by Marion Nestle

Search results: added sugar

Jan 7 2011

Bad news on food prices: up, up, and away

The FAO (Food and Agriculture Organization of the U.N. has just released its 2010 food price index.  Compared to 2002-2004, commodity food prices sharply increased, especially those of sugars and fats.

The new index is higher than in 2008 when people throughout the world rioted in protest.  It is also at the highest level recorded since the index began in 1990.

What’s going on?  In 2008, FAO explained the crisis as the result of the combined effects of:

  • Competition for cropland from the growth in biofuels
  • Low cereal stocks
  • High oil prices
  • Speculation in food markets
  • Extreme weather events

I’ve discussed other possible explanations I’ve collected in previous posts.

This time, supply problems in grains, sugars, and meat are making the problemworse.  FAO experts are predicting that prices will go even higher this year.

High food prices are a disaster for the poor and are also a ticket to social disorder.   World leaders: get to work!

Added clarifications: It turns out that the FAO food price index is not inflation-adjusted.  Oops.  This means that the prices are not necessarily higher than they were in 2008. Nevertheless, food riots are already happening.  Ben Grossman-Cohen of Oxfam sends this report of such disturbances in Algeria, for example.

Oct 9 2010

Reprint from Civil Eats: Andy Fisher on Food Stamps vs. sodas

The most thoughtful comments I’ve seen on the proposal to block food stamp recipients from buying sodas come from Andy Fisher’s post on Civil Eats.

Mr. Fisher is currently a Kellogg Food and Society Fellow with the Institute for Agriculture and Trade Policy in Minneapolis.  He is the Co-Founder/Executive Director of the Community Food Security Coalition (CFSC).

I have added the red-highlighted emphases:

Banning Soda for Food Stamps’ Recipients Raises Tough Questions

October 8th, 2010  By Andy Fisher

On Thursday, New York City Mayor Michael Bloomberg announced that he had asked the US Department of Agriculture to allow the city to exempt soda from the permitted list of items its 1.7 million food stamp recipients can purchase with their benefits. This ban would last for two years, enough time to assess its effects and determine whether the ban should be continued on a permanent basis. New York City food stamp recipients spend an estimated $75 million to $135 million of their $2.7 billion in food stamps annually on soda, according to AP.

Anti-hunger and public health advocates at odds over proposal

Public health advocates contend the obesity epidemic is costing the US hundreds of billions of dollars per year in increased health care costs, and sugar sweetened drinks are a major factor.   They correctly note that low income persons tend to have higher rates of diet related diseases than the general public: poor New Yorkers have twice the rate of adult-onset diabetes than compared to the wealthiest. Mayor Bloomberg noted, “Sugar-sweetened drinks are not worth the cost to our health, and government shouldn’t be promoting or subsidizing them.”

On the other hand, anti-hunger advocates argue that food stamp recipients should have the same freedom of choice at the supermarket checkout counter as any middle class person. Exercising that freedom is a matter of personal dignity that the poor all too often are not afforded. Restricting soda is the first step in a slippery slope toward further demeaning regulations on what food stamp recipients can buy.  They correctly point out that poor people often can’t afford produce, as nutritious foods tend to be more expensive per calorie than less healthy food.

The anti-hunger community is correct that historically, as a nation, we have treated the poor paternalistically. American social, educational and health policy is littered with countless examples of this failed approach. Regulating what food stamp recipients can and can’t buy with their benefits puts forth the message that they are not capable of making good decisions, and the government needs to set forth boundaries to protect them from their own poor choices. To the contrary, some studies have shown that food stamp recipients actually buy more nutritious food per dollar than non-food stamp recipients.

Anti-hunger advocates are also right that poor people typically can’t afford nutritious foods. Highly processed foods, such as ramen, fill up a belly more cheaply than broccoli and whole wheat pasta.  In our food system, high calorie foods with low nutritional value are cheaper than nutrient dense foods. For example, a 12 pack of 12 ounce cans of Coke (144 oz) at Kroger’s costs $2.79 on sale, while a half gallon (64 ounces) of Minute Maid orange juice (also a Coca Cola Inc. product) is $2.49. The bad choice is the cheap choice.

On the other hand, public health groups are dead-on accurate that it is irresponsible public policy to be subsidizing with tax dollars the purchase of unhealthy products that will burden society with increased health care costs in the future.  As a nation, we’re subsidizing soda companies $4 billion annually through the food stamp program. In return, decades later, the public will be stiffed with the hospital bill for billions of dollars more for extra health care costs from these poor dietary choices.

Thorny issue raises questions

Why are anti-hunger advocates in the absurdly precarious position of protecting the right of poor people to drink soda? Do I have a right as an American to poison myself with “soft” drinks that can dissolve the rust off a car? Does it matter whether I use my own money or tax dollars?  Should freedom of choice apply to products of marginal utility if not harmful products?

Why does it cost Coca-Cola more to produce a half-gallon of orange juice than a half gallon of Coke? How do we reverse this situation, such that healthful products are more affordable and unhealthy products are more costly?

Are food stamps an income support program- or as the program’s new name indicates, a Supplemental Nutrition Assistance Program? If it is a “supplemental nutrition” program, then shouldn’t USDA define which products are nutritious based on Institute of Medicine standards, and limit purchases to these products? USDA does this with the Women Infants and Children (WIC) program, which is widely touted for saving billions in health care costs.

If food stamps are an income support program, and anti-hunger advocates want to maximize poor people’s freedom of choice, then why shouldn’t food stamps be distributed as cash rather than as a debit card good for food purchases? Doesn’t receiving cash maximize a person’s dignity as it bestows trust upon that person that he or she will make the right choice with their money?  Would food stamps not then become a welfare program, and be subject to the negative public perception of welfare?

The real story behind food stamps is that it is neither a nutrition program nor an income support program. It is a massive subsidy for the food retailers, grocery manufacturers, and industrial growers. That is why commodity groups, the Grocery Manufacturers of America and the Food Marketing Institute all line up behind the food stamp program every five years when the Farm Bill is being debated. They know the extra buying power food stamps provides to low income Americans will end up in their pockets.

In their noble effort to reduce human suffering and to improve the livelihood of the 41 million Americans on food stamps, anti-hunger advocates are caught in an ever-tightening bind. They frame food stamps as a nutrition program, because a nutrition program has more public support and more powerful allies in Congress than a welfare or income support program. Yet, burgeoning rates of chronic diseases and the growing presence of the public health community as a player in federal food and farm policy, translates into increased accountability for the nutritional impact of the food stamp program.

What boat are both camps missing?

There is one very important point neither the anti-hunger nor the public health advocates are making. Our tax dollars, especially the $80-90 billion spent annually on federal food programs, are a powerful force in shaping the food system. Food stamps, like school meals and WIC, should be the cornerstone of a food system that is grounded in principles of environmental sustainability, social justice, and health. Directed toward the small farm economy, community-oriented retailers, brokers, and processors, even a modest percentage of these funds could ignite a transformation of our food system.

Consider this. While nationally food stamp recipients are spending $4 BILLION per year on soda, in 2009, only $4 MILLION of food stamps were redeemed at farmers markets. This difference is shaped by the fact that USDA has not equipped farmers markets with free debit card terminals (which are needed to accept food stamp benefits), and prohibited federal nutrition education programs to promote farmers markets. Does this mean the Department of Agriculture values soft drinks one thousand times more than farmers markets?

Mayor Bloomberg has proposed only half the solution. USDA should grant him the waiver he requests if and only if New York City agrees to redirect the $75-$135 million that would have otherwise been spent on soda to programs that encourage food stamp recipients to purchase locally grown foods at farmers markets, community supported agriculture farms, and other community-oriented venues.

Sep 5 2010

San Francisco Chronicle column: nutrition advice to doctors

This month’s San Francisco Chronicle column evolved in answer to a question from a former colleague at the UCSF School of Medicine.

Q: What do you think doctors should be telling patients about how best to care for themselves and their families, nutritionally?

A: I had my chance when, long ago, I ran a nutrition education program for medical and other health professions students and practitioners at UCSF.

Then, as now, it was obvious that just about every patient who landed in the hospital needed nutrition intervention. Practically everyone who visited the outpatient clinic either wanted or needed nutrition advice.

Then, as now, few doctors were taught anything about nutrition, let alone the details of what they needed to know to help patients address dietary concerns.

In today’s health care environment, even doctors with advanced nutrition training do not have time to use it. Blame this on how our health care system systematically rewards doctors for treatment of disease, not its prevention.

What doctors need to tell patients about nutrition depends on who the patients are. If people are sick, doctors need to talk to them about how dietary changes and improvements will help them recover and prevent further illness.

But I’m guessing that your question refers to healthy patients who want to stay that way. With these people, what doctors do and say can have profound effects. Doctors are authority figures and their advice is taken seriously.

As a standard part of patient care, doctors routinely ask about drugs, cigarettes and alcohol. Even if they only have a minute, adding one more question about diet can do much good. If nothing else, it conveys that diet matters to health.

Given the reality of time constraints, my wish list for what to do next is necessarily short.

Tell patients that healthy eating simply means three things: variety, minimal processing and moderation.

Variety means choosing many different kinds of foods from the various food groups: meat, dairy, fruits, vegetables, grains. It counts because foods vary in nutrient content. Varying foods within and among food groups takes care of needs for nutrients without having to think about them. People who consume adequate amounts of varied diets rarely exhibit nutrient deficiencies. It’s the most restrictive diets that are likely to be deficient in one or another nutrient.

Minimal processing means that the foods should be as close as possible to how they came from the animal or plant. The greater the level of processing, the less the foods resemble their origins, the less nutritious they may be, and the more salt, sugar and calories get added to disguise the changes.

Minimal processing excludes foods high in salt and sugars and low in fiber, as well as sugary sodas and juice drinks, those popularly known as junk foods.

My definition of minimal processing is only slightly facetious: Don’t eat anything with more than five ingredients or an ingredient you can’t pronounce.

Moderation is about balancing calorie intake with expenditure and maintaining a healthy weight through food choices and physical activity.

These are general principles. Beyond them, nutrition advice must be personalized to the particular individual or family. To do that quickly:

  • Ask patients what they and their children eat. You can start with a waiting-room questionnaire that probes typical intake of foods and supplements.
  • Screen the responses for variety, minimal processing, moderation and excessive or unusual supplement use. Note whether body weights are within healthy ranges.
  • Reassure patients whose diets are varied, minimally balanced and moderate that they are doing wonderful things for their health and should keep doing what they are doing.
  • Refer observations that need further discussion to a nutritionist.

Doctors: You don’t have to do it all. Making it clear that diet matters is often enough to encourage patients to make better dietary choices. Use the services of a nutritionist. Nutritionists are professionally trained to answer patients’ questions about diet and health and to counsel them on dietary interventions.

Patients (meaning everybody): Tell your doctors that you want their advice about diet and health and expect them to know something about it.

Aug 11 2010

More about imaginative food marketing

The Pop-Tarts store in Times Square (see yesterday’s post) is only the loudest example of innovative food marketing to come out recently.  I’ve been collecting more subtle examples:

Using social media (and getting customers to pay for it): For 99 cents to I-tunes, you can buy an app that gives nutritional information for products at Jack-in-the-Box or at McDonald’s.   As Mark Douglas of Culinate explains: “They want $0.99 to tell you what you probably already know… Watch Out!”

Co-opting health professionals: Michele Simon (author of Appetite for Profit) writes on AlterNet about how PepsiCo hires distinguished health professionals and experts to give a company that sells snack foods and soft drinks an aura of health and wellness.

Co-opting professional organizations: Lisa Young (the Portion Teller) points me to a Webinar on August 25 run by the industry-sponsored School Nutrition Foundation and the Milk Processor Education Program on what is surely an urgent issue for sellers of chocolate (sugar-added) milk: “Keep flavored milk from dropping out of school!”

Deflecting attention from diet: Lisa sends another Webinar notice for September 14, this one for “skills & tools to enhance change in physical activity behavior.”  Its sponsor?

The Coca-Cola Company’s Beverage Institute For Health & Wellness is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) – provider number BF001.

Plain, old-fashioned lobbying: Food Safety News has a nifty report on food company lobbying expenditures (huge), mainly on the food safety bill but also on many other bills that might affect labeling or sales of food products.

I reviewed these methods in my book, Food Politics. A revised edition came out in 2007.  Not much change, alas.

Addition: Attracting school kids: Michele Simon sends this Pepsi partnership with Hy-Vee stores in Iowa.  Parents buy five Pepsi products; Pepsi buys backpacks for their kids.

Jun 11 2010

Health claims: Should the First Amendment protect bad science?

I keep complaining about the health claims on Enfagrow toddler formula, a sugary product aimed at children from ages one to three:

These claims, for the uninitiated, are a special kind called structure-function.  Congress authorized such claims when it passed the Dietary Supplement Health and Education Act (DSHEA) in 1994.

Structure-function claims do not say that the product can prevent or treat disease. They merely suggest that the product can help in some unspecified way with some structure or function of the body.

When Congress passed DSHEA, it meant the claims to apply to dietary supplements, not foods. Enfagrow is marketed as a food, not a supplement.  It displays a Nutrition Facts label, not a Supplement Facts label.

Over the years, the FDA has issued cease-and-desist warnings about foods that bear structure-function claims.  In recent years, it has simply stated that manufacturers are responsible for ensuring that the claims are “truthful and not misleading.”

One reason for the shift is what the Courts have ruled.  The Courts say that structure-function claims are protected by First Amendment guarantees of free speech.  The most recent case is Alliance for Natural Health USA v. Sebelius. As described in Food Chemical News (June 7), a D.C. District Court judge ruled that the FDA cannot deny health claims that link selenium supplements to reduced risk of several diseases, or require those claims to be qualified, just because the claims lack adequate scientific substantiation.

In other words, supplement makers can say anything they want to about the benefits of their products—on the grounds of free commercial speech—whether or not science backs up the claim.

Recently, the FDA issued a warning letter to Nestlé, the maker of a Juicy Juice product aimed at toddlers, which displays a claim that its content of added omega-3 DHA improves brain development.  The FDA did not take on the claim, even though research seems unlikely to find that such drinks have any special benefits for brain development.  Instead, the FDA focused on a technicality:

The product makes claims such as “no sugar added,” which are not allowed on products intended for children under 2 yrs of age because appropriate dietary levels have not been established for children in this age range.

I’m guessing—this is speculation—that the FDA is reluctant to take on Enfagrow’s brain or immunity claims because Mead-Johnson has deep pockets and might well be willing to fight this one in court as a First Amendment case.

I am not a lawyer but I thought that intent mattered in legal cases.  Surely, the intent of the founding fathers in creating the First Amendment was to protect the right of individual citizens to speak freely about their political and religious beliefs.  Surely, their intent had nothing to do with protecting the rights of supplement, food, and drug corporations to claim benefits for unproven remedies, or to promote sales of sugary foods to babies.

I think it is time to give these First Amendment issues some serious thought.  How about:

  • FDA: Fire those lawyers and hire some who will protect the FDA’s ability to use science in its decisions.
  • FTC: Take a look a the immunity claim on the Enfagrow Vanilla toddler formula, now that the Chocolate is off the market.
  • Legal scholars: Surely there are ways to protect real First Amendment rights while restricting unsubstantiated health claims?

Other ideas are most welcome.  Your thoughts?

Jun 10 2010

Mead-Johnson withdraws Chocolate toddler formula: Meaningful or just PR?

Mead Johnson announced yesterday that it was withdrawing its Enfagrow Chocolate Toddler Formula–just the Chocolate version–from the market:

Like all our Enfagrow Premium products, the recently introduced chocolate-flavored version has a superior nutritional profile to many other beverages typically consumed by toddlers — including apple juice, grape juice, and similarly flavored dairy drinks. Unfortunately, there has been some misunderstanding and mischaracterization regarding the intended consumer for this product and the proper role it can play in a child’s balanced diet. The resulting debate has distracted attention from the overall benefits of the brand, so we have decided to discontinue production of Enfagrow Premium chocolate toddler drink and phase it out over the coming weeks.

I can’t resist quoting the Chicago Tribune’s explanation of the origin of the debate caused by “misunderstanding and mischaracterization:”

Introduced in February, the chocolate-flavored formula was widely criticized in the blogosphere after Marion Nestle, professor of nutrition, food studies and public health at New York University, wrote that the drink would lead children to crave sugary beverages on her influential blog, www.foodpolitics.com.

Influential?  Maybe, but it seems that my comments on this formula did not go nearly far enough.  Mead-Johnson may be withdrawing the Chocolate version, but it is keeping the Vanilla (as explained by Susan James on ABCNews.com, which also quotes me).

What’s the difference?  The Vanilla has exactly one gram less sugar than the Chocolate, 18 grams per 6-ounce serving, rather than 19 grams.  In contrast, the milk in my refrigerator has 9 grams of sugar (natural, not added) in 6 ounces.

Clearly, Mead-Johnson doesn’t get that it’s the sugars, stupid.

Why do I think this is a PR stunt?  Three reasons:

  • The Vanilla doubles the sugars in regular milk.
  • The Vanilla has the same health claims as the Chocolate: growth, brain development, and immunity.
  • Mead-Johnson’s stock went up after the announcement.

One more time: Where are the FDA and FTC on this product?  This Immunity claim is no different from the one on Kellogg’s Krispies cereals that the FTC went after a couple of days ago.

Tomorrow: Some speculation on why the FDA is reluctant to take on things like this.

Addition, June 11: Here is Melanie Warner’s take on this on her BNet Food Industry blog site (she quotes my post).

Mar 16 2010

Cargill thinks beta-glucan is the new oat bran

In 2008, in response to a petition by Cargill, the FDA authorized a health claim for beta-glucan extracted from barley.  Beta-glucan is a form of soluble fiber similar to that from oats, psyllium, and other grains or from the cell walls of yeast.  It can help lower blood cholesterol levels and, therefore, the risk of coronary heart disease.

Cargill must think that beta-glucan will create another oat bran craze such as the one that occurred in the late 1980s.  Or at least that’s the impression given by the latest news from the U.K.: “Cargill says EFSA health claim will transform beverage fibre fortunes.”

The deal with beta-glucan is that it can be added to drinks (presumably sugary).  If so, the drinks can carry the claim:

3 grams per day of barley beta-glucan, as part of a diet low in saturated fat, and a healthy lifestyle, can help manage normal blood cholesterol (my emphasis).

Beta-glucan is a “functional” ingredient, meaning that it is something added to a food ostensibly to boost its health value.  But the entire point of functional ingredients is to be able to make health claims for them.  Health claims sell food products when nobody bothers to read the fine print.

Mar 12 2010

Disturbances on the GM front

If you want to know what’s really happening in the world of food and nutrition, the business pages are a good starting place.  Today’s New York Times business section documents the “stunning” rise in the price of soybean seeds (up 108% since 2001) and corn seeds (up 135%).

Why care?  Genetically modified (GM) varieties are now the majority – and increasingly the vast majority – of crops planted in the United States.   The seeds are patented.  Farmers cannot harvest and save them.  Farmers must buy new patented seeds every year.  And since one company – Monsanto – owns most of the patents, it gets to set the price.

USDA keeps track of the rise in use of GM crops.  Impressive, no?

The USDA does not track GM sugar beets on this chart, but should.  Monsanto also patents GM sugar beets.  The USDA approved Monsanto’s sugar beets in 2005.  By 2009, 95% of U.S. sugar beets were grown from Monsanto’s patented varieties.

Oops.  When it approved the beets, the USDA let them be planted without the required environmental impact statement (EIS).   Advocacy groups argued that the beets should not be planted without that assessment.  A judge agreed and blocked further plantings.  The judge is still sitting on the case.  Until he rules, no GM sugar beets can be planted.

We have a similar situation with GM alfalfa.  This crop was also approved in 2005 without an EIS and also was taken to court and banned.  But now the EIS is done and the USDA has found “no safety concerns.”  Perhaps GM alfalfa will be added to the chart next year?

What are we to make of this?  Is it a good idea for one company to own most of the seeds planted in the United States?  Especially when that company is permitted to enforce its own patent protection and to set its own prices?

The great promise of food biotechnology is that it will feed a hungry planet.  Is this the best way to met world food needs?  Whatever you think of GM foods, these questions are worth pondering.