mortality in the general population. However, egg consumption may be associated with an increased incidence of type 2 diabetes among the general population and CVD comorbidity among diabetic patients.

Were these references based largely on studies funded by the egg industry?  If so, PCRM is correct in arguing that the question of egg consumption and blood cholesterol levels merits much closer scrutiny and analysis than it is currently receiving.

What does a study funded by the egg industry look like?  Here are two one from my recent collection:

The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study—a 3-mo randomized controlled trial, by Nicholas R Fuller, Ian D Caterson, Amanda Sainsbury, Gareth Denyer, Mackenzie Fong, James Gerofi, Katherine Baqleh, Kathryn H Williams, Namson S Lau, and Tania P Markovic.  Am J Clin Nutr 2015; 101:705-713.

• Conclusion: High egg consumption did not have an adverse effect on the lipid profile of people with T2D [type 2 diabetes] in the context of increased MUFA [monounsaturated fatty acid] and PUFA [polyunsaturated fatty acid] consumption. This study suggests that a high-egg diet can be included safely as part of the dietary management of T2D, and it may provide greater satiety.
• Sponsor: Australian Egg Corporation

Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis. Berger, S., Raman, G., Vishwanathan, R., Jacques, P.F., Johnson, E.J., 2015. Am J Clin Nutr ajcn100305. doi:10.3945/ajcn.114.100305.  Am J Clin Nutr August 2015
vol. 102 no. 2 276-294

• Conclusion: Reviewed studies were heterogeneous and lacked the methodologic rigor to draw any conclusions regarding the effects of dietary cholesterol on CVD risk.  [Implication: suggestions that eggs might raise cardiovascular risk are unwarranted]
• Sponsor: Supported by USDA agreement 1950-51000-073 and the American Egg Board, Egg Nutrition Center.  The funders did not have a role in the study selection, quality assessment, data synthesis, or manuscript preparation.

Snacks are trending.  As Food-Navigator-USA’s analysts see it, “there are new opportunities in gluten-free, ethnic breads and gourmet bakery items, while snack makers are tapping into consumer demand for ancient grains and seeds, plant-based proteins, and bean, pea and lentil-based ingredients….Americans are increasingly abandoning three square meals a day for serial snacking.”

• Come fly with me! Inflight snacking with JetBlue: Unless you’re sitting in the front of the cabin, the food and beverage options on most airlines are, well, pretty uninspiring. But what if an airplane could be a place to discover new and exciting foods and brands that you haven’t had before?.. Read
• That’s it enjoys explosive growth as snackers seek simplicity: When Dr Lior Lewensztain first started pitching That’s it fruit bars to retailers, pretty much everyone he talked to wanted in. Three and a half years later he is in tens of thousands of locations nationwide from Starbucks to 7-Eleven, and sales are still growing in the triple-digits. So what’s his secret?.. Read
• As seaweed snacks gain popularity, they present a chance to get in at ground level, expert says: Seaweed snacks are riding a rising tide in the U.S. with sales swelling between $250 million and $500 million in 2014, according to an industry trends expert… Read
• Nourish Snacks co-founder Joy Bauer talks sugar, portion control, and the key pillars of healthy snacking: The ‘healthier’ snacks market is awash with non-GMO, gluten-free, and ‘no artificial’ claims, while corn syrup is out and ‘real’ (cane) sugar, coconut sugar, and agave syrup are in. But are these products really delivering in the nutritional stakes, given that snacks now account for a quarter of energy intakes?.. Read
• Manitoba Harvest sales approaching C$100m in 2015 as hemp food market heats up:OK, so the Declaration of Independence was not, as urban myth would have it, written on hemp (the said document was written on parchment). But 239 years later, this ultra-versatile super seed is finally gaining traction as a food ingredient in the United States, according to the world’s largest hemp foods manufacturer… Read
• Snack spotting at Expo East turns up paleo muffins, veggie treats, on-the-go nut butter & more: With snacking replacing more meals in the US, manufacturers are responding with a variety of fast, on-the-go options that are packed with nutrients, protein, fiber and energy… Display
• Mediterra expands its savory bar portfolio, welcomes competitors to the nascent category: For years the nutrition bar category was mostly limited to sweet flavors, but now that is changing, thanks in part to Mediterra – a pioneer in making savory snack bars. .. Watch now
• Where next for gluten-free, and what’s the real size of the prize?: The #1 gluten-free brand in Europe, Schär entered the US market in 2007 and set up a manufacturing facility in New Jersey in 2012, and is now the #2 player in the US gluten-free bread market behind Udi’s Gluten-Free. FoodNavigator-USA (FNU) caught up with marketing director Roberto Cruz (RC) to talk about growth opportunities, market definitions, and the firm’s new Artisan Baker line… Read
• 20% of snack, granola, energy bars feature non-GMO claims, reveals Label Insight: Data from Label Insight* shows that one in five (21%) snack, energy or granola bars in the US now makes a non-GMO claim of some kind – making it the leading category for non-GMO claims, compared with an average of 4.2% for all the grocery products in its database. .. Read
• Flapjacked meets demand for more protein with easy-to-make pancake and muffin mixes: High protein, easy-to-eat foods are no longer limited to bars and shakes – now they can also be found in familiar baked goods that appeal to carb-loving consumers, thanks to companies like Flapjacked. .. Watch now
• 479 Degrees popcorn gets multi-million dollar cash injection from investors including KIND founder Daniel Lubetzky: San Francisco-based ready to eat popcorn maker 479 Degrees has raised a new round of capital from some high profile investors including KIND founder Daniel Lubetzky and Emil Capital Partners, which has also pumped cash into fast-growing brands including Bare Snacks, Sipp, and Goodbelly… Read
• Which ancient grains are gaining the most traction in the US food & beverage market?: Ancient grains continue to gain traction in the US food retail and foodservice market, with quinoa leading the pack. However, lesser-known grains such as teff, amaranth and freekeh are starting to picking up some steam as well, according to a new report* from Packaged Facts… Read
• nomva brings a fresh twist to burgeoning fruit pouch category with HPP and probiotics: If GoGo SqueeZ and Munk Pack have proved that fruit pouches aren’t just for babies, nomva, a new food brand co-founded by Suja Juice founding member Caroline Beckman, is hoping to take the concept one step further with HPP (high pressure processed), organic fruit & veggie probiotic pouches that sit in the yogurt aisle.  .. Read
• The meteoric rise of barkTHINS snacking chocolate: ‘It took off like a rocketship’: Sometimes the most disruptive food products are less about blue-sky innovation than taking something familiar, adding a new twist, and creating a completely new category, says Ripple Brand Collective founder and CEO Scott Semel, who has seen his latest creation – barkTHINS snacking chocolate – “take off like a rocket ship”… Read
• Karma Baker: Dairy-free, egg-free, gluten-free… and delicious: If you’re going to launch a gourmet organic, vegan and gluten-free bakery business, L.A. is probably the place to do it, acknowledges Karma Baker’s founder Celine Ikeler. But if you plan to stick around, you’ve got to make products that will appeal to a broader customer base, for whom dairy- or gluten-free is an added bonus, not the primary purchase driver. .. Read
• Bakery, snacks & beverage could be next frontier for high-protein products, experts say: As the high-protein trend matures from niche to mainstream, innovative manufacturers are tapping into the still-significant growth opportunity by adding the ingredient to a broader range of platforms, including baked goods, snacks and beverages, according to experts in the segment… Read
• Freedom Foods: Gluten-free is well-established, but free-from (foods free of all the big 8 allergens) is the emerging opportunity: It’s the leader in the Australian ‘free-from’ market (free from all eight major allergens), but can Freedom Foods achieve similar success in the US? Two years into its campaign to crack America, the signs are encouraging, says US CEO Michael Bracka… Read
• Digital web series helps Nestle Toll House reach desirable millennial generation: Digital videos can be an effective marketing tool to help food and beverage brands reach the much-vaunted and hard-to-access millennial generation, but for them to succeed, they must be authentically engaging and tightly targeted, according to digital development firm Reach Agency. .. Read

The World Health Organization has issued a statement of clarification of the significance of its International Agency for Research on Cancer (IARC) report on the increased risk for colorectal cancer from eating processed and red meat (see my post on this).

The latest IARC review does not ask people to stop eating processed meats but indicates that reducing consumption of these products can reduce the risk of colorectal cancer.

Got that?

The New York Times explains the meaning of this increased risk.  To understand it, you need to know the risk of colorectal cancer among people who never eat processed or red meat.

The main problem with the public health messages put out by the W.H.O. is that the agency did a poor job of explaining what its risk-ranking system really means…it’s based only on the strength of the overall research, not on the actual danger of a specific product…Even the most strident anti-meat crusader knows that eating bacon is not as risky as smoking or asbestos exposure. Smoking raises a person’s lifetime risk of developing lung cancer by a staggering 2,500 percent. Meanwhile, two daily strips of bacon, based on the associations identified by the W.H.O., would translate to about a 6 percent lifetime risk for colon cancer, up from the 5 percent risk for people who don’t enjoy bacon or other processed meats.

My interpretation: Can processed and red meats be included in healthful diets?  Yes, of course.  But for many reasons, people and the planet would be healthier if these foods were consumed in smaller portions, less often.

Today’s Politico Morning Agriculture report has this brief note:

SENATE TO TAKE UP WOTUS FIX: The Clean Water Rule’s days could be numbered. The Senate could as early as next week take up a bill from Sen. John Barrasso to require the EPA to withdraw its Clean Water Rule and re-draft the measure with the help of states and other affected groups…The bill has the backing of 46 senators…Given that the House has already passed a similar measure, a “yea” vote from the Senate could signal a quick demise for the rule.

This sent me to try to understand what the Clean Water Rule is about and why so many groups want to get rid of it.

In June, the Environmental Protection Agency (EPA) published a final rule defining the Waters of the United States (WOTUS) covered by its regulations. This, as far as I can tell, extends regulatory protection beyond large streams to the small streams that flow into them.

On its website devoted to this rule, the EPA says “The rule ensures that waters protected under the Clean Water Act are more precisely defined, more predictably determined, and easier for businesses and industry to understand.”

Maybe so, but I’m having a hard time understanding how the new rules would require agricultural producers to clean up the waste they discharge into local streams.

The agricultural implications are particularly contentious—think of the huge volumes of animal waste delivered to streams by Confined Animal Feeding Operations (CAFOs) or of pesticides and herbicides running off from mega-farms.

But the EPA insists that there are no changes to the current rules that exempt agriculture from having to protect local water supplies.

Agricultural producers evidently do not believe this. They have done everything possible to block the rules and apparently will succeed in this effort.

The strength of the opposition—farm organizations, golf course groups, municipalities—suggests that somewhere in these rules must be restrictions on discharges into water supplies.    If so, the Clean Water rules deserve plenty of support.

I wish I could find a clear, straightforward explanation of what the WOTUS rules would do.  If the rules are overturned, which it looks like they will be, I’m wondering if this is because only lobbyists can understand the details and implications.

This document from the American Water Works Association has useful diagrams illustrating which streams are affected by the EPA’s rules.

Are any groups supporting the WOTUS rules?  If so, they are very quiet.

Addition

The National Resources Defense Council (NRDC)’s position paper on the failings of the Clean Water Rule

I’ve managed to collect another five industry-sponsored studies with results that the funder must love, bringing the total to 75 since mid-March.  As always, please keep your eye out for industry-funded studies that are contrary to the sponsor’s interests.  I’ve only managed to find 6 so far.

Dairy products consumption and metabolic syndrome in adults: systematic review and meta-analysis of observational studies.  Guo-Chong Chen, Ignatius M. Y. Szeto, Li-Hua Chen, Shu-Fen Han, Yan-Jie Li, Rina van Hekezen, and Li-Qiang Qin^.. Science Reports. 2015; 5: 14606. Published online 2015 Sep 29. doi:  10.1038/srep14606

• Conclusions: Higher dairy consumption significantly reduced MetS [metabolic syndrome] by 17% in the cross-sectional/case-control studies…and by 14%…in cohort studies….Our findings suggest an inverse dose-response relationship between dairy consumption and risk of MetS.
• Funding: This study was supported by Yili Innovation Center, Inner Mongolia Yili Industrial Group Co., Ltd. The funding source had no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.
• Comment: The Yili Group is a privately owned Chinese company headquartered in Hohhot, Inner Mongolia, engaged in processing and manufacturing milk products, including ice-cream, powdered milk, milk tea powder, sterilized milk and fresh milk.

Energy compensation following consumption of sugar‑reduced products: a randomized controlled trial.  Oonagh Markey · Julia Le Jeune · Julie A. Lovegrove  Eur J Nutr First online: 09 September 2015 DOI 10.1007/s00394-015-1028-5.

• Conclusion: Consumption of sugar-reduced products, as part of a blinded dietary exchange for an 8-week period, resulted in a significant reduction in sugar intake. Body weight did not change significantly, which we propose was due to energy compensation.
• Conflict of interest. This work was supported by Sugar Nutrition UK; however, the sponsor had no input into the study hypothesis and design, data analysis and interpretation.
• Comment: It is in the interest of sugar trade associations to demonstrate that eating less sugar has no effect on body weight. 

Trends in Sugar-Sweetened Beverages: Are Public Health and the Market Aligned or in Conflict?  William Shrapnel.  Nutrients 2015, 7(9), 8189-8198; doi:10.3390/nu7095390.

• Conclusions: drinks containing non-nutritive sweeteners enable the “small change” in health behaviour that individuals are willing to consider…Among those who currently consume carbonated beverages, the “small change” involved in moving from a sugar-sweetened beverage to a similar sugar-free beverage appears to be one that some consumers are willing to accept.  Facilitating this change may be a more productive public health strategy than advocacy for taxation of sugar-sweetened beverages.
• Author disclosure: William Shrapnel was paid a consultancy fee by the Australian Beverage Council Ltd. to prepare this paper…The authors declare no conflict of interest.

Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis.  Jonathan Sackner-Bernstein, David Kanter,  Sanjay Kaul.  PLoS One, October 20, 2015.  DOI: 10.1371/journal.pone.0139817.

• Conclusions: In conclusion, this trial-level meta-analysis of 17 randomized controlled trials shows that both LoCHO and LoFAT diets are effective in reducing weight. However, LoCHO diet appears to achieve greater weight loss and reduction in predicted risk of ASCVD [atherosclerotic cardiovascular disease] events compared with LoFAT diet. On the basis of these results, we suggest that dietary recommendations for weight loss should be revisited to consider this additional evidence of the benefits of LoCHO diets.
• Funding: The study was supported by Atkins Nutritionals….Jonathan Sackner-Bernstein owns and may receive compensation from ExVivos, LLC. ExVivos, LLC provided payment to authors (DK and SK) for their role as contractors to ExVivos, LLC.
• Comment: ExVivos, LLC has one employee—Jonathan Sackner-Bernstein.  Atkins Nutritionals markets a low-carbohydrate diet plan.

Breast-feeding and postpartum maternal weight trajectories.  Laura Mullaney, Amy C O’Higgins, Shona Cawley, Rachel Kennedy, Daniel McCartney and Michael J Turner.

• Conclusions: There are many reasons why breast-feeding should be strongly promoted but we found no evidence to support postpartum weight management as an advantage of breast-feeding.
• Financial support: This project was supported by the UCD Centre for Human Reproduction and was partially funded by an unlimited educational grant from Danone Nutricia Early Life Nutrition for the first author.
• Comment: Food companies often provide scholarships for doctoral research.  This particular arrangement raises some tough questions: Should dissertation research supervisors allow their students to accept such funding?  Or does accepting such an award run the risk of compromising the integrity of the student’s work?

First, the science

Study: obese kids lose weight and improve metabolic markers when sugars are removed from their diets.  The pediatrician Robert Lustig and his colleagues removed all sources of sugar from the diets of 43 extremely obese Latino and African-American children and teens, replacing the lost calories with starchy foods.  After nine days, the kids lost a little weight and greatly improved their metabolic markers.  We can argue about whether the effects are due to reduced calories, sugars, or fructose, and whether the results will hold up over a longer time period (as is explained in a careful critique).  But what’s impressive is that it took only nine days to achieve highly statistically significant and beneficial improvements to occur.   This finding deserves further research. 

And now the politics

Action for Health Food supports Added Sugars on food labels.  I learned this from Politico Pro Morning Agriculture.  The group, backed by Houston philanthropists Laura and John Arnold, support Added Sugars on food labels.  Action for Healthy Food says that it works with communities to inform consumers about the health effects of added sugars and where they are in food and drinks, and to support policies to help people reduce sugar intake and the amount of sugar in foods.

The International Food Information Council (IFIC) opposes Added Sugars labels.  Such labels, it says, “run counter to rigorous research by the IFIC Foundation and US Food and Drug Administration (FDA) demonstrating that consumers instead could be misled, not enlightened, by the addition of an ‘Added Sugars’ line.”

Also from Politico Pro Agriculture: Sam Kass favors Added Sugars labels.  Helena Bottemiller Evich did the interview:

Are you following the Nutrition Facts panel debate going on right now? There’s a divide in the food industry on the issue of labeling added sugars. You have Nestle and Mars supporting added sugars labeling and a Daily Value, but there’s also fierce opposition on the other side. I think it’s clear that this issue is a high priority for the administration. Do you think that will come to fruition? Has that ship sailed?

In my book, that ship has sailed. It’s absolutely the right thing to do for consumers. I think the FDA knows that and that’s why they proposed it. I think the evidence firmly backs it and I just don’t see a good argument not to do it. I think there’s fierce opposition because some of these companies are putting way too much added sugars in their products, and they don’t want that to be pointed out. But just like trans fats, this is one of these things where the health issues are pretty clear. I just don’t see any legitimacy in their pushback.

They argue that people will be confused by the label.

Yeah, that’s a nice claim.

They have studies showing that people are confused.

I’m sure they do. Money can buy whatever outcome you want. But I just think this one is clear as day, especially when you look at the diabetes epidemic and the relation to added sugars and health outcomes in this country.

Another from Politico Pro Agriculture: Nestlé and Mars have split with the Grocery Manufacturers Association over Added Sugars labeling.  “While the nation’s leading food group, the Grocery Manufacturers Association, welcomes the FDA’s labeling proposal about as much as it would a toothache, the pair of global powerhouses…are voicing support for even the thorniest details of the Obama administration’s plans, both in the regulatory docket and in the media.”  FDA’s own research in support of Added Sugars leaves room for debate.

The courts have rejected class action claims about Whole Foods’ use of the term “evaporated cane juice.   The plaintiff argued that this is a euphemism for sugar and is only used to hide sugar on foods labels.  The judge called the plaintiff “clueless, as elsewhere in his testimony he implies he knew ECJ was an unrefined form of added sugar: Added unrefined sugar is added sugar, no matter how Plaintiff tries to spin it.”

It’s Halloween and the Candy Industry is happy.  The industry considers October 31 its “Super Bowl,” with sales expected to hit a record $2.6 billion, according to Politico.  The candy industry complains that sugar is being demonized by “public activists.”  It is fighting to eliminate tariffs and quotas that protect sugar farmers and keep the price of U.S. sugar higher than on world markets. He said candy “plays a special, unique role in people’s lives in terms of a happy and balanced lifestyle, and it really is a moment of pleasure.”

On that note, trick or treat?