Food Politics

by Marion Nestle
Oct 7 2015

The bizarre saga of the 2015 Dietary Guidelines: Continued

Two events yesterday:

#1.  USDA and HHS announce that sustainability will not be part of the Dietary Guidelines.

This year, we will release the 2015 edition, and though the guidelines have yet to be finalized, we know they will be similar in many key respects to those of past years. Fruits and vegetables, low-fat dairy, whole grains and lean meats and other proteins, and limited amounts of saturated fats, added sugars and sodium remain the building blocks of a healthy lifestyle.

…In terms of the 2015 Dietary Guidelines for Americans (DGAs), we will remain within the scope of our mandate in the 1990 National Nutrition Monitoring and Related Research Act (NNMRRA), which is to provide “nutritional and dietary information and guidelines”… “based on the preponderance of the scientific and medical knowledge.”  The final 2015 Guidelines are still being drafted, but because this is a matter of scope, we do not believe that the 2015 DGAs are the appropriate vehicle for this important policy conversation about sustainability.

OK, but see Michele Simon’s analysis of the legal issues related to sustainability in the guidelines, and My Plate My Planet’s analysis of the comments filed on the sustainability question.

As my analysis shows, the USDA and HHS would be well within its legal authority to include sustainability. In summary:

    • A plain reading of the statute does not preclude sustainability;
    • The Congressional intent was to further a broad agenda on health;
    • Previous DGA versions included issues beyond “nutrition and diet”.

And also see Kathleen Merrigan et al’s argument in favor of sustainable dietary guidelines in Science Magazine.

So this is about politics, not science.

#2.  A coalition of critics of the Dietary Guidelines is attempting to block their release.

Yesterday’s Hagstrom Report and, later, Politico (both behind paywalls) reported that this group is calling on  USDA and HHS to turn over the guidelines to a committee of the National Academy of Sciences Food and Nutrition Board for reexamination before releasing them to the public.

The issues?  The meat and beverage recommendations.

The group is funded by philanthropists Laura and John D. Arnold, who fund Nina Teicholz’s work.

Teicholz is on the board of the group as is Cheryl Achterberg, dean of the Ohio State University College of Education, and John Billings, who directs the Wagner School’s Health Policy and Management Program at NYU (why they agreed to do this is beyond me).

Hagstrom notes that coordinating support is coming from Beth Johnson, a former undersecretary for food safety at USDA who has her own consulting firm with clients apparently including the National Restaurant Association and the National Cattlemen’s Beef Association.

Other members of the advisory board include several scientists who do research funded by food companies.

The Coalition’s website is here.

This morning’s Politico Pro Agriculture has a long piece on the funding behind the coalition.

In the lead up to congressional hearings on the proposed 2015 dietary guidelines, the Arnolds are spending an initial $200,000 to communicate that critique and to advocate for changes that they say would improve the process. They have funded the new political action group, called The Nutrition Coalition, whose well-placed lobbyists have helped Teicholz score face-to-face meetings with top officials in Congress and the White House to push for an independent review of the guideline process. The team helped persuade lawmakers to insert language in the fiscal 2016 House agriculture spending bill to direct the National Academy of Medicine to conduct such a review.

Really? Eating fruits and vegetables and not overeating calories requires this level of lobbying?

This too is about politics.

The mind boggles.

Addition

The Hagstrom Report is keeping track of the testimony at today’s congressional hearing on the guidelines.

Oct 6 2015

Two rare industry-funded studies with results that must have disappointed the funders

Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.  Susan K Raatz, LuAnn K Johnson, and Matthew J Picklo.  J. Nutr. 2015; 145:2265-2272 doi:10.3945/jn.115.218016 

  • Conclusions: Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG [triglyceride] concentrations in both GT [glucose tolerant] and IGT [glucose intolerant] individuals and elevated glycemic and inflammatory responses in the latter.
  • Funding: Supported by a grant from the National Honey Board and by the USDA Agricultural Research Service.
  • Comment.  The authors hypothesized that honey would result in improved glycemia and insulin sensitivity compared with sucrose and HFCS.  But they found that their “data do not support the contention that the consumption of honey vs. HFCS or sucrose provides an added health benefit for maintenance of glucose homeostasis and other cardiometabolic outcomes because all 3 sugars evaluated exerted similar metabolic effects.”

Sugar-sweetened beverage consumption and incident hypertension: a systematic review and meta-analysis of prospective cohortsViranda H Jayalath, Russell J de Souza, Vanessa Ha, Arash Mirrahimi, Sonia Blanco-Mejia, Marco Di Buono, Alexandra L Jenkins, Lawrence A Leiter, Thomas MS Wolever, Joseph Beyene, Cyril WC Kendall, David JA Jenkins, and John L Sievenpiper.  Am J Clin Nutr 2015; 102:914-921 doi:10.3945/ajcn.115.107243.

  • Conclusions: SSBs were associated with a modest risk of developing hypertension in 6 cohorts. There is a need for high-quality randomized trials to assess the role of SSBs in the development of hypertension and its complications.
  • Funding: “The Canadian Institutes of Health Research…through the Canada-wide Human Nutrition Trialists’ Network and by the Diet, Digestive Tract, and Disease (3D) Centre, which is funded through the Canada Foundation for Innovation.  The Ministry of Research and Innovation’s Ontario Research Fund provided the infrastructure for the conduct of this project.”  Some of the investigators also received funds from other Canadian government agencies or health associations.  This, therefore is actually an independently funded study.
  • Authors’ funding disclosures: RJdS has received research support from the Calorie Control Council and the Coca-Cola Company…ALJ is a part owner, vice president, and director of research of Glycemic Index Laboratories, Toronto, Canada….JB has received research support from the Calorie Control Council and The Coca-Cola Company…CWCK has received research support from the Calorie Control Council, the Coca-Cola Company (investigator initiated, unrestricted grant), Hain Celestial, Kellogg, Kraft, Loblaw Companies Ltd., Solae, and Unilever…DJAJ has received research grants from Loblaw Companies Ltd., Unilever, the Coca-Cola Company… JLS has received research support from the Calorie Control Council and the Coca-Cola Company…travel funding, speaker fees, or honoraria from the Calorie Control Council, the Canadian Sugar Institute, World Sugar Research Organization, White Wave Foods, Abbott Laboratories, Dairy Farmers of Canada, Dr. Pepper Snapple Group, The Coca-Cola Company, and the Corn Refiners Association….
  • Comment: In this study, a group of investigators, some—but not all— of whom typically receive funding from food companies, participated in a study funded by Canadian government and health agencies.  If nothing else, this study is evidence for the importance of independent funding of nutrition research.

The score, for those of you following this saga, is now 65 studies with results favoring the sponsor to 5 with unfavorable results.  But I will soon be posting another 5 of the former kind.

Oct 5 2015

Soda Politics is published—today!

Today is the official publication date for Soda Politics.  This means it should now be available in bookstores and open for review and comment.  Cover for<br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /> Soda Politics<br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />

For more information, see the book page for it on this site.  There you will find the blurbs, reviews, media interviews, and the list of media resources—videos, audios, music, movies, commercials, and anti-commercials—that I ran across while working on the book.

Enjoy!

Oct 2 2015

Weekend Reading: Emily Yates-Doerr’s “The Weight of Obesity”

Emily Yates-Doerr.  The Weight of Obesity: Hunger and Global Health in Postwar Guatemala. University of California Press, 2015.

Emily was a student in NYU’s anthropology department and I’ve admired her work for a long time.  Her book is based on her remarkable dissertation work, and I was happy to be asked to blurb it:

Emily Yates-Doerr gives us an anthropologist’s tough analysis of how one resource-poor Guatemalan population responds to an increasingly globalized food supply as it transitions rapidly from widespread hunger and malnutrition to the increasing prevalence of obesity and its health consequences.  The Weight of Obesity views this “nutrition transition” from the unusually revealing perspective of an insider who experienced it personally with eyes wide open.

For me, the most riveting parts of her book are the transcribed conversations between clinic nutritionists and patients newly diagnosed with type 2 diabetes—a case study in the cultural gap between nutrient-based advice (“nutritionism”) and the way people actually eat.  The effects of the rapid influx of “ultra-processed” products on the health of the populations studied here are also painfully clear.  This is an ethnography of the nutrition transition caught just as these cultural and dietary shifts were occurring.

Oct 1 2015

Latest in supermarket marketing: Paleo friendly

IMG_3681

Thanks to Andy Bellatti for noticing this at his local Las Vegas Whole Foods.

This reminds me so much of the Low-Carb craze way back in 2005.

Picture1

Oh well.  Whatever works.

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Sep 30 2015

Five more food-industry funded research studies with predictable results. Score 65:3.

Let me start with a reminder that since mid-March I’ve been collecting examples of studies funded by food companies or trade associations that come up with results favorable to the sponsor’s interests.  I post them five at a time.  I am having a hard time finding industry-funded studies that do not favor the sponsor’s interests.  If you run across any, please send.  Here’s the latest collection.

Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial.  Estefanía Toledo, MD, MPH, PhD; Jordi Salas-Salvadó, MD, PhD; Carolina Donat-Vargas, PharmD; et al.  JAMA Intern Med. Published online September 14, 2015. doi:10.1001/jamainternmed.2015.4838

  • Conclusions and Relevance  This is the first randomized trial finding an effect of a long-term dietary intervention on breast cancer incidence. Our results suggest a beneficial effect of a Mediterranean diet supplemented with extra-virgin olive oil in the primary prevention of breast cancer.
  • Conflict of Interest Disclosures: Dr Salas-Salvadó received grants from Instituto de Salud Carlos III and the International Nut and Dried Fruit Foundation during the conduct of the study and has received consultancy fees from Danone Research and Eroski outside the present work; he is also a nonpaid member of the Scientific Committee of the International Nut and Dried Fruit Foundation. Dr Estruch, outside the present work, has received grants from the California Walnut Commission, nonfinancial support from Patrimonio Comunal Olivarero (Spain), La Morella Nuts (Spain), and Borges SA (Spain) and grants from Novartis Farmaceutica SA, Cerveceros De España, Sanofi, FIVIN-Spain, Instituto Cervantes Albuquerque, the Harvard School of Public Health, the Culinary Institute of America, the International Family Doctors Association, and Instituto Cervantes (Milan, Italy). Dr Ros, during the conduct of the study, received grants from Instituto de Salud Carlos III and nonfinancial support from the California Walnut Commission, Patrimonio Comunal Olivarero, La Morella Nuts, and Borges SA. Dr Ros, outside the present work, has received grants from the California Walnut Commission and nonfinancial support from Nuts for Life, La Asturiana SA, the International Nut and Dried Fruit Council, and the California Walnut Commission and personal fees and other compensation from Nuts for Life and La Asturiana SA. Dr Hu, outside the present work, has received grants from the California Walnut Commission and Metagenics. Dr Fitó, outside the present work, has received personal fees from Menarini and AstraZeneca. No other disclosures are reported.
  • Funding/Support: Although most funding support came from government agencies, “The supplemental foods used in the study were generously donated by Patrimonio Comunal Olivarero and Hojiblanca, Spain (EVOO); the California Walnut Commission, Sacramento, California (walnuts); and Borges SA (almonds) and La Morella Nuts (hazelnuts), both from Reus, Spain.”

Evaluation of 4-methylimidazole, in the Ames/Salmonella test using induced rodent liver and lung S9 Carol Beevers1,* and Richard H. Adamson.  Environ. Mol. Mutagen., Article first published online: 10 SEP 2015.  DOI: 10.1002/em.21968.   

  • Conclusions: No induction of mutation (as measured by an increase in revertant colonies) was observed and it was concluded that 4-MeI was not mutagenic in S. typhimurium using either rodent liver or lung S9 for exogenous metabolism.
  • Conflicts of Interest: The work described in this publication…was funded entirely by the American Beverage Association. ABA had no direct involvement in the study design, collection, analysis or interpretation of the data. ABA were not involved in the writing of this manuscript or the decision to submit the manuscript for publication. Richard H Adamson has received fees for serving as a consultant for the American Beverage Association. He was an observer for the International Technical Caramel Association for IARC Monograph- volume 101 and acted as Study Monitor for the work described in this manuscript. Carol Beevers is an employee of Covance Laboratories Ltd and acted as GLP Study Director for the work described in this manuscript.
  • Comment: 4-MEI is a chemical produced during the Maillard (browning) reaction and found as a component of caramel coloring in diet sodas.  It is listed as a probable carcinogen under California’s proposition 65 rules, and CSPI has petitioned the FDA to require companies to remove it.

Reduced Symptoms of Inattention after Dietary Omega-3 Fatty Acid Supplementation in Boys with and without Attention Deficit/Hyperactivity Disorder.  Dienke J BosBob OranjeE Sanne VeerhoekRosanne M Van DiepenJuliette MH WeustenHans DemmelmairBerthold KoletzkoMonique GM de Sain-van der VeldenAns EilanderMarco Hoeksma, and Sarah Durston.  Neuropsychopharmacology. 2015 Sep; 40(10): 2298–2306.  Published online 2015 Apr 22.  doi:  10.1038/npp.2015.73.

  • Conclusion: this study offers support that omega-3 supplementation may be an effective augmentation for pharmacological treatments of ADHD [Attention deficit/hyperactivity disorder].
  • Funding: This study was financially supported by Unilever Research & Development, Vlaardingen, The Netherlands. Unilever Research & Development was involved in the conception and design of the study. They provided financial support for research staff to run the study and provided the intervention product.  Marco Hoeksma and Ans Eilander are employees of Unilever.

Milk Modulates Campylobacter Invasion into Caco-2 Intestinal Epithelial Cells. Rogier Louwen, R. J. Joost van Neerven.  European Journal of Microbiology and Immunology 5 (2015) 3, pp. 1–7 2015.  doi:10.1556/1886.2015.00019.

  • Conclusions: We found that all milk products modulated the invasion of Campylobacter species into the Caco-2 cells in a dose-dependent manner…This in vitro study shows for the first time that pasteurized and formula milk affect the invasion of Campylobacter… Industrially made milk-based formulas…specifically reduced the invasion of the C. coli and C. fetus strain into the Caco-2 cells.
  • Funding: “Part of this study was supported by FrieslandCampina by paying material costs, but FrieslandCampina was not involved in study design or data analysis.”
  • Comment: FrieslandCampina makes dairy-based beverages, infant nutrition, cheese and desserts, and sells them in Europe, Asia, and Africa.  The study results suggest that even pasteurized milk contains substances that reduce pathogenic bacteria, at least in cell cultures.

Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial.   Dorte Eskesen, Lillian Jespersen, Birgit Michelsen, Peter J. Whorwell, Stefan Müller-Lissner and Cathrine M. Morberg. British Journal of Nutrition. DOI: http://dx.doi.org/10.1017/S0007114515003347 , 9 pages. Published online: 18 September 2015.

  • Conclusions: Overall, 4 weeks’ supplementation with the probiotic strain BB-12® resulted in a clinically relevant benefit on defecation frequency. The results suggest that consumption of BB-12® improves the GI health of individuals whose symptoms are not sufficiently severe to consult a doctor.
  • Funding: Design, conduct, analysis and reporting of the study, as well as writing of this manuscript, were funded in full by Chr. Hansen…S. M.-L. and P. J. W. perform consultancy work for Chr. Hansen A/S. L. J., D. E., C. M. M. and B. M. are employees of Chr. Hansen A/S.
  • Comment: Chr. Hansen develops and produces cultures, enzymes and probiotics for the dairy industry in particular as well as products for dietary supplements, pharmaceuticals and infant formula.
Sep 29 2015

Cocoa flavanols: science or marketing?

Sunday’s New York Times carried this full-page advertisement.

cocoa via

The ad is from Cocoa Via, a company owned by Mars.  It quotes a dietitian stating that cocoa flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”

The ad directs you to the full story at nytinmes.com/cocoavia (where you see more ads).

I posted the science behind this ad earlier this month in my collection of industry-funded studies with results favorable to the sponsor’s interests.  To repeat:

Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

  • Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
  • Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
  • Comment: Lest the “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”

Now we have a full-page ad in the New York Times.

Here’s what the ad does not say:

  • CocoaVia is owned by MARS, Inc (this appears nowhere in the ad).
  • Flavanols are usually destroyed during normal cocoa processing.
  • Most chocolate contains few flavanols; CocoaVia’s process preserves some of the flavonols in very dark chocolate.
  • Flavonol-rich or not, chocolate candy is not a health food.

Like most conflicted research, this is about marketing—hence, the ad—not science.

Sep 28 2015

Never a dull moment: the BMJ’s attack on the Dietary Guidelines Advisory Committee report

Really, the Dietary Guidelines Advisory Committee’s (DGAC) report shouldn’t be this controversial and shouldn’t be controversial at all (as I’ve said before).  But lots of people—the food industry, of course, but also some scientists and journalists—seem to have exceptionally intense opinions about the fat recommendations [Recall:  The DGAC report does not constitute the Dietary Guidelines; these are written by USDA and HHS and are not due out until the end of this year].

Now, we have the journalist Nina Teicholz, author of The Big Fat Surprise, repeating the themes of her book in the BMJ: The scientific report guiding the US dietary guidelines: is it scientific?.

The BMJ has also found that the committee’s report used weak scientific standards, reversing recent efforts by the government to strengthen the scientific review process. This backsliding seems to have made the report vulnerable to internal bias as well as outside agendas.

Teicholz’s interpretation of the science relating dietary fat to health has been thoroughly critiqued (see end of post).   The way I see it, these arguments are difficult to resolve outside the context of dietary patterns as a whole.

My hypothesis (note: hypothesis) is that for people who balance calorie intake with expenditure, the type of fat—or carbohydrate—matters much less than it does for people who overeat calories.  This hypothesis needs testing to confirm it.

What troubles me about Teicholz’s work is the certainty with which she presents her ideas.  She comes across as utterly convinced she is right, even in the face of substantial and substantive criticism of her statements and interpretations.

At least one error

Here, for example, is one statement in the BMJ article that I know from personal experience cannot be correct.

Much has been written about how industries try to influence nutrition policy, so it is surprising that unlike authors in most major medical journals, guideline committee members are not required to list their potential conflicts of interest.

I was a member of the 1995 DGAC and I was required to declare conflicts of interest.  So were members of the committees in 2000, 2005, and 2010, as shown in this excellent short video.

Later, discussing conflicts of interest among DGAC members, Teicholz says:

Still, it’s important to note that in a field where public research dollars are scarce, nearly all nutrition scientists accept funding from industry. [Nearly all?  I don’t, and I doubt this is correct].  Of far greater influence is likely to be bias in favor of an institutionalized hypothesis as well as a “white hat” bias to distort information for what is perceived as righteous ends.

The “white hat bias” comment refers to a paper by authors who themselves report food-industry funding:

Competing Interests. Drs. Allison and Cope have received grants, honoraria, donations, and consulting fees from numerous food, beverage, dietary supplement, pharmaceutical companies, litigators, and other commercial, government, and nonprofit entities with interests in obesity and nutrition including in interests in breastfeeding and NSBs. Dr. Cope has recently accepted a position with The Solae Company (St Louis, MO.).

Responses to the BMJ article

The DGAC wrote a rebuttal to Teicholz.  It is published on the BMJ website.

HHS also published a statement, reproduced by Mother Jones.

The British Medical Journal’s decision to publish this article is unfortunate given the prevalence of factual errors. HHS and USDA required the 2015 Dietary Guidelines Advisory Committee to conduct a rigorous, systematic and transparent review of the current body of nutrition science. Following an 19-month open process, documented for the public on DietaryGuidelines.gov, the external expert committee submitted its report to the Secretaries of HHS and USDA. HHS and USDA are considering the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, along with comments from the public and input from federal agencies, as we develop the 2015 Dietary Guidelines for Americans to be released later this year.

Yoni Freedhoff’s Weighty Matters blog provides a handy summary of additional responses to the BMJ article.

Scientific analysis of The Big Fat Surprise

Many of the scientific claims in this book seemed so far-fetched that they induced a nutritionist, Seth Yoder, to go over it line by line, read the references, and point out discrepancies.   These are posted on his website in two parts.

A summary quote from Part 1:

What makes this particular book interesting is not so much that it is bad (which it is) or that it is extravagantly biased (which it also is). No, what really fascinates me about this book is that the author excessively and shamelessly lifts other people’s material.

And a quote from Part 2

The Big Fat Surprise (BFS) by Nina Teicholz is yet another book in a long line of books that informs the reader that everything you thought you knew about nutrition is wrong: saturated fat from animals is actually quite good for you, cholesterol isn’t really important, the government lied to you, nutritionists and dietitians lied to you, the American Heart Association lied to you, etc… Leaving aside that the concept of that kind of a conspiracy actually existing is really absurd, what I’m surprised about is that publishers can keep churning out books like this and people are gullible enough to keep buying them.

Caveat emptor.

Additions: