Search results: food policy action

When giving talks here and there, I am invariably asked how listeners can get involved in social and political action on food issues.

From the standpoint of personal responsibility, it’s easy: Vote with your fork!  Buy and eat according to your principles to the extent that you can.

But participating in democratic processes is also part of personal responsibility, and here is where things get more complicated.  Over the next week or so, I am going to post suggestions about how to get involved in a variety of food issues, starting with work on the 2012 Farm Bill, the legislation that governs everything having to do with agricultural policy in the United States—subsidies, water rights, organics, food assistance programs, and anything else you can think of.

I only am familiar with a few organizations gearing up to work on this bill:

• Institute for Agriculture and Trade Policy: Advocates to bring agricultural policy in line with health policy.
• Food and Water Watch:  Advocates to bring agricultural policy in line with health and environmental policy.
• National Sustainable Agriculture Coalition: Advocates for small and medium-size farms.
• Organic Trade Association: Advocates for organic producers.
• National Food Security Coalition: Advocates for improved SNAP (food stamp) benefits, access to food in inner cities, and food justice.
• Food Research and Action Center (FRAC): Advocates for improved food assistance programs.

If you know of others, please tell me about them in a comment.

Also: please mention groups advocating for better school food, limits on food marketing to children, and other food policy issues—groups that beginners might want to join.

Thanks!

I have now had time to look at the full report of the 2010 Dietary Guidelines–all 95 pages of what they are calling “the policy document.”

Oh no!  What happened to the Selected Messages for Consumers that I posted yesterday?  “Enjoy your food” is not in it and neither are any of the other clear, straightforward messages.  This is a big disappointment.

Nevertheless, the document is well worth reading.

It addresses my complaints about the executive summary.  It explains the meaning of the annoying SOFAS (solid fats and added sugars).  It discusses the need to improve the food environment.

Let me share a few thoughts about selected issues.

SOFAS

The report translates its advice (pages 62-68).   It translates  “Cut back on foods and drinks with added sugars,” a nutrition euphemism, as:

Drink few or no regular sodas, sports drinks, energy drinks, and fruit drinks.  Eat less cake, cookies, ice cream, other desserts, and candy.  If you do have these foods and drinks, have a small portion.

But it translates “Cut back on solid fats” in yet another euphemism:  “Select lean meats and poultry, and fat-free or low-fat milk and milk products.”  This, no doubt, is to avoid the politically impossible “eat less meat.”

Added sugars

The report lists synonyms for added sugars that you might find on a food label (page 75).  The 2005 Dietary Guidelines included “fruit juice concentrates” on that list.  The 2010 guidelines do not.  The Table lists “nectars” but not fruit juice concentrates.  How come?  It doesn’t say.

Food group patterns

The report describes healthy patterns for diets ranging from 1,000 to 3,200 calories a day.  For a diet containing 2,000 calories, you are only allowed 258 calories a day from SOFAS.  That’s all? One 20-ounce soft drink contains more than that and so does  one tablespoon of butter and a 12-ounce soft drink.  No wonder the guidelines don’t want to be specific about foods when they mean “eat less.”

Sodium

The recommendation to reduce sodium intake to 2,300 or 1,500 mg per day is addressed to the wrong people.  Individuals cannot do this on their own since most salt is already added in restaurant and processed foods.  The report recognizes this:

• Consume more fresh foods and fewer processed foods that are high in sodium.
• Eat more home-prepared foods, where you have more control….
• When eating in restaurants, ask that salt not be added….
  

Vegetarian and vegan diets

The report includes diet plans for lacto-ovo vegetarians and vegans (pages 81 and 82).  Applause, please.  When I was on the dietary guidelines advisory committee in 1995, we tried to say something useful about vegetarian diets but were forced to add something about the nutritional hazards of such diets, minimal as they are.  Not having to do this is a big improvement.  But you too only get 258 calories for SOFAS.

How about changing the food environment?

The report makes it clear that the food environment strongly influences the food choices of individuals, and it urges efforts to

• Improve access to healthy foods
• Empower people with improved nutrition literacy, gardening and cooking skills
• Develop policies to prevent and reduce obesity
• And for kids, fix school meals, encourage physical activity, and reduce screen time

In short, there is plenty to work with here.  You just have to look hard and dig deep to find it.

What is the food industry’s reaction?

Just for fun, I’ve been tracking some of the industry reactions.  The soy people love it.  The report mentions soy along with nuts and seeds in the USDA’s meal patterns (page 79), and soy has its own category in the vegetarian and vegan diets (page 81 and 82).

The meat people don’t love it so much.  They are a little worried that seafood is pushed more than meat, but the American Meat Institute is giving it a nice spin, pointing out that the overall meat recommendation has not changed since 2005.

And the Salt Institute?  “Dietary Guidelines on Salt Drastic, Simplistic, Unrealistic.”

I rest my case.

I listened in on the conference call at which the Grocery Manufacturers of America and the Food Marketing Institute announced their new Nutrition Keys design for front-of-package labels.

My favorite comment: We are all “singing kumbaya” here.  Nutrition Keys, they said, was the result of a” monumental, historic effort” in which food companies “stepped up to the plate in a big way,” “with 100% support.”

Why did they go to all this trouble?  Because “A healthy consumer makes for a happy consumer.”

Kumbaya, indeed.

The real reason, as I explained yesterday, is to preempt the FDA’s front-of-package food labeling initiatives which might make food companies reveal more about the “negatives” in processed foods.

Here’s what GMA and FMI say the new label will look like:

Four of these things are required: Calories, Saturated fat, Sodium, and Total (not added) sugars.  Packages can also display up to two “nutrients to encourage” picked from this collection:  protein; fiber; vitamins A, C, and D; and potassium, iron, and calcium.

Let’s give these food trade associations credit for listing sugars instead of the Institute of Medicine’s recommendation for trans fat.  Trans fats are already gone from most processed foods.  Everyone cares about sugars.  But these are total sugars, not added sugars, which is what really matters.

And protein?  Since when does protein need to be encouraged in American diets?  We already eat twice the protein we need.  The rationale?  Vegetarians.   I repeat.  Since when don’t vegetarians get enough protein?  Never mind, protein makes the products look better.

Nutrition Keys merely repeats what’s on the Nutrition Facts labels, only worse.  It makes the percent Daily Values practically invisible.  Which is better?  High or low milligrams or grams.  You have to know this, and Nutrition Keys doesn’t help with that problem.

Nutrition Keys, says the industry, is about “more clarity in labeling.”  Really?  Here’s what it will look like on a food package.

I’ve been collecting reactions.

Although GMA and FMI insist they they are doing this in response to the First Lady’s Let’s Move campaign, the White House issued this statement:

The White House, including the First Lady, recognizes these companies for the leadership they have shown in advancing this initiative. We regard their commitment to dedicate space, for the first time, to an industry-wide front-of-pack label as a significant first step and look forward to future improvement. The FDA plans to monitor this initiative closely and will work with experts in the field to evaluate whether the new label is meeting the needs of American consumers and pursue improvements as needed. We will continue to work on seeking solutions for the problem of childhood obesity in America.

Congresswoman Rosa DeLauro was more forthcoming:

The industry’s unveiling today of its front-of-package labeling system is troubling and confirms that this effort should not circumvent or influence FDA’s effort to develop strong guidelines for FOP labels.

Given that negative and positive nutrients will not be differentiated on the package, there is significant risk that these labels will be ignored.  An adequate labeling system must clearly alert consumers about potentially unhealthy foods, and should not mislead them into believing that some foods are healthy when they clearly are not.

Reporters asked tough questions on the conference call about preemption of FDA efforts to do front-of-package labeling in a rational way (see my post from yesterday).  Perhaps space limitations made full accounts impossible:

• USA Today story (I’m quoted)
• Washington Post
• New York Times

A recent commentary in the British Medical Journal (BMJ) is causing a furor among breastfeeding advocates in Great Britain.

Titled Six months of exclusive breast feeding: how good is the evidence?, its authors argue that four months is probably just as good and less likely to cause harm.

The current British recommendation is for six months of exclusive breastfeeding—meaning no added solid foods.  This is based on a systematic analysis of research first published as a Cochrane review in 2002 and updated in 2006.  It compared the health of infants breastfed for six months to those breastfed for three-to-four months, and concluded that the science demonstrated significant advantages to the longer breastfeeding period.

That analysis was the basis of breastfeeding recommendations by United Nations agencies, such as the World Health Organization and UNICEF.  In Great Britain, UNICEF UK has issued its own statement defending the six-months recommendation.

Adding to the furor, the British Guardian titled its article about the new commentary, “Six months of breastmilk alone is too long and could harm babies, scientists now say.”  A second account in the Guardian provided a more cautious interpretation of the science.

I can understand why breastfeeding advocates are so upset about the BMJ paper.  They are worried about promotion of infant formulas as substitutes for breast milk, especially in developing countries.  Infant formulas can be adequate, if not perfect, substitutes for breast milk under conditions where they can be properly diluted and refrigerated.  When those conditions are impossible, as is the case in many low-income areas, formulas can become contaminated with harmful bacteria.  Use of infant formulas has a long history of association with infant illness and death (I wrote about this in Food Politics).

Formula companies did and continue to promote their products as convenient—and preferable—substitutes for breast feeding.

As it turns out, several of the authors of the BMJ commentary consult for formula companies.

Those authors vehemently deny that their ties to formula companies influence their opinions.  That may or may not be so, but such ties strongly correlate with research results and opinions favorable to the corporate ally.

In the United States, pediatricians strongly advocate breastfeeding, but flexibly.  In 1997, the American Academy of Pediatrics (AAP)  policy statement said.

Exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing protection against diarrhea and respiratory tract infection….Complementary foods rich in iron should be introduced gradually beginning around 6 months of age.

But the AAP noted,

Unique needs or feeding behaviors of individual infants may indicate a need for introduction of complementary foods as early as 4 months of age, whereas other infants may not be ready to accept other foods until approximately 8 months of age.

As any parent of more than one child can tell you, babies differ.  Some are happy with exclusive breastfeeding.  Others want solid foods the instant they learn how to swallow.

The new commentary isn’t wrong, exactly, although it says nothing new.

It just isn’t helpful.  And that’s reason enough to be upset about it.

The November issue of San Francisco Medicine is devoted to Food for Thought: Practical Nutrition for Physicians (the entire issue is online).

It’s got a great collection of short articles, if I may say so myself.  A throwback to the days when I taught nutrition at the University of California San Francisco School of Medicine, my contribution, the first one, is called “Doctor’s Orders: What Should Doctors Tell Patients About Nutrition?”

I am a realist. I am well aware of the fact of time constraints, and my list of suggestions for what doctors should tell patients about diet and health is necessarily short. Fortunately, it doesn’t take long to tell patients that what they eat matters to their health. It takes only a minute to explain that healthy eating simply means attending to food variety, minimal processing, and moderation.

This collection is worth a read.  For example:

• David Wallinga: An Unhealthy Food System: Suggestions for Physician Advocacy
• Brian Raymond: Taking Action: A Health Sector Guide to Food System and Agricultural Policy
• Kelly Brownell: How the Food Industry Drives Us to Eat
• Narsai David: Eating Sensibly: Using Common Sense and Moderation
• Shannon Udovic-Constant, MD, and Steve Heilig: Health Policy Perspective: Sugar Politics Versus Health

Take a look and use!

I have now seen the talking points used by FDA senior scientific advisor Jessica Leighton in her speech to the Food Policy Conference last week.  These are indeed quite different from those I reported a few days ago.  Here is my understanding of what she actually said.

Dr. Leighton reported that the FDA was working on a number of food labeling initiatives:

• Updating elements of the Nutrition Facts Panel such as calories, serving sizes, and Daily Values.
• Identifying a front-of-pack nutrition label based on sound nutrition science and easily noticed, understood and used by consumers.
• Implementing the new federal menu labeling law with regulations to be released by March 2011.

She emphasized that the focus of FDA’s public health efforts is to address chronic disease and obesity problems by making the best information available in the best way to help consumers make healthy food choices.

FDA seeks input.  To that end, it is releasing solicitations and draft guidance documents.

FDA especially seeks research that can help the agency determine the best way its initiatives can improve consumer food behavior.

These goals make sense to me, and I’m glad to have them clarified.

Footnote: Food Chemical News has just filed a correction to its original story:

Food Chemical News, in our Sept. 27 weekly issue, incorrectly identifies a flow-chart containing a list of dates for proposing food labeling-related proposals and final rules as coming from Jessica Leighton, a FDA senior science advisor. The document was actually provided by the Center for Science in the Public Interest and drafted with the assistance and/or blessing of as many as 12 consumer and health-oriented trade groups as a recommended approach for the FDA to follow, clarifies Bruce Silverglade, CSPI’s director of legal affairs.

The one-page document was handed out during a session at the 33^rd National Food Policy Conference, an event jointly sponsored by the Consumer Federation of American and Grocery Manufacturers Association, in Washington, D.C.  Leighton, Silverglade and three others were presenters in the session. The one page sheet, entitled “Timetable for Food Labeling Reform and Need for Concurrent FDA/USDA Action,” does not identify a source.

Silverglade, who takes credit for having the document given to attendees at the meeting, says it originally was provided as part of a three-page letter sent to Martha Coven, special assistant to the President for the Domestic Policy Council, and Zeke Emanuel, senior advisor in the Office of Management and Budget (see FCN Aug. 9, Page 1). The American Cancer Society, American Medical Association, Consumers Union and American Heart Association were among the many groups to sign the letter.

The editorial staff of Food Chemical News apologizes for the error.

The Food and Agriculture Organization and the World Food Program released their most recent figures on world hunger yesterday.

The good news: the number is 98 million fewer than in 2009, and below one billion.

The bad news: it is 925 million, a level the U.N. considers “unacceptable.”

In conjunction with the U.N. report, Oxfam America has released one of its own: “Halving Hunger: Still Possible.”  

Oxfam issued a press release on its report:

Ten years after world leaders committed to halve world hunger by 2015, little progress has been made to reduce the number of people who go to sleep hungry, and many hard-won achievements have been undone by the global economic, food and fuel crises….In the ten years since the MDGs [Millennium Development Goals] were agreed, the proportion of hungry people in the world has decreased by just half a percent – from 14 percent in 2000 to 13.5 per cent today.

Gawain Kripke, Policy Director for Oxfam America , said:

A new global food crisis could explode at any time unless governments tackle the underlying causes of hunger, which include decades of under investment in agriculture, climate change, and unfair trade rules that make it difficult for families to earn a living through farming.

The report says that “with a coherent and coordinated global response, halving hunger is still possible.”  That, however will require an increase in aid of $75, at least half from developed nations.

Hunger, it says, “is not inevitable; we can end it if we choose to.”

But will we choose to?  Doubtful.   The Senate is holding up action on the food safety bill because it is estimated to cost a little over $1 billion, and at least one senator thinks that’s too much to pay for a safe food supply, let alone making sure that people have enough to eat.

Here’s what today’s New York Times has to say about all this.  Oxfam is right.  Hunger is not inevitable.  But why don’t we have the political will to do something about it?

On July 30, Center for Science in the Public Interest (CSPI)—in collaboration with representatives of a long list of distinguished health and consumer organizations (see below)–wrote Martha Coven of the Domestic Policy Council and Ezekiel Emanuel of the Office of Management and Budget urging them to encourage the FDA to take more vigorous enforcement action against misleading health claims on food packages.

Their petition responds to comments by the FDA’s Michael Taylor (discussed in a previous post) in a July 19 article for the Atlantic Food Channel, titled “How the FDA is picking its food battles.”   In explaining why the FDA is backing off from doing anything about unsubstantiated health claims on food products, Taylor said:

FDA must pick its battles—and set its priorities—in a way that will best benefit the public health….We have no pre-market review authority over such claims, and, under prevailing legal doctrines concerning “commercial free speech,” the evidentiary requirements placed on FDA to prove that such claims are misleading are significant and costly to meet. Moreover, meeting them requires tapping the same team of nutritionists, labeling experts, and lawyers who are working on our other nutrition initiatives.

We’re also conscious of the cleverness of marketing folks, who, once we prove today’s claim is misleading, can readily come up with another one tomorrow. Going after them one-by-one with the legal and resource restraints we work under is a little like playing Whac-a-Mole, with one hand tied behind your back.

So, we must make choices….especially considering the other high-priority nutrition and food safety initiatives that compete for FDA’s finite resources. We’ll consider all possibilities, but, in the meantime, we call on the food industry to exercise restraint, and we welcome the scrutiny CSPI and the media give to this issue.

Clearly, I was not the only one dismayed by this statement, which appears to be an open invitation to food companies to do whatever they like with health claims.  Indeed, Taylor’s statement reminded me of the Bush Administration’s FDA which, in 2003, announced that it had lost so many first amendment  health claims cases in court that it no longer intended to fight them.

But Taylor’s statement is also an open invitation to food advocates to get busy, as CSPI and the other signers of this letter have now done. The letter, dated July 30, 2010, is a follow up to a June 11 meeting on FDA/USDA Food Labeling Reform Efforts:

At Zeke’s suggestion, we are attaching a Priority List/Timetable Chart that provides an overview of the recommendations we made at our meeting and delineates how those recommendations intersect. As we discussed:

• We commend the Food and Drug Administration (FDA) for increasing the number of enforcement actions it has taken against misleading food labeling, and we urge the agency to increase those efforts. We also commend the FDA’s initiative to develop a system for disclosing key nutrition information on the fronts of food labels. However, we emphasize that the existing Nutrition Facts panel must also be modernized. In particular, nutrition information must be based on up-to-date serving sizes, a Daily Value for added sugars must be established and added to the existing Nutrition Facts panel, and “Calories per serving” must be displayed more prominently. Revisions to the Nutrition Facts panel and the development of a front-of-pack disclosure system are closely intertwined and should be developed concurrently.

• We urge the Domestic Policy Council to ask the FDA to ensure that any front-of-pack labeling scheme is not undercut by deceptive health-related claims on the fronts of food packages. Such claims, if unabated, will divert attention from any front-of-pack scheme the FDA develops. Since our meeting, the Federal Trade Commission (FTC) issued a consent order prohibiting claims that a food product could strengthen immunity because the claim lacked sufficient clinical evidence. Such claims are called “structure/function” claims by the FDA. The FDA should take a consistent position regarding the use of those claims. In addition, the FDA should address claims exaggerating the presence of healthy ingredients stressed in the U.S. Dietary Guidelines such as whole grains, fruits, and vegetables. For example, failure to remedy claims such as “Made with real fruit” on products that contain little fruit will detract from a declaration of sugar content that the FDA may specify in a front-of-pack labeling scheme, thus frustrating the Administration’s attempts to reduce childhood obesity.

• One way to remedy exaggerated claims for healthy ingredients (other than prohibiting them completely) is for the FDA to revise the ingredient list to require that the percentage of key ingredients such as fruit be disclosed in a clear, easily readable manner. FDA could also require that ingredient lists group all sources of added sugars to provide consumers with a clearer indication of the amount of added sugar in a product. The First Lady has recognized that ingredient labeling reform is an integral part of the Administration’s broader efforts to combat childhood obesity. The U.S. Department of Agriculture (USDA) is already working on new formats for ingredient labeling. We support those efforts and request the Council to encourage the FDA to follow USDA’s approach.

• In regard to a timetable, the recommendations we have made are closely intertwined with efforts already ongoing at the FDA. In some cases, they are necessary to ensure that those ongoing efforts by FDA succeed. We, therefore, urge the Council to recommend that the FDA expand its food labeling reform initiatives to include these additional issues and address them concurrently. Additional efforts that complement existing FDA labeling reform initiatives should commence as soon as the first set of initiatives is published in the Federal Register. All initiatives should be finalized by October 2012. This request is based on the fact that the FDA implemented the Nutrition Labeling and Education Act of 1990 in two years. The reform efforts we request are more limited than the requirements of the 1990 Act, and the FDA should be able to accomplish them by 2012 based on the agency’s previous performance on such matters.

• Rep. DeLauro, Chair of the House Agriculture Appropriations Subcommittee, asked the FDA how many FTEs the agency would need to issue regulations to revise the Nutrition Facts panel, increase the prominence of calories per serving, require caffeine labeling, and establish a daily value for added sugars, as well as other issues. The FDA stated that approximately “10-12” additional FTE’s would be necessary to address such concerns. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations for 2005: Hearings Before a Subcomm. of the House Comm. on Appropriations, 108th Cong. 2d Sess. 323 (2004). While the FDA’s response at the time involved some issues not covered by our current requests, we believe that the FDA’s estimate is still reasonable, and we urge the Council and the Office of Management and Budget to work with the FDA to ensure that the FDA devotes additional resources to this effort.

We welcome the opportunity to assist the Administration and look forward to continuing our dialogue.

The letter is signed by Bruce Silverglade, Director of Legal Affairs, CSPI and representatives of Consumers Union, American Public Health Association, American Medical Association,  American Cancer Society Cancer Action Network, American Heart Association,  American Society of Bariatric Physicians, American Diabetes Association,  American Dietetic Association, Alliance for Retired Americans, Society for Nutrition Education, American Institute for Cancer Research, and Directors of Health Promotion and Education.

Let’s hope the FDA pays attention and gets busy on these issues.