Food Politics

by Marion Nestle
Jun 13 2013

The endless debates about salt: Don’t worry. Eat (real) food

Since 1980, U.S. dietary guidelines have advised eating less sodium (salt is 40% sodium, 60% chloride).  Although sodium is an essential nutrient, most Americans consume way more than they need or is good for them—around 3,400 milligrams a day.

The 2010 guidelines advised healthy people to consume no more than 2,300 mg per day (~6 grams, or 1.5 teaspoons).  They advised even less, 1,500 mg, for people with or at high risk for high blood pressure.  Since blood pressure increases with age in countries with high salt intake, this applies or will apply to just about everyone.  

In 2011, the Institute of Medicine said it was imperative to find effective strategies to lower salt intake.  This means dealing with processed and restaurant foods, because that’s where most of the salt comes from, as can be seen from this list of major food sources

Because consumers have no choice about the amount of salt in processed and restaurant foods, education cannot be enough to achieve salt reduction.  Scientists in Australia have just proved this point.

As I explained to a reporter,

Why anyone would think that nutrition education alone would change behavior is beyond me. By this time everyone should know that to change behavior requires not only education, but a food environment—social, political, economic—that supports and promotes the behavior change.

Most dietary sodium comes from processed foods, restaurant foods, and other pre-prepared foods.  All the label can do is say ‘don’t eat me’ It can’t help with what people can eat.

The easiest and most effective way to help people reduce sodium intake is to require food producers and food preparers to use less of it. Good luck with that. I’m not optimistic, particularly given the conflicting and confusing science. 

Ah yes.  The conflicting science.  The IOM now says that there’s no evidence one way or the other that reducing sodium below 2,300 mg per day, or even to 1,500 per day, does much good, and that low sodium intakes could be harmful (but this too is controversial).

Yes, they could, but as Mark Bittman blogs,    

It may be true that there are no benefits in an ultra-low-salt diet, but almost no one is eating an ultra-low-salt diet. It’s not quite like worrying about whether we get “enough” sugar, but it’s nearly as ridiculous.

And now, as Food Navigator explains, the IOM committee is complaining that its report has been badly misinterpreted.  All they said was:

As to whether we should cut back to 1,500 mg or to 2,300 mg sodium a day, meanwhile, the jury is out, says the IOM, not because consuming 1500 mg/day is dangerous, but because there is just not enough data on the benefits of consuming such low levels to support a firm conclusion.

IOM committee members were so bothered by misleading press accounts that they wrote an op-ed to JAMA to clarify:

Rather than focusing on disagreements about specific targets that currently affect less than 10% of the US population (ie, sodium intake of <2300 mg/d vs <1500 mg/d),  the IOM, AHA, WHO, and DGA are congruent in suggesting that excess sodium intake should be reduced, and this is likely to have significant public health effects. Accomplishing such a reduction will require efforts to decrease sodium in the food environment….

The bottom line, Bittman says (and I enthusiastically agree), is that

Salt intake — like weight, and body mass index — is a convenient baseline for public policy people to talk about. If you focus on eating less salt — and, indeed, less sugar — you will inevitably eat less processed food, fast food, junk food (it’s all the same thing.) If you eat less processed food (etc.) you eat more real food. If you eat more real food, not only are you healthier, but you probably don’t have to pay attention to how much salt you’re eating. Wowie zowie. 

Jun 12 2013

NYC is back in court over 16-ounce soda cap

I attended the brief appeals hearing yesterday at which lawyers for the New York City Department of Health (DOH) and the American Beverage Association (ABA) presented final arguments for and against the DOH 16-ounce soda cap initiative (for recap, see previous post).

The judges challenged the DOH lawyer on jurisdiction, judicial precedents, scientific basis, efficacy, rationality, and triviality.  One said “Do you need a PhD in public health to know that sugary drinks aren’t good for you?”

Another kept referring to the initiative as a ban: “It would mean sodas cannot be sold…”

The big issues raised by ABA:

  • Does DOH have jurisdiction?
  • Is the cap rational?
  • Does the soda cap adequately balance public health, personal liberty, and economic factors (i.e., beverage companies’ “rights” to sell as much sugar water as they can get away with)?

DOH argues that it does have jurisdiction and that there is plenty of precedent.

DOH also argues that the proposed 16-ounce cap is well supported by research and makes good sense.

I find DOH Commissioner Tom Farley entirely rational—and persuasive—when he talks about these issues.

Reporters from the Associated Press and the New York Times must have been there too.  Both noted that the judges were much tougher on the DOH attorney than on the one from the ABA.   The DOH attorney seemed to have trouble responding to questions about precedents.  Did she not read the DOH’s impressive “plenty of precedent” piece?  

Obesity—and its type 2 diabetes consequences—are problems requiring action.  I’d like to see the soda cap tried.

But despite Commissioner Farley’s optimistic statements to reporters, this hearing didn’t make the possibility sound hopeful.

And here’s CDC’s reminder of what this is all about:

CDC The New (Ab)normal

Jun 11 2013

NYC Health Department: one New Yorker dies of diabetes every 90 minutes

The NYC Health Department goes to court at noon today for a hearing on the 16-ounce soda cap (I’ll be there).

Yesterday, it released alarming data on diabetes deaths, now at an all-time high.

The press release notes that although NYC’s overall deaths are going down,  diabetes-related deaths are going up.

The deaths are highest in low-income communities.

In April, the Health Department reported that nearly 650,000 New York adults have diabetes, an increase of 200,000 in a decade.   Most of these are due to type 2 diabetes, the “adult” kind.

Why?  Obesity.

Although a small percentage of overweight people develop type 2 diabetes, most people with type 2 diabetes are overweight.

Losing weight is the first thing to do to prevent or treat type 2 diabetes.

Reducing intake of sugary sodas is the first thing to do to lose weight.

That is why the health department wants to reduce the portion sizes of sugary drinks at food service establishments.

Today’s court hearing should be interesting. Stay tuned.

Jun 10 2013

Books not to miss: The food politics of restaurant workers

I’m going to be doing some catching up on reading over the summer, starting with this one.

Saru Jayaraman.  Behind the Kitchen Door.  ILR Press/Cornell, 2013.

This shocking, hugely important book takes a compassionate yet tough-minded look at the working conditions of restaurant workers—the poorly paid ($2.13 an hour), largely invisible people who wash dishes, clear tables, and mop the floors of the places from high end to low where many of us eat our meals.  Their work is not covered by federal labor laws.

Jayaraman, who co-founded the Restaurant Opportunities Centers United and directs the Food Labor Research Center at UC Berkeley, begins the book with a plea for advocacy:

When people ask what are the most important changes that we could make to our food system right away, I reply:  Enforce the nation’s labor laws and increase the minimum wage.

Think of that the next time you go out and eat.  And what you can do to support these goals.

Jun 7 2013

Chicago’s self-cancelling health program

A reader writes that she rode by this ad on her way to work yesterday.  It’s on Chicago’s beautiful lakefront walking-and-bike path.

Chicago

It’s for a Big Gulp 32-ounce drink, and a bargain at 69 cents.

The Chicago Park District explains that it:

partnered with Chicago-based AdTraction Media to develop a temporary outdoor advertising solution that adheres to concrete areas and will be displayed April through October.  The additional revenue from this agreement will help the Chicago Park District enhance the programs, projects and events offered to Chicagoans and visitors.

Did nobody in the Park District consider the irony?

Better get moving!  It takes at least 4 miles of running and 8 to 10 of biking to work off the 400 calories in that 32-ounce soda.

Jun 6 2013

More Q and A’s about food politics

More responses to questions that came in last week:

Q3.  Have you seen Dannon’s new campaign for their Greek yogurt?  I’m a nutritionist and received a huge package of collateral promotion material they wanted me to distribute.  The tagline for the product is, “Too delicious to be nutritious.”  Are they kidding?  They want a nutritionist to ratify the idea that healthy food is expected not to be good tasting? 

A.  I’m so with you on this one.  Of course healthy foods can be delicious and should be, every time.  Yogurt, especially the Greek kind, is a hot-selling product these days.   The advertising agency gets a hand slap for this one.  Of course Dannon will argue that the advertising worked.  Ink is ink and you and I are writing about it.

 

Q4.  There’s a recent op-ed in Forbes Magazine entitled, “Top Science Journal Rebukes Harvard’s Top Nutritionist” written by Trevor Butterworth. Could you respond to what’s going on around the controversy surrounding this Harvard professor?   

A.  Sure.  I already did, in comments posted last  January.  The controversy centers on disputes over the interpretation of research showing little effect of overweight on mortality except for the extremely obese.  The article in Nature discussing the controversy does an excellent job of explaining the inevitable uncertainties in nutrition research and the need to leave wiggle room—in case the science changes—whenever discussing new studies.

Jun 5 2013

Coke as a broker of peace and conflict

Coca-Cola as a peace broker

I don’t know what to make of Coca-Cola’s recent marketing strategies, as reported in the Washington  Post.   The ad,

“Small World Machines” starts with a relatively straightforward premise: India and Pakistan do not get along so well. It ends with the promise of peace: “Togetherness, humanity, this is what we all want, more and more exchange,” a woman, either Indian or Pakistani, narrates as the music swells. Sounds great. How do we get there? By buying Coke, of course.

The idea is to have two vending machines, one in Lahore and one in New Delhi, each with views of the other.  To buy a Coke, buyers have to cooperate.  Here are photos showing how it works.  And here’s how Coke explains it, with video and slides. 

As the Post explains, this may not be as far-fetched as it seems.

Sharing tasks and short-term, low-risk social interactions are classic conflict resolution tactics, including as a part of the civilian-to-civilian interactions sometimes termed “track two diplomacy.”  Indo-Pakistani tensions could use all the help they can get.

But the Post concludes with an update: 

Deputy foreign editor Karin Brulliard, a former Pakistan bureau chief, alerts me that, per the Wall Street Journal, Pepsi dominates the soda market there. Maybe that’s what’s been holding back peace?

This is not the first time that Coke markets its products as the key to world peace.  Those of you who are old enough might recall the “I’d like to teach the world to sing” video from 1990.

Coca-Cola as a conflict promoter

Who at Coke got the clever idea of producing personalized bottles with 150 popular names—in Israel, of all places?

Oops.  Forgot the 1.5 million Arabs who live there.

Alas, the campaign has caused a huge controversy in the Mideast.

Recall: All this is about selling Coke internationally.  Americans aren’t buying it so much anymore, so overseas it goes.

Jun 4 2013

Questions about food politics: iPhone apps and phytonutrients

I’m always happy to answer questions dealing with issues related to food politics.  Here are responses to two that came in last week.  I’ll do another two sometime this week. 

Q1.  I was just introduced to your book, What to Eat, and I read it, cover to cover, thoroughly enjoying each area of the market.  I am emailing in hopes that you have a suggested iPhone App, which suggests or promotes healthy eating.  Not so much calorie counter Apps, but Apps which make suggestions towards healthier options or perhaps even suggests macro or micronutrients which we may be lacking based on the foods we are purchasing and consuming.  Any help is much appreciated!  Thanks!

A.  I’m a diehard BlackBerry user and haven’t a clue.  Readers: suggestions?

Q2.  I’m an NYU MPH student and will probably be taking your Food Advocacy class next spring.  I adore your blog and as of late have been especially appreciative of your Farm Bill breakdowns. (What a confusing document!)  I was wondering what your take was on the NYTimes article that appeared in the Week in Review on Sunday titled, “Breeding the Nutrition out of Our Food” by Jo Robinson.  Have we really been losing the phytonutrients in our food since we became farmers?

A.  Ms. Robinson, whose terrific new book, “Eating on the Wild Side” is out this week, collected data on phytonutrient (plant antioxidant) levels in wild foods and their bred-to-be-less-bitter supermarket counterparts.  The wild ones have more, but they usually don’t taste as good.  The idea that foods now are less nutritious than foods in the past fits conveniently with concerns about our industrialized food system.  But data on trends in nutrient content are difficult to come by (the methods change over time), and differences in health benefits are impossible to assess.  The bottom line: people who eat fruits and vegetables—even supermarket varieties—are healthier than people who don’t.  Would they be even healthier if the vegetables were more bitter because of the phytonutrients?  Hard to say.  I’m going to eat my veggies and not worry about this one.