by Marion Nestle

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Jan 10 2023

Chile’s new dietary guidelines

Twitter still has its uses.  It’s how I found out about about Chile’s new dietary guidelines.

Even without speaking Spanish, you can see what they do that the US Dietary Guidelines do not.  They emphasize:

  • Sustainability (the forbidden word in the 2020-2025 US Guideines)
  • Fresh, minimally processed foods–“Avoid products ultra-processed and labeled as “high in” (“ultra-processed is not mentioned in the US Guidelines)
  • Home cooking
  • Respect for traditional cultural values
  • Farmers’ markets
  • Recycling

One odd message: “Consume làcteos en todas las etapas de la vida,” which I translate as “Consume dairy foods through all stages of life.”

I’m wondering how that got in there and guessing that Chile must have a powerful dairy industry.

But I hope the new, soon to be appointed, I’m told, 2025-2030 Dietary Guidelines Advisory Committee will pay attention to Chile’s version.  It has much to teach us.

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Jan 9 2023

Industry funded study of the week: ultra-processed foods are OK, really

Jim Krieger of Healthy Food America sent me this Food Navigator article titled “Can ultra-processed packaged food play a role in healthy, sustainable diets of the future.”

Uh oh.  Another attack on the concept of ultra-processed foods.  These, you will recall, are strongly associated in observational studies with poor health outcome, and one clinical trial demonstrates them to cause people to eat more calories.

The makers of highly processed foods are understandably worried that the word will get out and people will stop eating them.

Clif Bar to the rescue.

It sponsored a small session to establish guidelines for making highly processed foods healthier: “Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods

The publication emphasizes flaws in the concept of “ultra-processed,” an approach it says

lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health.

Acknowledgments: “Staff at Clif Bar & Company developed the meeting agenda, synthesized all prework inputs, participated as observers in the workshop, and assisted in the gathering of the materials used to prepare this manuscript.”

Here is an ingredient list for an oatmeal raisin walnut Clif Bar:

ORGANIC ROLLED OATS, ORGANIC BROWN RICE SYRUP, SOY RICE CRISPS (SOY PROTEIN ISOLATE, RICE FLOUR, BARLEY MALT EXTRACT), ORGANIC ROASTED SOYBEANS, ORGANIC TAPIOCA SYRUP, ORGANIC CANE SYRUP, ORGANIC RAISINS, CHICORY FIBER, ORGANIC SOY FLOUR, WALNUTS, SUNFLOWER AND/OR SOYBEAN OIL, NATURAL FLAVORS, SALT, ORGANIC CINNAMON, MIXED TOCOPHEROLS (ANTIOXIDANT).

My definition of ultra-processed is that you can’t make it in your home kitchen because the ingredients are industrially produced and not available in supermarkets.  By this definition, the soy rice crisps are ultra-processed and maybe chicory fiber, but that’s about it.

The Clif people must be worried that they will be viewed in the same category as seriously ultra-processed snack foods.

Let’s give them and their parent company, Mondelez, credit for full disclosure.

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Jan 5 2023

A bill to legalize kratom? What’s up with this?

I received an email from the American Kratom Association, an organization I did not know existed. (now, I do).

Landmark Bipartisan Bill Regulating Kratom in the United States Introduced in Congress

Bill will ensure consumers have continued access to safe, regulated kratom products

The American Kratom Association is elated to announce Federal Kratom Consumer Protection Act legislation has been filed in both the Senate and House. This is a monumental moment for kratom consumers and a significant step towards protecting the rights of millions of Americans. The fight is far from won, but we are only arriving at this exciting event because of the support of so many amazing advocates.

What is kratom?  It depends on whom you ask.

The American Kratom Association says:

Kratom is a plant that has been used safely for centuries in Southeast Asia and in the United States since the early 1970s. ..for a variety of health and wellness purposes, including for an energy boost, increased focus, reducing anxiety, and as a personal harm reduction tool for managing acute and chronic pain.   [see KratomAnswers.org for details]

The U.S.  Drug Enforcement Administration agrees that Kratom has a long history of use in Southeast Asia.   But, it says,

Consumption of its leaves produces both stimulant effects (in low doses) and sedative effects (in high doses), and can lead to psychotic symptoms, and psychological and physiological dependence….In the U.S., the abuse of kratom has increased markedly in recent years…The FDA has not approved Kratom for any medical use. In addition, DEA has listed kratom as a Drug and Chemical of Concern.

The FDA says kratom is an unapproved drug and writes cease-and-desist letters to its sellers.

This begins to sound  just like what’s going on with hemp and marijuana in New York State (see yesterday’s post).

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Jan 2 2023

Industry-funded study of the week: Ashwagandha

Happy new year to all.!

And now, back to my Monday postings of industry-funded studies.  Today’s is about the popular herbal supplement, ashwagandha.   This is typically taken to reduce stress and improve a wide variety of health problems, but little science backs up those contentions.  Hence, this study, which I learned about from reading an account of it: Single ashwagandha dose may exert cognitive performance: Study.  That headline was all it took to get me to ask my usual question: Who paid for this?

The study: Effects of Acute Ashwagandha Ingestion on Cognitive Function. Int. J. Environ. Res. Public Health 202219(19), 11852; https://doi.org/10.3390/ijerph191911852

Methods: The study assessed performance on the Berg–Wisconsin Card Sorting (BCST), Go/No-Go (GNG), Sternberg Task (STT), and Psychomotor Vigilance Task (PVTT) tests.   Participants took a placebo or ashwagandha (ASH) extract (NooGandha®, Specnova Inc., Boca Raton, FL, USA).

Conclusions: Acute supplementation with 400 mg of ashwagandha improved selected measures of executive function, helped sustain attention, and increased short-term/working memory.

Funding: “This study was funded as a fee-for-service project awarded to the Human Clinical Research Facility at Texas A&M University from Specnova, Inc. (Boca Raton, FL, USA)…Specnova was not involved in any way in data collection, analysis of the data, or the writing of the manuscript.”

Comment: Specnova, you will not be surprised to learn, is a supplier of supplement ingredients.  The company ordered the study to its specifications.  It got the result it wanted, as funders almost invariably do.  Despite booming sales of ashwagandha, so little is known about its properties that the National Center for Complementary and Integrative Medicine does not even have a fact sheet for it among its reviews of herbal supplements.  Industry-sponsored research to the rescue!  And of course it “was not involved in any way…”  It didn’t have to be.  Funding is usually enough to induce unconscious bias on its own.

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Dec 22 2022

My latest update on plant-based meat and dairy substitutes

Much is happening in the plant-based food sector.  I love trying to keep up with it.

First, the bad, or somewhat bad, news:

Next, the new product launches:

And where the industry might be headed:

Comment: Despite the current drop in sales, I don’t see these products disappearing off the shelves.  There is a demand or them among people who do not want to eat meat or dairy foods for reasons of health, animal welfare, or the environment.  The products need to taste good if they are going to continue to sell.  And they need to become more food-based rather than ingredient-based if they are to overcome concerns about their meeting definitions of ultra-processed.

I will keep following this sector with great interest.  Stay tuned.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Dec 13 2022

Healthy People 2030 releases early progress report

Healthy People 2030 has released its latest set of tracking data.  This, you will recall, is the latest of the US Public Health Service’s 10-year plans for improving the health of Americans.  The agencies involved set specific, measurable objectives and track progress toward achieving them.

You can browse the full set of objectives here.

The objectives for overweight and obesity are here.  Three have tracking data available.  Of these,

One shows no change: Reduce the proportion of children and adolescents with obesity — NWS‑04

Two are getting worse

The objectives for Nutrition and Healthy Eating are here.

Of the objectives with data available, two showi improvement!

Three show no change:

Two (plus the obesity one above) are getting worse:

Dec 12 2022

Industry-funded study of the week: Headline vs. Study

As regular readers know, I subscribe to the weekly newsletter, Obesity and Energetics Offerings, and particularly enjoy its section on Headline vs Study.

Here’s a particularly amusing example, which right away triggers my question: Who paid for this?

Headline vs Study

Let’s take a look.

Headline: Snacking on Almonds Can Help People Reduce Calorie Intake: Study.

A handful of almonds may be the latest weight loss hack, new research suggests.

new study from the University of South Australia found that eating 30 to 50 grams of almonds could regulate appetite, leading to less calories consumed each day.

The research, which examined both the hormones that regulate appetite and how almonds could aid in controlling hunger, discovered that the consumption of the nut ultimately led to about 300 fewer calories [sic*]consumed at the following meal.

Press Release: Believe It or ‘Nut’, Almonds Can Help You Cut Calories, Study Finds.

Examining how almonds can affect appetite, researchers found that a snack of 30-50 grams of almonds could help people cut back on the number of kilojoules they consume each day.

Published in the European Journal of Nutrition, the study found that people who consumed almonds — as opposed to an energy-equivalent carbohydrate snack — lowered their energy intake by 300 kilojoules (most of which came from junk food) at the subsequent meal.

Study:  Acute feeding with almonds compared to a carbohydrate-based snack improves appetite-regulating hormones with no effect on self-reported appetite sensations: a randomised controlled trial. Carter, S., Hill, A.M., Buckley, J.D. et al.Eur J Nutr (2022). https://doi.org/10.1007/s00394-022-03027-2

Results: “…Cholecystokinin, ghrelin, glucagon-like peptide-1, leptin and polypeptide YY AUCs were not different between groups. Self-reported appetite ratings and energy intake following the buffet did not differ between groups.”

Conclusion: “More favourable appetite-regulating hormone responses to AL did not translate into better self-reported appetite or reduced short-term energy consumption. Future studies should investigate implications for longer term appetite regulation.”

Funding: “This work was funded by the Almond Board of California. This funding source had no role in the design of this study or the analysis and interpretation of the data.”

Conflict of interest: “AMC has consulted for Nuts for Life (an initiative of the Australian Tree Nut Industry). S-YT has previously been involved in studies funded by the Californian Walnut Commission. AMC, JDB and S-YT have previously been involved in studies funded by International Nut and Dried Fruit Council.”

*Comment: How could the headline get it so wrong?  The authors write: “Although not significant, the AL group consumed 300 kJ less energy in the meal challenge than the SB group, 270 kJ of which came from discretionary foods, which may be a clinically important benefit in weight management.”  The sic partly explains the problem.  The 300 refers to kilojoules (kj), not calories.  300 kj = 72 calories, not 300.  No wonder the result wasn’t statistically significant.

But the press release and resulting headline explain why the nut industry funds studies like this.  Even when the result shows no difference, the PR people can spin the data to produce the expected favorable result.

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Dec 7 2022

Expert committee releases FDA evaluation report

The Expert Committee tasked with evaluating the FDA’s human foods program has released its report.

The Committee begins by pointing out that to do its job, the FDA needs adequate resources, sufficient authority, and a structure and culture that breeds success.

In its judgment, the FDA has none of those.  Instead, it is an agency in “constant turmoil.”

The report focuses on lack of leadership.

A leadership skill set, it says, should include:

  • Expertise and knowledge in food safety and/or nutrition
  • Ability to make decisions in a complex regulatory environment
  • Ability to lead in a complex work environment
  • Strong demonstrated management capability
  • Superb communication skills
  • Ability to identify and nurture talent

Instead, the FDA is risk averse, which it admits is “not surprising in a program subject to significant external criticism.”

The committee makes many (too many) recommendations:

Identify vision and mission.

Change the agency’s culture.

Give it more resources.  Food programs are under-resourced; budget and staffing have been flat for at least a decade.

Expand user fees.  [Uh oh.  Bad idea.  The committee even explains why, but ignores the hazard.]

There is also significant skepticism in the public interest community about the potential for “industry capture” of the Human Foods Program if FDA is overly reliant on industry fees.  Efforts to establish structures to secure additional industry funding, such as enhanced registration fees, may address these concerns. While the Panel acknowledges these concerns, the Panel recommends that FDA explore whether common ground can be found on this issue.

Reinstate the Food Advisory Committee.  [I was on the first one in the early 1990s, but our job was to react to decisions the agnecy had already made, not advise it about tough issues].

Reorganize the agency to give the food programs more visibility, integrate them, and give them clear lines of authority [Note: one big weakness of this project is that the committee was instructed not to include the Center for Veterinary Medicine, as if food for pets and food animals has nothing to do with the human food supply, which of course it does].

The report gives five options for reorganization, all of them complicated and undoubtedly politically difficult.  It lists their strengths and weaknesses, but does not state a preference.

  • Create a separate food administration within HHS
  • Create a Deputy Commissioner for Foods
  • Put CFSAN in charge of human food programs
  • Puts Commissioner in charge of human food programs
  • Create a Deputy Commissioner for Foods

Do more about nutrition labeling, research on consumer behavior.  [Really?  That’s all?]

Comment: The committee only had a couple of months to pull this together and was required to leave out the Center for Veterinary Medicine.  Even so, the report makes it clear that the FDA is in serious trouble, so much so that the committee did not even get into what the FDA ought to be doing about about taking steps to prevent diet-influenced chronic disease.  This, of course, would require it to take on the food industry—an unlikely scenario given everything else that’s not happening.

The next step is to see what the Commissioner does with the report, if anything.  And whether Congress will appropriate more funding.

The report did not say a word about what I see as a major political handicap for the FDA; it’s funding comes from congressional agriculture committees, not health committees, even though FDA is an agency of the public health service.   That too needs to change.

What the press is saying:

  • Washington Post: Scathing report recommends major changes at FDA, including possibly breaking up agency
  • Bloomberg:  FDA’s Food Program Needs Strong Leader, Outside Reviewers Find
  • USA Today:  Report finds FDA’s food regulatory agency lacks leadership, is in ‘constant turmoil’
  • Politico:  ‘Constant turmoil’ at FDA’s food regulatory agency, report says

Anda quote from a colleague:

“While we appreciate the Panel’s thoughtful attempt to dig into complicated food issues and their recommendation to elevate nutrition/chronic food illness, creating a seperate, unfunded, nutrition center would have the opposite effect. That’s unacceptable.” Jerold Mande CEO Nourish Science
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