by Marion Nestle

Search results: food policy action

May 17 2016

Congressional (mis)action on child nutrition

First the good news

The USDA is applying its school-food rules  to child and adult care programs.  It has just released its final rule for these programs.  These go into effect in October 2017.

Previously, the USDA released standards for the Women, Infants and Children program and for the National School Lunch Program.

Now all three food assistance programs are more or less aligned with the Dietary Guidelines.

The child and adult feeding programs will specify more fruits and vegetables, less sugar and fat, but have reduce the standards for whole grain-rich products and sodium.  Presumably, this will make the rules more acceptable to people who don’t like them, of which there are many (see below).

And now the bad news

The House has released its child nutrition reauthorization bill, with the Orwellian title: “Improving Child Nutrition and Education Act.”  Like all such titles, this one means the opposite of what it says.

The House bill increases reimbursements for school breakfasts (good), but then lowers the nutrition standards for school meals and makes it harder for schools to qualify for universal free meals.  Here’s the committee’s bill summary.  And here is what the House Education and Workforce Committee says in its fact sheet.

The Hagstrom Report quotes Margo Wootan of Center for Science in the Public Interest saying that the House bill will:

  • Freeze sodium reduction for at least three years.
  • Require yet another scientific review of sodium.
  • Weaken the whole grain standards.
  • Let junk food back into schools
  • Allow schools to replace fresh produce with dried (without a sugar limit), canned (without a sodium or sugar limit), and frozen fruits and vegetables, thereby allowing schools to replace fresh apples and carrots with sugary fruit snacks, potato chips, jam, or trail mix containing candy.

The Center on Budget and Policy Priorities says this bill will increase food insecurity among children.

Fortunately, not everyone in the House loves this bill.  A letter signed by 111 House members details objections.

The House will be working on this bill tomorrow.  What will the Senate do?

School food advocates: it’s time to get busy.  Here’s the list of House members.  Write to yours today!

Nov 25 2015

A retraction and apology

The Journal of Public Health Policy (JPHP) will soon announce the retraction of a Viewpoint—an opinion piece—I co-authored with a Guatemalan physician, Dr. Joaquin Barnoya, “The food industry and conflicts of interest in nutrition research: A Latin American perspective.” Because of factual errors in the piece, and in response to valid objections about the errors from its subjects, they and we requested its retraction and JPHP is doing so.

I believe it is useful to explain how this happened.  In late summer, Dr. Barnoya brought to my attention an advertorial, a sponsored news account, published in el Periódico and other Guatemalan newspapers announcing an alliance among the Central American Bottling Corporation (cbc), the largest beverage distributor in Guatemala and bottler for PepsiCo; the Guatemala-based Institute of Nutrition of Central America and Panama (INCAP); and the U.S.-based Shalom Christian Foundation to distribute a supplemental food product, Mani+, to chronically malnourished children in rural areas (here is a translation of the advertorial).  Mani+ is a sweetened, peanut-based, nutrient-fortified supplemental food made from local ingredients in Guatemala, used to prevent malnutrition in young children.  The advertorial displayed a photograph of the directors of the three organizations holding the agreement.  It also displayed statements from all three directors emphasizing the alliance’s importance in addressing childhood malnutrition.

As readers of this blog should know, I have long been concerned about the conflicts of interest that arise when food companies—especially soda companies—enter into alliances with public health organizations.   The New York Times made the consequences of such alliances clear in its recent revelations of Coca-Cola sponsorship of the Global Energy Balance Network and the fallout from those revelations.  The announced alliance between cbc and INCAP raises similar concerns, particularly in the light of more general food industry partnerships with research and health institutions in Latin America.  Our intention in writing the Viewpoint was to question the appropriateness of this alliance, as well as of other such partnerships and alliances.

We should, however, have exercised more care.  Shortly after publication of the Viewpoint, Carolina Siu Bermúdez, the director of INCAP who appears in the advertorial, wrote to object that our piece incorrectly implied a financial relationship with cbc, and that Dr. Barnoya had failed to disclose that INCAP paid a substantial portion of his salary via a grant from yet another organization.  We also received letters from Dr. Edward Fischer, the founder of NutriPlus/Mani+, Professor of Anthropology and Director of the Center for Latin American Studies at Vanderbilt University, objecting to our statement that the alliance was responsible for manufacturing (rather than just distributing) the product.   Both asked us to retract the Viewpoint.

Upon investigation, we realized their objections had merit.  Indeed, further investigation by us and by the editors of the JPHP exposed additional errors.  Together, these include the following clarifications and corrections:

  • The alliance is involved only in the distribution of Mani+, not its manufacture (as we had asserted).
  • The actual nature of the alliance between cbc, INCAP, and the Shalom Christian Foundation—who does what—is, in fact, unclear. The Viewpoint should have characterized the relationship with less certainty and specified that cbc has no financial relationship with either INCAP or the Foundation.
  • Dr. Barnoya should have disclosed his financial relationship with INCAP, and I should have insisted that he do so.
  • The Viewpoint was triggered by the advertorial, and we should have made this connection more explicit.
  • The reference in the Viewpoint to the advertorial is incorrect. It is listed as (2015) cbc co. Unidos contra la desnutricion. INCAP, cbc y Fundacion Crisitiana Shalom Firman Convenio 23(July): 9.  The correct reference is Alianza Contra la Desnutricion. elPeriódico. July 23, 2015;Advertorial: 9.

To correct and clarify these issues, we would need to revise the Viewpoint.  Doing so, however, is not possible once a paper is published.  That left us no choice but to request a retraction, which I believe is the right course of action in this situation.

In my books and other writing, I try as hard as I can to be precise and accurate.  This incident is a lapse that I regret deeply, for which I take responsibility, and for which I apologize to Carolina Siu Bermúdez, to Dr. Fischer, and to my readers.  I also apologize to Phyllis Freeman and Anthony Robbins, the editors of JPHP, and to Lucy Wheeler of Palgrave, who have set an exemplary standard of ethics and integrity throughout these investigations and discussions.

As for lessons learned: Although I fully intend to continue to write critically about alliances between food companies and public health organizations, I also intend to use this experience to recommit myself to accountability and to diligence in checking and double-checking facts and disclosures going forward.   Again, my deepest apologies.

Addition, December 14: The actual retraction notice is published here.  The discussion on Retraction Watch is here.

Oct 23 2015

100 Mayors Sign Milan Urban Food Policy Pact

This morning, I received this press release from Franca Roiatti in Milan, announcing that on October 15 the mayors of more than 100 cities signed the Milan Urban Food Policy Pact and Framework for Action.  This pact commits these cities—New York among them—to work for more equitable and sustainable urban food systems.

The mayors made 7 commitments, among them working to

  • Develop sustainable food systems that are inclusive, resilient, safe and diverse, that provide healthy and affordable food to all people in a human rights-based framework, that minimise waste and conserve biodiversity while adapting to and mitigating impacts of climate change;
  • Engage all sectors within the food system (including neighbouring authorities, technical and academic organizations, civil society, small scale producers, and the private sector) in the formulation, implementation and assessment of all food-related policies, programmes and initiatives;
  • Use the Framework for Action as a starting point for each city to address the development of their own urban food system and we will share developments with participating cities and our national governments and international agencies when appropriate;

The Framework recommends 37 actions, among them

  • Identify, map and evaluate local initiatives
  • Develop or revise urban food policies and plans
  • Address non-communicable diseases associated with poor diets and obesity, giving specific attention where appropriate to reducing intake of sugar, salt, transfats, meat and dairy products and increasing consumption of fruits and vegetables and non-processed foods
  • Develop sustainable dietary guidelines to inform consumers, city planners (in particular for public food procurement), food service providers, retailers, producers and processors, and promote communication and training campaigns.
  • Explore regulatory and voluntary instruments to promote sustainable diets involving private and public companies as appropriate, using marketing, publicity and labelling policies; and economic incentives or disincentives; streamline regulations regarding the marketing of food and non-alcoholic beverages to children in accordance with WHO recommendations.
  • Those aimed at social and economic equity (cash transfers, school feeding programs, employment, education, training, research).
  • And those aimed at improving food production and reducing waste.

Finally, it comes with an e-book that collects 49 selected good practices from 28 signatory cities.

The point?  Even though everything about this pact and framework is voluntary, these findings and recommendations ought to be enough to give any city mayor a mandate to start working on sustainability issues.

I am looking forward to seeing how New York City uses the report and framework.

Additional documents

Aug 5 2015

Obama’s Clean Power Plan will reduce methylmercury in seafood. Yes!

Earlier this week, President Obama announced a plan to reduce toxic emissions from coal-burning power plants.  The purpose of the EPA’s Clean Power Plan  is to reduce greenhouse gases that contribute to climate change.

But from the standpoint of food politics, the new rules do something really important.  They will force coal-burning power plants to further reduce emissions of mercury.

In 2005, the EPA promulgated a rule to control mercury emissions from fossil fuel-fired power plants under section 111(d): the Clean Air Mercury Rule (CAMR). The EPA established a nationwide cap-and-trade program that took effect in two phases: In 2010, the cap was set at 38 tons per year, and in 2018, the cap was lowered to 15 tons per year. The EPA expected, on the basis of modeling, that sources would achieve the second phase, 15-ton per year cap cost-effectively by choosing among a set of measures that included shifting generation to lower-emitting units.

Mercury from coal-burning power plants is the largest human-induced source of methymercury in the fish food chain, accounting for 40% of the amount that gets into oceans (most of the rest comes from underseas volcanos).  Mercury is converted to toxic methylmercury in seawater, and the toxin moves up the fish food chain as bigger fish eat smaller fish.  Methylmercury does very bad things to the nervous system of the growing fetus (recall the mass poisonings in Minamata, Japan in the 1950s and the shocking photos of the victims). 

Fish advisories

Large, predatory fish have the most methymercury and should not be eaten in large amounts, or at all by pregnant women.

Fish advisories expect pregnant women to know the kinds of fish they can and cannot eat, and how much.  This is not easy.

Wouldn’t it be better to prevent mercury from getting into seawater in the first place?

I like to use eliminating methylmercury as an example of why public health (“upstream”) approaches work better than personal responsibility (“downstream”) approaches.

An exceptionally clear example is how to avoid toxic levels of methylmercury in fish.   We can teach pregnant women to recognize which fish are high in methylmercury and hope this works well enough so they will avoid buying such fish (personal responsibility) or we could–as a society–require coal-burning power plants to scrub their emissions so mercury doesn’t get into ocean or lake waters in the first place (public health).

That’s what this rule does.

For explanations of how the Clean Power Plan will work, see the Union of Concerned Scientists’ review.

Vox.com explains:

The basics of the Clean Power Plan are fairly simple. The EPA is giving each state an individualized goal for reducing emissions from their electric power plants. States can then decide for themselves how to get there…. Power plant emissions have already dropped 15 percent between 2005 and 2013, thanks to a brutal recession, cheap natural gas pushing out coal, the rise of wind power, and improved efficiency. So with this new plan, EPA is expecting a further 20 percent cut in power-plant emissions from 2013 levels by 2030.

For what Obama stands to gain from this rule, see the New York Times.

But hold the celebration.  Politico Pro Energy reports that Republicans in Congress view the rule as a key component of the administration’s “war on coal” and will try to block it or sue to stop it.   The Supreme Court says that the EPA has the authority to issue this rule, but “Challengers are expected to argue that the rule is invalid because it exceeds EPA’s authority, contradicts a Clean Air Act provision meant to avoid duplicative rules, and violates the 5th and 10th Amendments to the Constitution.”   And, of course, a post-Obama president could undo the whole thing, as it is an executive branch action, not a law passed by Congress.

Yesterday’s New York Times had a front-page story on how coal lobbyists and corporate lawyers started organizing more than a year ago to fight this plan.

An important ally in the effort was the American Legislative Exchange Council, or ALEC, a conservative advocacy group that pushes policy through state legislatures. Typically, the council’s committees of corporate members will craft a model bill designed to push through policies it supports, such as rolling back environmental regulations.

The Clean Power Plan deserves massive support.

This may be a climate-change plan, but it is also a critically important public health measure.

Anyone who likes eating fish should do everything possible to support this measure.

Aug 3 2015

Retraction of the Golden Rice paper: an issue of ethics

Despite my long interest in and dubious opinion about the benefits of Golden Rice (genetically modified to contain the beta-carotene precursor of vitamin A), I somehow completely missed the huge and highly embarrassing uproar over a study demonstrating the effectiveness of this rice in raising vitamin A levels in young children.

This particular uproar began with publication of the study in the American Journal of Clinical Nutrition in 2012.  Last week the journal announced that it has retracted the study—on ethical, not scientific, grounds.

To explain:  Dr. Guangwen Tang, a long-time researcher at Tufts University, and her colleagues at Tufts, in China, and at Baylor and the NIH, compared the effectiveness of vitamin A capsules, Golden Rice, and spinach in raising vitamin A levels in the blood of Chinese schoolchildren.  They reported that Golden Rice proved just as effective as capsules, and somewhat better than spinach, in inducing higher vitamin A levels, just as it is supposed to do.

Golden Rice, of course, is the poster child for the benefits of GMOs, extolled by many as the solution to the developing world’s high prevalence of vitamin A deficiency (I’m dubious because I view vitamin A deficiency as a social problem requiring policy and cultural shifts).

Soon after, Greenpeace, which is decidedly anti-GMO, challenged the ethics of the study, charging that the children were being used as “guinea pigs.”

As reported in Nature,

none of the children, their parents or school teachers was aware that Golden Rice was involved, according to a 45-minute investigative news programme broadcast on 8 December on CCTV, China’s state television channel.  The informed-consent form said that the rice contained β-carotene, but not that it was genetically modified or that it was Golden Rice. Nor did it highlight uncertainty around any potential risks of ingesting such rice…Moreover, Wang didn’t apply for ethical evaluation of the trial, instead fabricating the approval documents, according to CDC. And Tang brought Golden Rice from the United States to China illegally, without due declaration to the relevant Chinese authorities, it said.

According to a report on NPR, Tufts University did a year-long investigation and agreed that ethical standards had been violated:

the study was not “conducted in full compliance with … policy or federal regulations”… the researchers did not adequately explain the nature of golden rice and made some changes in the study without getting approval from the committee at Tufts that is supposed to review all research involving human subjects.  Guangwen Tang will be banned from conducting research on human subjects for two years. For two years after that, any research that she conducts will be under the direct supervision of another investigator.

A report on the case in ScienceInsider explains the ethical problem raised by the study’s informed consent form :

U.S. guidelines stipulate that such forms use plain language understandable to lay people, and the IRB [the Tufts Institutional Review Board] agreed to let Tang say that “Golden Rice is a new rice which makes beta-carotene,” without using the loaded words “genetically modified.” (The consent form for a very similar study by Tang among adults in Boston, published in 2009, didn’t use that term either.) Given the sensitivities over transgenic food, which existed in China as well, that was the wrong decision, according to the external panel.

In 2014,  Dr. Tang sued the ASN:

ASN twice asked Tang and her six co-authors to withdraw the paper voluntarily, which they declined to do. The society recently decided to retract the paper on its own…but it has agreed to a 90-day stay after Tang filed her lawsuit, to see if the matter can be settled out of court.

But the court ruled in favor of ASN.  Hence, the retraction.  ASN issued a press release:

In a ruling by the Massachusetts Superior Court, Judge Salinger…cleared the way for the American Society for Nutrition (ASN) to retract the article “β-Carotene in Golden Rice is as good as β-carotene in oil at providing vitamin A to children”…ASN is very pleased that the Massachusetts courts have upheld the organization’s First Amendment rights and have allowed ASN to move forward with the retraction of the article.

In its online retraction notice, ASN states the reasons:

  1. The authors are unable to provide sufficient evidence that the study had been reviewed and approved by a local ethics committee in China in a manner fully consistent with NIH guidelines….
  2. The authors are unable to substantiate through documentary evidence that all parents or children involved in the study were provided with the full consent form for the study.
  3. Specific eligibility issues were identified in regard to 2 subjects in the study.

Last week, Retraction Watch published a lengthy summary of this case that includes a long statement from Tufts University:

No questions were raised about the integrity of the study data, accuracy of the research results or safety of the research subjects…Tufts University has always been and remains deeply committed to the highest ethical and scientific standards in research.  In September 2012, w …convened an external review committee to interview those involved and to review documentation of the study…There was no evidence found of falsification or fabrication of the data that underlie the study’s primary findings. Those reviews did, however, determine that the research had not been conducted in full compliance with Tufts research policies and federal research regulations.

The retraction is a huge embarrassment, not only for the researchers involved but also for Tufts University’s Friedman School of Nutrition Science and Policy, Tufts’ Institutional Review Board, the American Journal of Clinical Nutrition, and the American Society for Clinical Nutrition.

The study was funded by NIH, USDA, as well as a program in China.  NIH takes research ethics very seriously and expects the researchers it funds to adhere to the highest possible standards for research on human subjects.  Because the study did not follow standard ethical guidelines, especially with regard to research on children, Tufts had no choice but to investigate and impose sanctions, and the journal had no choice but to retract the paper.

This case reinforces my views about GMOs in general and Golden Rice in particular.

The controversies are not (or not usually) about the science.  They are very much about ethics and other questions of values.

Jun 9 2015

The Lancet series on obesity policy (in case you missed it)

Some time ago, I posted the terrific Lancet infographic on obesity policy.

Here are the series articles (or at least the abstracts) that go with it.

Mar 23 2015

Critical Public Health: special issue on “Big Food”:

With Simon Williams, I have just co-edited a special issue of Critical Public Health: “Big Food”: Critical perspectives on the global growth of the food and beverage industry.”

Here’s what’s in it.

Editorial

Research

Commentaries

  • Big Food’ and ‘gamified’ products: promotion, packaging, and the promise of fun, by Charlene Elliott.
  • Food as pharma: marketing nutraceuticals to India’s rural poor, by Alice Street.

Thanks to Simon Williams for initiating (and doing the heavy lifting on) this project, and to all the terrific contributors.

Enjoy!

 

Feb 5 2015

Food politics in action: Potatoes!

The National Academy of Sciences’ Institute of Medicine (IOM) has just recommended that white potatoes be included in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) program.*

This recommendation contradicts previous policy, which excluded white potatoes from the WIC package on the grounds that starchy vegetables are not lacking in the diets of WIC recipients and it would be better to use WIC to encourage consumption of a broader range of vegetables.

As I’ve discussed in earlier posts, the potato lobby objected, insisted that white potatoes were just as healthy as other starchy vegetables, and that women weren’t eating enough of them.  It got Congress to overturn USDA’s restrictions on the number of times white potatoes (usually fried) could be served in the school lunch program.

And it got Congress to order USDA  to put potatoes back into WIC—unless it conducted a study demonstrating that potatoes should be excluded.  The USDA gave up and told state agencies to allow potatoes to be purchased by WIC recipients starting next summer.

In deciding in favor of potatoes, the committee said it is concerned that “”Current consumption of starchy vegetables does not meet 2010 DGA [Dietary Guidelines for Americans] recommendations for this food group.”

Really?  I have a hard time believing that WIC recipients are suffering from lack of potatoes in their diets.  Potatoes are fine foods, but highly caloric when prepared in the usual ways.  Encouraging WIC recipients to choose leafy greens and other vegetables seems like a good idea.

But the IOM committee took the 2010 Dietary Guidelines at face value and says this is what the rules are until changed.  So they effectively tossed this hot potato into lap of the 2015 Dietary Guidelines committee.

While waiting to see that committee’s report—expected soon—the take-home lesson is clear: lobbying works.

*The USDA has a new report out on WIC: The WIC Program: Background, Trends, and Economic Issues, 2015 Edition.