Search results: added sugar

I could not go to the Federal Trade Commission’s December 15 forum on food marketing to children (see previous post), but from all reports I missed quite a show.

Officials of four federal agencies involved in food and food regulation – FTC, FDA, USDA, and CDC – released the results of their collaborative efforts to set standards for marketing foods to kids through an Interagency Working Group on Food Marketed to Children.  Congress established this group through the 2009 Omnibus Appropriations Act.  It specified that the group was to set up standards for identifying foods that should not be marketed to children and to publish them by July 15, 2010.

And what standards did the four agencies come up with?  Here are the working group’s recommendations:

Take a look at these “Tentative Proposed Standards for Marketing Food to Children 2-17” and decide for yourself whether they are even remotely meaningful.

The Standards are divided into three categories: Standard 1 is real (largely unprocessed) foods with no added sweeteners or functional ingredients.  These could be marketed to children with no further scrutiny.

Foods that do not meet Standard 1 would be required to meet both Standards 2 and 3 in order to be marketed to children.

Standard 2 applies to foods that “must provide a meaningful contribution to a healthful diet” in one of two ways: containing 50% by weight of real foods (Option A), or by containing defined amounts of some useful nutrients per RACC (Option B).  RACC is a new term to me.  Apparently, it means “reference amount customarily consumed.”   I have no idea what these are but let’s call them serving size.

And what about the cut points?  No foods marketed to children can exceed Standard 3 (“nutrients to limit”):

• Saturated fat: 1 gram or less per serving and not more than 15% of calories
• Trans fat: less than half a gram per serving
• Sugar: no more than 13 grams per serving
• Sodium: no more than 200 mg per serving (equivalent to half a gram of salt)

Got that?  It’s enough to make me weep.

Apparently, the agencies did not give examples of products that might qualify or not, so you have to do your own work on this.  So that leaves me with some questions about the tentative proposed standards:

• Which products qualify and which do not?  It looks to me like the criteria will continue to permit the marketing of questionably nutritious products to kids.  Sugary kids’ breakfast cereals should easily qualify; most do not contain more than 13 grams of sugars per serving or more than 200 mg sodium.
• What is the definition of RACC?  I don’t see a definition in the document.  Without a definition, are companies permitted to define serving sizes for themselves and, maybe, reduce the stated serving size to meet the standards?
• Is there any accountability for meeting the standards?  The entire program is voluntary. Alas, we have already had years of experience with industry “self-regulation” and know that it does not work.

This is the best government agencies could come up with?  I see this as further evidence for the need to stop companies from marketing foods to kids.  Period.

Or am I missing something?

My latest column in the San Francisco Chronicle deals with the immunity health claim on boxes of Kellogg Cocoa Krispies (see previous posts).  I’ve been writing the column for the last year at irregular intervals of about once every three weeks.  Beginning in January 2010, it has its own slot and will appear on the first Sunday of the month.  Here’s this one:

Q: It’s great that San Francisco City Attorney Dennis Herrera put a stop to the absurd “immunity” claim on Kellogg’s Cocoa Krispies, but how do companies get away with this?

A: I confess; I’m a health-claims junkie. I snatched up the immunity-claiming box of Cocoa Krispies the minute I saw it in a supermarket last August. I consider it a treasure: “Now helps support your child’s IMMUNITY.”

How does Cocoa Krispies perform this miracle? The cereal contains 25 percent of the daily value of antioxidant vitamins A, B, C and E per serving instead of the old 10 percent. Vitamins, Kellogg points out, play an important role in immunity.

Of course they do. All nutrients are involved in immune function. But is it remotely possible that Cocoa Krispies might protect your child against colds or swine flu? I wish.

Antioxidants present an unparalleled marketing opportunity. Kellogg does not have to prove that its cereals are protective. Immunity claims fall into a Food and Drug Administration regulatory gray area. “Supports immunity” is a “structure-function” claim, so called because it promises to support a structure or function of the human body. However you might interpret such claims, they do not really promise to prevent, treat or cure disease.

Congress expressly authorized structure-function claims when it deregulated dietary supplements in 1994. But that law did not apply to foods. Food companies wanted to use these claims, too. At first the FDA balked. When faced with further legislation and court overturns, the FDA gave up. Now it merely says that structure-function claims on supplements must be truthful and not misleading. The FDA says nothing about structure-function claims on food products. It mostly looks away when they appear.

“Misleading” is inevitably in the eye of the beholder. Herrera turns out to be a skeptic.

“The Immunity claims,” he said, “may falsely suggest to parents that cereals like Cocoa Krispies are more healthy for their children than other breakfast foods … [and] mislead parents into believing that serving this sugary cereal will actually boost their child’s immunity.” Kellogg, he said, must produce the evidence or have the claim subject to “immediate termination or modification.”

Faced with this threat and with ridicule in the press, Kellogg wisely decided to phase out the immunity-labeled Cocoa Krispies packages. Consider them collectors’ items.

Much is at stake. Ready-to-eat cereals produce more than $8 billion a year in sales. Kellogg spent about $32 million in 2008 to promote Rice Krispies cereals, and $4 million of that amount went to advertise Cocoa Krispies alone.

Shoppers care about health. If cereals can be advertised with special health benefits, more boxes will fly off the shelves. Food companies consider health claims essential for marketing their products.

This explains why so many companies are adding omega-3 fats, probiotics and antioxidants to so many foods. These ingredients make foods “functional,” meaning that the foods contain something beyond their usual nutritional value. Although little evidence shows that functional foods make healthy people healthier, companies can use functional ingredients to make health claims, no matter how far-fetched. These days, functional foods are about the only processed foods with increasing sales.

Kellogg has plenty of company with functional ingredients and health claims. See, for example, the claims on Nestlé (no relation) Juicy Juice products targeted to toddlers. One product adds antioxidants to “help support immunity.” The other adds omega-3s to “aid brain development.”

Think about it: Will feeding your toddler a sugary juice product really make her smarter? Face it. You are not supposed to think about it. You are supposed to buy – and feel good about doing so.

Absent the FDA, Herrera stepped into the breach. He does not care whether the claims are on Kellogg cereals or Juicy Juice cartons. If companies make such claims, he insists that they produce the evidence for them.

This will not be easy to do. It is one thing to find evidence that specific nutrients are involved in immune function. It is quite another to show that people who eat sweetened cereals or juices containing such nutrients are healthier than those who do not.

That is why the European Food Standards Agency denied hundreds of company petitions for health claims. The agency cannot find much evidence for the health benefits of foods with added functional ingredients. Its decisions have put European food marketers into crisis. How are they supposed to sell products without health claims?

As I keep saying, health claims are about marketing, not health. If it were up to me, I would remove all health claims from food packages. Foods are not drugs. Health claims cannot help but mislead.

So let’s congratulate Herrera for filling a regulatory gap. His colleagues – and the press – are doing their job on this one. FDA: Get to work!

First, the “Nutrifluff,” my term for research with results that are intriguing but of unknown clinical significance.  I thank everyone who sent me links to the New York Times account of the new study linking chocolate milk to reduced inflammation.  It quotes the lead author:  “Since atherosclerosis is a low-grade inflammatory disease of the arteries, regular cocoa intake seems to prevent or reduce [it].”   But the giveaway is the next magic words that cover all bases: “more studies needed.”

The study suggests – but in no way proves – that drinking chocolate milk reduces the risk of coronary artery disease.  Inflammation is an intermediate marker of suggestive but unconfirmed clinical implications.  More research is needed, indeed.

Next, policy.  Recall the fuss over chocolate milk (see previous post on the topic)?   Marlene Schwartz of the Rudd Center at Yale has posted an explanation of her views on the matter.

The “chocolate milk controversy” story this week is not about nutrition; it’s about marketing…They explain that “more than half of all flavored milk is sold in schools,” and “the importance of flavored milk goes beyond the school market because it is a key growth area for milk processors.”

They are trying to sell their product. There is nothing wrong with that as long as their marketing efforts are not misleading. Chocolate milk is not the nutritional equivalent of regular milk. It is significantly higher in calories, sugar (often high fructose corn syrup), sodium, and usually contains artificial colors and flavors.

In the promotional video on YouTube, expert dieticians acknowledged that chocolate milk has about 60 more calories per serving than regular milk, but then quickly added that “in the grand scheme of things, that’s nothing compared to the amount of nutrients they are going to be getting.”

That sounded really familiar.

“In the grand scheme of things, these calories don’t count” is exactly what we heard from David Mackay, the CEO of Kellogg in his defense of marketing his company’s high-sugar cereals: “Twelve grams of sugar is 50 calories. A presweetened cereal as part of a regular diet for kids is not a bad thing.”

50 calories here, 60 calories there, and pretty soon we are talking about real weight gain.

Our research has found that children will eat low-sugar cereals and drink white milk when these are the foods that are served. We also found that most children will also eat a piece of fruit if you prompt them to take it. School cafeterias are the perfect place to reinforce the nutrition lessons that begin at home and promote nutrient-dense foods.

If chocolate milk were the only treat children were exposed to in schools, it would not be nearly as much of a problem.  But it is not.  In many schools, kids are offered sweet treats all day long (birthday celebrations, rewards from teachers, etc) or exposed to those readily available from vending machines.  So sweet foods have become the norm.  Norms are hard to change, but let’s at least not make them worse.

Earlier this week, I received a phone call from Dr. Celeste Clark, Kellogg’s senior vice president for global nutrition, corporate affairs and chief sustainability officer.

She had seen my previous blog post on the Smart Choices program, and wanted me to know that Froot Loops has been reformulated to contain 3 grams of fiber, not less than 1 gram, as I had posted, and that  in all fairness, I ought to post the new version.  Sure.  Happy to.  Here it is.

This higher fiber product, of course, gets us into the philosophical question:  Is a somewhat-better-for-you, highly processed food really a good choice?  Does the additional 2.5 grams of fiber convert this product to a health food?  Whether Froot Loops really is a better choice than a doughnut as the Smart Choices program contends, seems debatable.

If I read the Nutrition Facts and ingredient list correctly, Froot Loops cereal contains:

• No fruit
• Sugar as the first ingredient (meaning the highest in weight–41%)
• Sugar as 44% of the calories
• Partially hydrogenated vegetable oil and, therefore, trans fat (although less than half a gram per serving so the label can read zero)

But with an implied endorsement from the American Society of Nutrition, which is managing the Smart Choices program, I guess none of that matters.  Or maybe the added fiber cancels all that out?

I pointed out to Dr. Clark that I had just bought the fiberless Froot Loops at a grocery store in midtown Manhattan, which means the old packages must still be on the market.

I discussed this and other such products with William Neuman of the New York Times whose reporting on the Smart Choices program appears on the front page of today’s business section under the title, “For your health, Froot Loops.  Industry-backed label calls sugary cereal a ‘Smart Choice.'”

According to his well reported account, Kellogg’s and other participating companies pay up to $100,000 for that seal.  No wonder the American Society of Nutrition and everyone else involved in the program want to set nutrition standards so loosely that they can encompass as many products as possible.   The more products that qualify for the Smart Choices logo, the more money the program gets.  I’d call that a clear conflict of interest.

Neuman managed to find nutritionists who defend the program.  I am not one of them.

Update September 6: CBS did a story on Smart Choices (I’m interviewed in it)

Update September 9: The American Society of Nutrition must be getting a bit defensive about the negative publicity, as well it should be.  It has issued an explanation to members.

Thanks to Bill Marler for discussing this question on his blog this morning and for suggesting starting with the ingredient list.  As a typical example, here is the ingredient list for Nestlé’s Chocolate Chunk cookie dough (others can be found at this site):

INGREDIENTS: BLEACHED ENRICHED FLOUR (WHEAT FLOUR, NIACIN, REDUCED IRON, THIAMIN MONONITRATE, RIBOFLAVIN, FOLIC ACID), SUGAR, NESTLE SEMI-SWEET CHOCOLATE CHUNKS (SEMI-SWEET CHOCOLATE [SUGAR, CHOCOLATE, COCOA BUTTER, MILKFAT, SOY LECITHIN, VANILLIN – AN ARTIFICIAL FLAVOR, NATURAL FLAVOR]), MARGARINE (PALM OIL, WATER, SUNFLOWER OIL, HYDROGENATED COTTONSEED OIL, SALT, VEGETABLE MONO- AND DIGLYCERIDES, SOY LECITHIN, SODIUM BENZOATE, CITRIC ACID, NATURAL AND ARTIFICIAL FLAVOR, BETA CAROTENE COLOR, VITAMIN A PALMITATE ADDED), WATER, CORN SYRUP SOLIDS, MOLASSES, EGGS, EGG YOLKS, BAKING SODA, SALT, CORNSTARCH, SODIUM ALUMINUM PHOSPHATE, VANILLA EXTRACT, VANILLIN – AN ARTIFICIAL FLAVOR

MADE ON EQUIPMENT THAT ALSO PROCESSES PEANUTS/NUTS

CONTAINS: MILK, EGG, SOY, WHEAT INGREDIENTS

For starters, we don’t really know yet whether raw cookie dough is the source of this E. coli outbreak.  It could be something else, and Nestlé will have recalled 300,000 cases purely out of precaution.  The most likely source of bacterial contamination is eggs, but eggs typically carry Salmonella, not E. coli O157:H7.   And besides, the eggs in raw cookie dough are undoubtedly pasteurized, which ought to kill any bacteria that happen to be present.

The usual source of this toxic form of E. coli is cow manure.  Cows that carry this bug do not necessarily become ill, but they excrete it. Recall the spinach E. coli outbreak in 2006?  The spinach field was one mile away from a cattle crossing over a stream.  California investigators identified the particular strain of E. coli that caused the problem in cattle, cattle feces, and water at the cattle crossing, but did not found it in the field.

All they could do is speculate. Their leading hypotheses were runoff, a change in the water table, and (my favorite) wild boar.  Unfortunately for this last theory, when they surveyed wild boar for E. coli O157:H7, they found fewer than 0.5% to carry it.  So how E. coli got into the spinach remains a mystery.

As for the cookie dough, I’m guessing that everyone involved is having a busy weekend testing the ingredients, the packing plants, and everything else they can think of.  Let’s hope they find the source right away.

Center for Science in the Public Interest has filed a class-action lawsuit against Coca-Cola, the parent company of Glaceau Vitamin Water.   Vitamin Water, says CSPI, makes sugary drinks that promote obesity but positions these products as healthful because they contain added vitamins and herbs.  Does this make them healthier?  No, but it certainly makes them sell better.

Oh dear.  The Robert Wood Johnson Foundation has just released a summary of a new report on the use of USDA surplus commodity foods in school meals, mainly in California.  The major findings?  More than half the commodity foods are processed before they get to the schools and that means added fat, sugar, or salt (example: chicken to nuggets).  More than 80% of funds for commodities are used for meat and cheese; only 13% is spent on fruits and vegetables.  There is so little correlation between foods recommended by the USDA pyramid and those purchased by schools that the report displays a nifty side-by-side illustration of a commodities pyramid next to a USDA pyramid (the useful old one).  It is an almost perfect inverse.  The complete report has lots more good stuff in it.   High marks to the groups that collaborated on this one, the California Food Policy Advocates and Samuels & Associates.

… You can appreciate why I so enjoy the cereal aisle. I like reading the health claims on the processed cereals and wondering what marketers will dream up next. The packages are, in their weird way, fun to look at. They represent the best thinking of marketers about how to get you to eat processed cereals, to believe that they are good for you, and to insist that nothing else will do for breakfast. (more…)