If kids really are to eat more healthfully, food and beverage companies have to stop pushing products at them.  But if companies don’t market to kids, they lose money.  Regulation would solve the problem, but is not politically feasible.  Voluntary efforts are limited to companies that agree to participate.   Short of regulation, what more can be done?

This invitation felt like history in the making.  I accepted with pleasure.

Mrs. Obama’s speech alone was well worth the trip.

You can see it for yourself thanks to Eddie Gehman Kohan, who posted a video and a transcript of the speech on her ObamaFoodorama site.

Here is a small excerpt:

And I’m here today with one simple request — and that is to do even more and move even faster to market responsibly to our kids…the goal here is to empower parents instead of undermining them as they try to make healthier choices for their families.  And we need you to lead the way in creating demand for healthy foods so that kids actually start “pestering” us for those foods in the grocery store.  And then parents actually start buying them, and then companies have incentives to make and sell even more of those foods.

And ideally, in a decade or so, we would see a dramatic shift across the entire industry.  We’d see companies shifting marketing dollars away from those less healthy products and investing those dollars in your healthier products instead…See, the decisions that you make about marketing won’t just affect what our kids are eating today — those decisions are going to also affect the health of your workforce tomorrow…. You see, over the past few years, we’ve seen some real changes in the foods our kids are eating, starting from the time they’re born…this isn’t just some passing trend or fad.

So there might be those out there whose strategy is to just wait this out — folks who might still be thinking to themselves, well, in a few years, this lady will be gone — (laughter) — and this whole Let’s Move thing will finally be over, so we can go back to business as usual.  And I know that none of you here are thinking that way.  (Laughter.)  But if you know anyone who is — (laughter) — you might want to remind them that I didn’t create this issue, and it’s not going to go away three and a half years from now when I’m no longer First Lady.

Obama Foodorama also posts the list of who attended.  This was a diverse group of representatives of the food industry, trade associations, media, government agencies, private organizations, and universities who sought common ground.

A few points seemed clear from the discussion:

• Some food companies are making substantial progress in trying to reduce their marketing of less healthful foods.
• Advocates wish they would do more, faster.
• The business barriers are formidable.

I think it’s wonderful that the First Lady is taking on this critical topic, impressive that such diverse opinions were represented, and remarkable that this meeting, if nothing else, holds the possibility of opening the door to further discussion.

An open door is needed.  As Bill Dietz, a former CDC official who was at the meeting, told FoodNavigator: “the food industry has repeatedly thwarted federal efforts to curb food marketing to kids.”

Center for Science in the Public Interest has some suggestions for what the next steps should be.

Cheers to Let’s Move! for taking this on.

Erica Peters.  San Francisco: A Food Biography.  Rowman & Littlefield, 2013.

For anyone curious about how San Francisco’s foods and restaurants became world-recognized icons of American regional cuisine, this book is a welcome starting place.

It’s one of a collection of books in the AltaMira Studies in Food and Gastronomy, edited by the prolific Ken Albala.  Readers may argue about Peters’ choice of topics to discuss—she left out some of my favorites—but the book is a great way to begin to delve into the city’s food history.  It’s well referenced and is wonderfully illustrated with photographs from historical collections (but alas, most of them are undated).

The American Journal of Hypertension has published a series of point-counterpoint articles on the salt debate: are public health campaigns to reduce sodium intake warranted by the data?  Public health agencies argue yes.Others argue to the contrary.

This debate is not easily resolved, mainly because everyone eats a high-salt diet; most salt is already in processed and restaurant foods and eaters have no choice.

So the issue really becomes one of whether it makes any difference to high blood pressure to reduce high salt intakes and, if so, to what level—questions difficult to answer with current methods.

Introduction

The Salt Discourse in 2013
Theodore A. Kotchen

CDC Response

Sodium Reduction Is a Public Health Priority: Reflections on the Institute of Medicine’s Report,Sodium Intake in Populations: Assessment of Evidence
Janelle P. Gunn, Jessica L. Barron, Barbara A. Bowman, Robert K. Merritt, Mary E. Cogswell, Sonia Y. Angell, Ursula E. Bauer, and Thomas R. Frieden

NYC DOHMH Response

Getting the Message Right: Reducing Sodium Intake Saves Lives
Jenifer E. Clapp, Christine J. Curtis, Susan M. Kansagra, and Thomas A. Farley

Editorial

The IOM Report Fails To Detect Evidence to Support Dietary Sodium Guidelines
Michael H. Alderman and Hillel W. Cohen

Researcher Responses

Physiology, Not Policy, Drives Sodium Intake 
David A. McCarron

Extreme Sodium Reductions for the Entire Population: Zealotry or Evidence Based?
Andrew Mente, Martin J. O’Donnell, and Salim Yusuf

Flawed Evidence Should Not Derail Sound Policy: The Case Remains Strong for Population-Wide Sodium Reduction
Lawrence J. Appel and Paul K. Whelton

Sodium: How and How Not to Set a Nutrient Intake Recommendation
Robert P. Heaney

Is arsenic in rice something you should be worried about?

I never know what to say about food contaminants consumed in tiny amounts, in this case, micrograms (millionths of grams) per serving.

The FDA devotes a web page to arsenic in rice.  Here, the agency releases the results of its testing, which found amounts of arsenic mostly below 6 micrograms per serving.

Higher levels—11 micrograms per serving—were found in three samples from Texas, Louisiana and California.  The highest was 30 micrograms per serving of hot ready-to-eat rice bran cereal.

Is this good, bad, or indifferent?  And how would we know?

The FDA says such levels are too low to cause concern about short-term health problems.

But Consumers Union thinks the real issue is the long-term effects.

Today’s widely-reported message on arsenic levels in rice misses the point.  The issue is not the short-term risks of rice consumption. The concern is the long-term effects from exposure to arsenic in rice. As Consumer Reports has said in the past, consumers should not ignore the potential risks from consuming rice and rice products over a long period of time…Consumers are not well-served if they do not have the full story. The concerns about long-term effects are significant and warrant the FDA’s decision to investigate further.

The FDA says it plans further investigations.  In the meantime, it says you should:

• Eat a well-balanced diet.
• Vary your grains.
• Consider diversifying infant foods

This is always good advice.

But Consumers Union  is more specific.  It suggests you worry a little and observe these limits:

At the moment, this is the best information available.  FDA: get to work!

FDA references:

• FDA Statement on Testing and Analysis of Arsenic in Rice and Rice Products 
• Consumer Update: FDA Explores Impact of Arsenic in Rice
• Updated Questions & Answers: Arsenic in Rice and Rice Products

Michele Obama’s Let’s Move! campaign to end childhood obesity within a generation has taken on a new angle: Drink Up.  It issued a press release yesterday urging Americans to drink more water.

The “Drink Up: You Are What You Drink” website explains:

Let me be absolutely clear: I am totally in favor of encouraging kids to drink water.

But:

• Water deficiency is not a public health problem in the United States.  Childhood obesity is the problem.
• Drinking water will only help to counter childhood obesity if it substitutes for sugary sodas.

• Bottled water companies such as Dasani (owned by Coca-Cola) and Aquafina (PepsiCo), and their trade group The American Beverage Association (ABA), are the main supporters of this initiative.
• This makes the message sounds like “drink bottled water,” without much attention to environmental implications.

The ABA’s congratulatory press release says:

Staying hydrated is important to staying in balance, and bottled water provides people with a convenient and popular choice. By supporting this new initiative, our industry is once again leading with meaningful ways to achieve a balanced lifestyle.”

Hydrated?  Not an issue for most people (exceptions—elite athletes, people at high altitude, the elderly).

Bottled water?  In places with decent municipal water supplies, tap water is a much better choice; it’s inexpensive, non-polluting, and generates political support for preserving the quality of municipal water supplies.  See, for example, what Food and Water Watch has to say about bottled water.

James Hamblin’s critical account  in The Atlantic indicates that the press conference must have been tough going.  Sam Kass, White House chef and executive director of Let’s Move! took the questions.

Another reporter: Are we talking about replacing sugary drinks and sodas with water?”

Lawrence Soler, president and CEO of Partnership for a Healthier America, fielded that one. “It’s less a public health campaign than a campaign to encourage drinking more water. To that end, we’re being completely positive. Only encouraging people to drink water; not being negative about other drinks. “

I consider Let’s Move! to be a public health campaign, and a very important one.

Hamblin concludes:

I know we’re just trying to “keep things positive,” but missing the opportunity to use this campaign’s massive platform to clearly talk down soda or do something otherwise more productive is lamentable. Public health campaigns of this magnitude don’t come around every day…Keeping things positive and making an important point are not mutually exclusive, you fools.

My interpretation

Let’s Move! staff have stated repeatedly that they must and will work with the food industry to make progress on childhood obesity.  I’m guessing this is the best they can do. Messages to “drink less soda” (or even “drink tap water”) will not go over well with Coke, Pepsi, and the ABA; sales of sugary sodas are already declining in this country.

I’m thinking that the White House must have cut a deal with the soda industry along the lines of “we won’t say one word about soda if you will help us promote water, which you bottle under lots of brands.”   A win-win.

Isn’t drinking water better than drinking soda?  Of course it is.

But this campaign could have clarified the issues a bit better.  Jeff Cronin, communications director of the Center for Science in the Public Interest circulated a poster created by Rudy Ruiz (of the communications firm Interlex) for a public health campaign in San Antonio:

Public health partnerships with food and beverage companies—especially soda companies—are fraught with peril.   Let’s hope this one conveys the unstated message like the one in San Antonio: My balance is less soda and more tap water.

Other resources

As always, Eddie Gehman Kohan writing at ObamaFoodorama provides a clear, detailed summary of the relevant details along with transcripts of Michele Obama’s remarks at the launch in Watertown, Wisconsin (site of a Pepsi bottling plant, among other things).

Amanda Chin has a good piece in the Huffington Post (I’m quoted).

A reader writes:

Willingboro, NJ School Board has taken action effective for the 2013-2014 school year to discard a school meal rather than feed a student, if their parents cannot, or haven’t arranged to, refill their student’s lunch account.

Take a look at this letter from the school board administrator announcing discontinuation of humanitarian meals:

If a student goes through the food service line and it is discovered that the student does not have the required funds for a meal, the Chartwells Food Service representative has been instructed by the Willingboro Board of Education to withhold the meal from the student, with the understanding that such meal cannot be re-served and must be discarded.

I was appalled by the letter.  Hungry kids need to be fed.  They can’t learn if they are hungry.

But before going on a rant, I consulted my go-to, school-food guru, Kate Adamick of Cook for America.  She explains the fiscal realities of current school-food policies:

The truth is that there are many, many school districts that do not feed kids whose parent will not pay for them.  Some, as seems to be the prior practice of the Willingboro district, offer a “humanitarian” meal (typically, a peanut butter sandwich and a carton of milk), though that is by no means required of them and by no means universal.

Of course, students who qualify for free meals under the USDA regulations cannot be refused free school meals (provided that the proper paperwork has been filled out on their behalf or that they qualify under other regulatory or statutory provisions).

The refusal to feed everyone, regardless of whether they pay, has become a more pressing issue in recent years, both because the number of families who don’t qualify for free meals but can’t afford to pay for them has increased at the same time the school food budgets have become tighter…Many school districts are truly struggling to keep their financial heads above water….

The REAL answer is for the federal government to provide free meals for all kids.  I doubt, however, that will come to pass in our lifetime.

Here’s how this system works:

• Unlike other aspects of school education, the government requires school-meals programs to be self-supporting.  They must at least break even or do better, which is not so easy given current reimbursement rates.
• The government reimburses schools for federally supported school meals based on the number of participants.
• Parents often cannot or do not want to fill out the paperwork.
• This leaves schools with a dilemma.  If they provide free meals, they lose money.

Some school districts, like the one in New York City, do everything they can to make the system work so that hungry kids get fed.   Willingboro’s school board has chosen to follow the rules to the letter, regardless of the effects of this decision on kids in its schools.

Universal school meals would solve many of the problems caused by current school food policies (for evidence, see Janet Poppendieck’s Free for All: Fixing School Food in America).

Ready to join the universal school meals movement, anyone?

As an undergraduate at Berkeley, I majored in Bacteriology.  I haven’t worked in that field for decades, but the training makes me appreciate the terrific job the Centers for Disease Control and Prevention (CDC) does in providing education about food safety microbiology.

The CDC website is always a good place to start (another is food safety lawyer Bill Marler’s blog).

I thought of this as I was trying to find out what’s going on with the latest big outbreak of foodborne illness, this time due to Cyclospora.

The CDC’s Cyclospora website, updated frequently, keeps track of the numbers of cases—in this case, 641 as of September 3, with 41 hospitalizations—from 24 states.

Investigators traced cases in Iowa and Nebraska to a salad mix produced by Taylor Farms de Mexico.  But this mix is not linked to cases in Texas, which complicates the investigations.

As for the biology of Cyclospora: it’s a parasitic protozoa transmitted through feces.  The CDC provides this handy diagram of its life cycle:

What are you supposed to do to prevent getting sick from Cyclospora?  The CDC says unhelpfully: “Consumers should continue to enjoy the health benefits of eating fresh fruits and vegetables as part of a well-balanced diet.”

Everyone, it says, should follow safe produce handling recommendations.

Translation: Wash your veggies!