Thanks to Courtney Scott, a doctoral student at University of North Carolina, for sending me this account of the fate of Britain’s salt reduction strategies, published in the BMJ (British Medical Journal).

The lead author on the article is Dr. Graham MacGregor, Britain’s leading advocate for diets lower in salt.  It is about the derailing of Britain’s remarkable successful salt reduction strategy.

Under the auspices of Britain’s Food Standards Agency (FSA), the salt reduction program initiated in the early 2000s—getting companies to slowly but steadily reduce the salt in their products—was working well.

Most impressive: salt intake, blood pressure, heart disease, and stroke declined in parallel with the decline in salt in the food supply.

But in 2010, Britain elected a more conservative government.

Andrew Lansley was appointed secretary of state for health, and he moved the responsibility for nutrition from the FSA to the Department of Health. This disrupted the salt reduction programme, making it unclear who would be responsible for the policy. In 2011 Lansley launched the responsibility deal, whereby he made the alcohol and food industries responsible for reducing alcohol consumption and improving nutrition, respectively. As a result, salt reduction lost momentum.

The key points of the article:

• Most of the foods that industry currently provide are very high in salt, fat, and sugars and are therefore more likely to cause cardiovascular disease and predispose to cancer than healthier alternatives.

• The UK’s salt reduction programme…led to a significant reduction in population salt intake, accompanied by reductions in blood pressure and cardiovascular mortality.

• The programme has been set back by the coalition government’s decision to hand power back to the food industry as part of the responsibility deal.

• An independent agency for nutrition with a transparent monitoring programme is urgently needed to improve the food that we eat.

As I’ve explained previously, most salt—80% or more—in American diets is already in processed and prepared foods when they are presented to us.  That’s where the salt reduction has to come from.  As the authors explain,

Members of the food industry have said that they are keen to reformulate their foods to make them healthier. All they require is to be on a “level playing field” with the other major companies, so that they can make their foods healthier in a structured, incremental way. They need to be assured that there are proper reporting mechanisms in place and that all of the companies are being monitored equally. Enforcement is required, and if it doesn’t work, regulation or legislation must be enacted.

The debates over salt may be the most contentious in the field of nutrition (as the Washington Post puts it), but the parallels between the British decline in salt intake and in salt-related disease are impressive.

On a population basis, eating less salt is healthier.

This is something you can’t easily do on your own.  The food industry has to do it.  And food companies don’t want to, for obvious reasons.

Hence: the need for regulation.

I am indebted to Pro Politico Morning Agriculture for this tidbit:

HOUSE AG COMMITTEE PRIES INTO DGAC COMMENT REVIEW: The chairman and ranking member of the House Agriculture Committee have requested that the USDA and HHS supply an accounting of how they intend to review the more than 29,000 public comments on the 2015 Dietary Guidelines Advisory Committee’s report, as well as an accounting of the staff maneuvering that’s been required to review those thousands of comments in a timely manner.

In a letter sent by Reps. Michael Conaway and Collin Peterson, the committee has also requested more information on whether the departments will be able to deliver the final Dietary Guidelines for Americans document by the end of the year, as originally intended.

“Have you reconsidered that goal given the overwhelming number of comments that now need to be reviewed,” the letter states. “If not, do you intend to incorporate the review of the 29,000+ comments received into this work product, and how do you intend to complete that process?” You can read the full letter, which the lawmakers expect a response to by June 10, here: http://1.usa.gov/1EJcrSM

OK.  Let’s review the process here.

• Congress, in its infinite wisdom, wants the Dietary  Guidelines reviewed and redone every five years.
• We’ve had Dietary Guidelines every five years since 1980.  Their basic messages have not changed much.
• The 2015 Dietary Guidelines Advisory Committee (DGAC) reviewed the research and issued a lengthy report.
• The report was released for public comment.  More than 29,000 comments came in.
• Now the agencies—USDA and HHS—must deal with the comments are write the actual Dietary Guidelines.

Until 2005, the DGACs wrote the actual guidelines with minimal editing from the agencies.  That was certainly how it worked in 1995 when I was on that committee.

We did the research and wrote guidelines based on that research.  The agencies published them pretty much as we wrote them.

That changed in 2005 under the Bush II administration.

By now, nutrition advice has become so politicized that the public—from individual consumers to corporations—has a say in them.

Which method helps the public eat healthier diets?

You decide.

I withholding judgment until I see how the agencies extract guidelines from the 650-page DGAC report and its 29,000 comments.

I’m guessing that after all this fuss, the guidelines will still basically say:

• Healthy diets are based largely on foods from plant sources (eat your veggies)
• Don’t eat too much sugar, salt, or saturated fat (avoid junk food)
• Don’t gain excess weight if you can avoid it (balance calories)

Good advice.  Too bad that following it does not increase profits for the food industry.

It’s tough to be a soda company these days, what will sales of both sugary and diet drinks falling steadily.  Hence, this May 15 press release:

Alliance for a Healthier Generation and America’s Beverage Companies Start Work In Los Angeles Area Neighborhoods As Part of Community Initiative To Help Reduce Beverage Calories Consumed 

(LOS ANGELES) –The Alliance for a Healthier Generation and America’s beverage companies announced today that work will begin in four Los Angeles area communities as part of a highly focused initiative to help reduce beverage calories consumed by 20 percent per person by 2025 in neighborhoods where there has been less interest in or access to lower-calorie and smaller-portion beverages.

…The beverage companies will utilize a range of marketplace activities in these neighborhoods in an effort to help people reduce their calories, such as making lower-calorie and smaller-portion beverages more available in stores, providing incentives for consumers to try these options and displaying new calorie awareness messages at points of sale. These activities will allow companies to test and learn in order to develop the best practices that can be implemented elsewhere.

Here’s what people in these neighborhoods will see:

The press release says nothing about:

• Less marketing targeted to African- and Hispanic-Americans
• Less marketing targeted to low-income children and adolescents

Is this public relations or something meaningful?  I’m skeptical but do try to stay open-minded about such things.

Let’s wait and see how this plays out.

Barry Estabrook.  Pig Tales: An Omnivore’s Quest for Sustainable Meat.  WW Norton, 2015.

I was happy to be asked to blurb this one.  It’s a great read:

Estabrook tells two powerful stories here.  The first is about the appalling ways in which Big Pig raises animals, pollutes the environment, and uses the political system to avoid and fight regulation.  The second is about how skilled animal husbandry and respect for the intelligence of pigs produces calmer animals, more delicious meat, and a far more satisfying life for farmers and pigs alike.  Pig Tales is beautifully written.  It is also deeply touching.

Throughout my travels in Italy the last couple of weeks, I was constantly asked for an assessment of the Milan Food Expo.

My answer: it’s too early to tell.  It’s only been open for two weeks and has lots more to do between now and the end of October.

In my posts on the Expo, I’ve talked about the logistics and a few of the pavilions.

But what about the overall content and take-home messages?  Expos are trade fairs, but this one is about feeding the planet—adequately and sustainably.

The U.S. Pavilion carries out this theme:

Most countries created exhibits based on these themes.  Many displayed vegetable gardens in raised beds or, in the case of the US pavilion, on a long, undulating wall.

It’s useful to start with the United Nations’ Zero Hunger Pavilion.  Its gigantic ticker-tape display tells you the price of food commodities throughout the world in real time.

The scrolling messages in English and Italian:

• The food sector: reality vs. abstraction.
• Extreme price volatility is a threat to food security.
• The gap between supply and demand is mainly caused by increasing food consumption, climate variability, expansion of agro-energy production, and financial speculation.
• Lack of transparency and profits for a few speculators intensify inequality in food distribution.
• New rules are needed for agricultural governance.

Like most of the exhibits, this one states the problems and says what is needed to solve them.  But it leaves it up to you to figure out how to set or obtain the new rules for agricultural governance.

My view from this brief visit: The very existence of Milan Food Expo 2025 is a strong statement that food issues are worthy of serious public attention, worldwide.

For that alone, it succeeds magnificently.

When the Milan Food Expo opened on May 1, there were plenty of protests, fires, store break-ins, and overturned cars.

The protesters have been angered by Expo’s reliance on volunteer workers, the involvement of corporations like McDonald’s and Coca-Cola and a perception that much of the public money ploughed into the project has been lost to corruption.

Coca-Cola has a big presence at the Expo (see my post from last week) and in the city.

Coca-Cola sponsors Milan’s public bicycle program: BikeMi.

McDonald’s also has a large restaurant on the Decumano (the main street of the fair), but the huge golden arches are in the back where they are only visible to people from outside the fair..

The day after the protests, cleaners were washing away the last of the “No Expo” graffitti on Milan walls.

Despite the initial controversy, the Expo is attracting huge crowds and vast hordes of school children.  Most pavilions are open, and some have long lines to get into.

Tomorrow: a preliminary assessment.

I especially enjoyed the pavilion of Coldiretti, an association of Italian farmers.

“No party” can—and is supposed to be—read two ways: no fun, or no political clout.

The pavilion houses a farmers’ market promoting the products of its members.

Coldiretti doesn’t have much use for GMOs, but for reasons we don’t often consider in the U.S.

In case you can’t read the photo:

What is good for the GMO multinational corporations is bad for Italy.

Because they cancel our extraordinary diversity.

Because they suffocate many to reward one.

Because the seeds of the earth belong to those who work it.

Because food certainties belong to “free research.”

Whatever you think of such views, I’m hoping the Milan Food Expo will get visitors thinking about these food issues and more.

Milan’s Trienniale Museum is offering an Arts & Foods exhibit in conjunction with the Food Expo.  Your Expo pass lets you in.

I’ve been to many food-and-art exhibits, but this one is beyond enormous.  I seems to have everything.

Gursky:

Warhol:

Gehry:

American World War II posters:

Food-related items—paintings, yes, but also teaspoons, coffee pots, refrigerators, and anything else you can think of that might have something to do with food—take up almost the entire museum.

And movie clips!  Buster Keaton!

The catalog is 4-inches thick, weighs at least 5 pounds, and costs 60 Euros.

Go.

But plan on many hours.