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The 2015 Dietary Guidelines Advisory Committee (DGAC) issued its more than 500-page report yesterday.

Before I say anything about it, please note that this report informs, but does not constitute, the Dietary Guidelines. The agencies—USDA and HHS—write the actual Guidelines and are not expected to do so until the end of this year.

Here are what I see as the highlights (these are direct quotes)

• A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.
• A diet higher in plant-based foods…and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet.
• It will take concerted, bold actions…to achieve and maintain the healthy diet patterns, and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative.

Some facts and statements from the report (not direct quotes).

• Half the energy intake in U.S. diets comes from a combination of burgers and sandwiches (~14%), desserts and sweet snacks (8.5%), sugary beverages (6.5%), mixed dished made with rice, pasta, and other grains (5.5%, savory snacks (~5%), pizza (4.3%), and meat, poultry and seafood mixed dishes (~4%).
• Nearly half of total sugar intake comes from beverages other than milk and 100% fruit juice

The report comments on issues under current debate.

• Saturated fat: “replacing SFA with unsaturated fats…significantly reduces total and LDL cholesterol…Strong and consistent evidence…shows that replacing SFA [saturated fatty acids] with PUFA [polyunsaturated fatty acids] reduces the risk of CVD [cardiovascular] events and coronary mortality…For every 1 percent of energy intake from SFA replaced with PUFA, incidence of CHD [coronary heart disease] is reduced by 2 to 3 percent. However, reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD risk.”
• Sugars: “Strong and consistent evidence shows that intake of added sugars from food and/or sugar sweetened beverages are associated with excess body weight in children and adults…Strong evidence shows that higher consumption of added sugars, especially sugar-sweetened beverages, increases the risk of type 2 diabetes among adults and this relationship is not fully explained by body weight.[Theae findings are] compatible with a recommendation to keep added sugars intake below 10 percent of total energy intake.”
• Food labels: “Consumers would benefit from a standardized, easily understood front-of-package (FOP) label on all food and beverage products to give clear guidance about a food’s healthfulness.” [This refers to the recommendations of the Institute of Medicine that I’ve written about previously; they disappeared without a trace.]
• Soda taxes: “Economic and pricing approaches, using incentives and disincentives should be explored to promote the purchase of healthier foods and beverages. For example, higher sugar-sweetened beverage taxes may encourage consumers to reduce sugar-sweetened beverage consumption.”
• SNAP: “Policy changes within the federal Supplemental Nutrition Assistance Program (SNAP), similar to policies in place for the WIC program, should be considered to encourage purchase of healthier options, including foods and beverages low in added sugars. Pilot studies using incentives and restrictions should be tested and evaluated.”

The DGAC recommends (these are direct quotes but not necessarily complete):

• Establish local, state, and Federal policies to make healthy foods accessible and affordable and to limit access to high-calorie, nutrient-poor foods and sugar-sweetened beverages in public buildings and facilities.
• Set nutrition standards for foods and beverages offered in public places.
• Improve retail food environments and make healthy foods accessible and affordable in underserved neighborhoods and communities.
• Implement the comprehensive school meal guidelines (National School Lunch Program) from the USDA that increase intakes of vegetables (without added salt), fruits (without added sugars), and whole grains.
• Limit marketing unhealthy foods to children.
• Make drinking water freely available to students throughout the day.
• Ensure competitive foods meet the national nutrition standards (e.g., Dietary Guidelines for Americans).
• Eliminate sugar-sweetened beverages [from schools].
• Nutrition Facts label should include added sugars (in grams and teaspoons).

And for all federal nutrition programs, the DGAC recommends:

• Align program standards with the Dietary Guidelines for Americans so as to achieve the 2015 DGAC recommendations and promote a “culture of health.”

Congratulations to this committee for its courageous recommendations.

Why courageous?  See my previous comments on the objections to such advice.

The next step: public comment:

The public is encouraged to view the independent advisory group’s report and provide written comments at www.DietaryGuidelines.gov for a period of 45 days after publication in the Federal Register. The public will also have an opportunity to offer oral comments at a public meeting in Bethesda, Maryland, on March 24, 2015. Those interested in providing oral comments at the March 24, 2015, public meeting can register at www.DietaryGuidelines.gov. Capacity is limited, so participants will be accepted on a first-come, first-served basis.

Here’s your chance to support this committee’s excellent ideas and demonstrate public approval for diets that promote the health of people and the planet.

Note: the reactions to the report are pouring in and I will deal with them next week.  Enjoy the weekend!

Food Politics will mourn the passing of the Colbert Report.

What, you might ask, did the Colbert Report have to do with Food Politics?

Plenty.

For one thing, I was lucky (well, nonplussed) to appear on the show in August 2009.

The topic?  Sugar trade policy.

Oh.  Of course.

I explained what this was about in a blog post.

Better, Colbert did occasional pieces: Thought for Food.

Eater has collected them all in one place (thanks to Eleanor Talbot West for sending).

Or, if you want to watch them separately…

• Thought for Food – Domino’s Smart Slice & Doritos Jacked …
• Thought for Food – Fairlife Milk & Pizza Hut’s Subconscious …
• Thought for Food – Ban on Trans Fats & McDonald’s McRib …
• Thought for Food – Kentucky Tuna & Grilled Cheese Burger …
• Thought for Food – Spreadable Sharia & Buddy Cup – The ...
• Thought for Food – Bug Food Coloring, Hot-Dog-Stuffed …
• Thought for Food – KFC’s Go Cup & Powerful Yogurt – The …
• Thought for Food – Responsible Snacking & Second Breakfast
• http://www.feedyourheaddiet.com/the-western-diet-can-be-funny.html

It was great while it lasted.  I will miss the brilliant satire.

Addition: A reader just sent this link to Colbert’s in-character testimony to Congress on agricultural labor issues (from the expressions on the faces of the people sitting behind him, they must have been taking him seriously).

The FDA released its long-awaited regulations on menu labeling at 12:01 this morning.

The big and most welcome news: the regulations apply across the board to

• Meals from sit‐down restaurants
• Foods purchased at drive‐through windows
• Take‐out food, such as pizza
• Foods, such as made‐to‐order sandwiches, ordered from a menu or menu board at a grocery store or delicatessen
• Foods you serve yourself from a salad or hot food bar
• Muffins at a bakery or coffee shop
• Popcorn purchased at a movie theater or amusement park
• A scoop of ice cream, milk shake or sundae from an ice cream store
• Hot dogs or frozen drinks prepared on site in a convenience or warehouse store
• Certain alcoholic beverages

The only exceptions: foods from grocery stores or delis that require additional preparation such as deli meats, cheeses, or large deli salads.

Why is this big news?  As I’ve written previously in this space,

• It’s been more than 4 years since Congress called for menu labels (in the Affordable Care Act signed by President Obama in 2010)
• When the FDA first proposed the regs in April 2011, it excluded movie theaters and other places whose primary purpose is not to sell food.
• It also excluded alcoholic beverages (these are regulated by the Treasury Department)
• The pizza lobby (yes, there is such a thing–remember “pizza is a vegetable” in school lunches?) fought to be excluded.
• The National Grocers Association and other retailers who sell prepared foods fought for exclusion.
• Rumors were that the White House wanted weaker regulations.

Well here they are.

• The FDA press release
• The FDA’s home page on menu labeling
• The FDA’s fact sheet on menu labels
• The Federal Register notice for menu labels
• The FDA’s fact sheet on vending machine labels
• The Federal Register notice for vending machine labels
• Statement from FDA Commissioner Margaret Hamburg

As for the response:

Center for Science in the Interest (CSPI), which has led the menu labeling efforts, is understandably pleased.  Congratulations!

The National Restaurant Association has pressed for national regulations to make the rules consistent across the country.  It says:

We joined forces with more than 70 public health and stakeholder groups to advocate for a federal nutrition standard so that anyone dining out can have clear, easy-to-use nutrition information at the point of ordering – information that is presented in the same way, no matter what part of the country. From Portland, Oregon to Portland, Maine, diners in restaurants will have a new tool to help them make choices that are right for them.

The New York Times reports that the The National Grocers Association said: “We are disappointed that the F.D.A.’s final rules will capture grocery stores, and impose such a large and costly regulatory burden on our members”

Really?  Lots of people eat at grocery stores these days (think: Whole Foods).

The Washington Post reports that the Food Marketing Institute is also disappointed.

I’m not.  Calorie labeling is an excellent tool for public education.

The regs won’t go into effect for another year or two.

Watch the lobbying begin!

In the meantime, congratulations to the FDA for putting public health first.

http://www.washingtonpost.com/national/health-science/calorie-counts-coming-to-a-restaurant-movie-theater-vending-machine-near-you/2014/11/24/e5bd25ae-7415-11e4-a5b2-e1217af6b33d_story.html​

It’s been 4 years since President Obama signed the Affordable Care Act authorizing menu labels to go national.

In 2011, the FDA proposed rules for public comment.  It proposed final rules in 2013:

• Rules for restaurant menu boards
• Rules for vending machines

But the FDA has never released the final rules.

How come?

The rumors I’m hearing say they are being held up by the White House Office of Management and Budget.

I first wrote about the delay in April 2013.

I complained about the delay again four months ago, when rumors suggested that it was due to pressures from owners of pizza chains and movie theaters.

I quoted Politico Pro Agriculture on the White House-induced delay:

It was three months ago today that the White House first received FDA’s final rules for calorie labels on menus and vending machines, and by the Office of Management and budget’s own rules, that means time is up. Interagency review at OMB is supposed to take no more than 90 days before the final release of a measure, though that timeframe is often extended with little explanation on more controversial initiatives. While OMB is always mum on its schedule for rule reviews and releases, the end of the standard review period is sometimes a hint that something will be coming, if not today — the day before a long weekend — then soon. In the meantime, brush up on the issue here: http://politico.pro/1mKNcFr and here: http://politico.pro/1lzZLDe.

Come on White House OMB: the election is over.  Let the FDA release the rules, please.

This is about public education, which is supposed to be bipartisan.

Last Sunday’s New York Times Magazine food issue dealt with such matters as what kids around the world eat for breakfast, and what happens when second graders are treated to a seven-course, $220 tasting meal.

But it also carried a major investigative piece by political reporter Nicholas Confessore about how the once-bipartisan school lunch program has become a political battleground.

when Michelle Obama started Let’s Move!, her campaign against child obesity, in 2010, the members of the School Nutrition Association were her natural allies…the Obama administration got behind the Healthy, Hunger-Free Kids Act, an ambitious bill that would impose strict new nutrition standards on all food sold in public schools. A generation raised on Lunchables and Pizza Hut, the bill’s authors believed, could learn to love whole-wheat pasta and roasted cauliflower…But to pass the bill, the White House needed to enlist not only Democrats and Republicans in Congress but also a host of overlapping and competing interest groups: the manufacturers who supplied food to schools, the nutrition experts who wanted it to be more healthful and the lunch ladies who would have to get children to eat it.

They succeeded with the nutrition experts, but failed to account for the cozy financial relations between the food product makers and the School Nutrition Association (SNA).

As I’ve discussed previously, the SNA, backed by product manufacturers, is now fighting the White House, the USDA, and research evidence that kids will indeed eat healthful food and will be better off for it.

Center for Science in the Public Interest has this to say about what’s happening with school meals.

The Robert Wood Johnson Foundation has a new infographic on how “Healthier School Meals Matter.”

Bettina Siegel, the Houston school lunch blogger at The Lunch Tray, and food consultant Nancy Huehnergarth, in consultation with SNA members, posted an open letter to urge SNA members to oppose the organization’s stance on school nutrition standards.

As Bettina Siegel describes, the SNA promptly sent an e-mailed “urgent message” from its board of directors to all 55,000 members, saying the association was “troubled” to learn about the open letter.

SNA welcomes the diversity of opinions in our association, and we consider all member input when developing or approving SNA positions…Members should be aware that this letter will try to discredit the association and limit SNA’s efforts to advocate on your behalf for any kind of flexibility under the new standards.

This inspired Nancy Huehnergarth to write an op-ed for the Hill. 

School food service directors, if you dare publicly disagree with the policy direction of the School Nutrition Association (SNA) you are in for an unpleasant surprise.  Your voice will likely be quashed…While SNA members have now been reprimanded and criticized for expressing divergent opinions through a sign-on letter, views held by SNA’s corporate sponsors seem to be welcome with open arms…Something is terribly amiss with the SNA leadership when a reasonable, respectful, member-driven request is quashed without even a discussion, while corporate sponsors are allowed to propose the association’s legislative positions. I strongly urge supportive SNA members to sign on to the open letter and ignore the intimidation tactics. The health of America’s schoolchildren, and the reputation of your organization, depends on it.

And so it does.

Remember menu labels?  We’ve had them in New York City since 2008.

In 2010, President signed national menu labeling into law as part of the Affordable Care Act.  The FDA proposed rules for labels in 2011, collected comments on the proposed rules, missed the July 3, 2014 deadline for issuing them, and by all reports sent them to the White House Office of Management and Budget last April.

• Food Labeling; Nutrition Labeling of Standard Menu Items in Restaurants and Similar Retail Food Establishments; Proposed Rule
• Food Labeling; Calorie Labeling of Articles of Food in Vending Machines; Proposed Rule

What is the holdup?  Lobbying of course.

• The delay on releasing the final rules is widely reported to be due to lobbying efforts by industry groups.  Known to have visited the White House and FDA officials are, among others, the Food Marketing Institute, Publix Super Market, Schnuck Markets, Kroger, Dominos Pizza, the Pizza Hut Franchise Association and Hungry Howies.
• The Food Marketing Institute (FMI), the National Grocers Association (NGA) and Food Industry Association Executives (FIAE) held a lobbying “fly-in” to prevent FDA’s final menu labeling rule for calorie disclosures being extended to grocery stores.
• A bill backed by the supermarket industry is the Common Sense Nutrition Disclosure Act (H.R. 1249/S. 1756) which would require menu labeling only for establishments where the majority of business is derived from restaurant-type food.

As for whether menu labels do any good:

• A CDC study reports that nearly all adults say they notice menu calorie labels, but only 57% say they use them.
• Research on the effectiveness of menu labeling has yielded mixed results and more research is needed, says a review published by the Robert Wood Johnson Foundation.
• One recent study says menu labeling has little influence on calories ordered regardless of how overweight people are.
• Menu labeling raises ethical issues related to population health and social equity, says another study.

At the moment, studies of the effects of menu labeling are restricted to laboratory models or situations in New York and other cities that passed such laws within the last few years.

More definitive research must wait for the final FDA rules and their application.

How about releasing the rules soon?  They’ve been dragging on way too long.

The FDA is taking comments on its proposals to revamp the food label through August 1, 2014 (instructions are at bottom of post).

I’ve already filed comments on Added Sugars and on whether Vitamin D should be added to food labels.

And I just filed further comments on the FDA’s proposals for the Nutrition and Supplement Facts Labels.  If you would like to read what I said, click here.

I’ve also filed comments on the FDA’s Serving Size proposals.

These proposals are highly technical and tough to slog through, so I tried to deal with the big picture.

July 27, 2014

TO:                  FDA

FROM:           Marion Nestle, Professor of Nutrition, Food Studies and Public Health, New York University

RE:                  Comments: Serving size proposals, Docket No. FDA-2004-N-0258

In addressing the question of how to change serving size designations on food labels, FDA is faced with an impossible dilemma .  Serving sizes, which are supposed to be based on amounts typically consumed from packaged products, are invariably perceived as recommendations for dietary intake.

To comment on each of the bold-face, italicized points:

• Typically consumed:  This information derives from dietary intake surveys which invariably underestimate actual intake, often by 30% to 40%.

• Packaged foods: Food labels only appear on packaged foods.  RACC amounts on packaged foods are often much lower than amounts served in restaurants or fast-food places (pizza is an obvious example).  It is unclear whether amounts reported as consumed are from packages (with Nutrition Facts labels) or are from restaurants or fast-food places where portion sizes can be much higher than those for foods in packages.

• Recommendation:  Substantial anecdotal information suggests that people view labeled serving sizes as what they should be eating.  They view the serving sizes as meaningless compared to the portion sizes of foods they are accustomed to eating.

What is well established is that overall calorie intake has increased since RACCs were established in 1993 and marketplace portion sizes have also increased.

Therefore, any increase in RACC runs the risk of being interpreted as a validation of current portion sizes and as a recommendation to eat more.

On the other hand, larger portions have more calories.  These must appear on the label.

To address this dilemma, FDA should:

• Make dual-column labeling mandatory for all food and beverage packages likely to be consumed in one sitting.
• Require total calories in the package to be displayed on the front of the package.
• Include a footnote explaining that the serving size is not meant as a recommendation

INSTRUCTIONS FOR FILING COMMENTS

The FDA provides:

• All necessary information in one place.
• A short guide and checklist

File comments here

• Nutrition and Supplement Facts Label: Docket FDA-2012-N-1210  Comment here now
• Serving Sizes: Docket FDA-2004-N-0258  Comment here now

USDA has a report out on consumers’ use of nutrition information in restaurants before the menu labeling law goes into effect.

What law?  The menu-labeling provision that is part of the Affordable Care Act still—four years later—waiting for the FDA to get around to issuing final rules (I last wrote about this in April 2013).

In 2011, the FDA proposed rules for public comment, and proposed final rules in 2013:

• Rules for restaurant menu boards
• Rules for vending machines

These too were opened for public comment with the process expected to be completed in February 2014.  Oops.  Missed that one.

Rumors are that the FDA is under pressure from pizza chains and movie theaters to be exempt from the final rules, and that the White House is holding them up.  The White House has had them for 90 days.  That’s supposed to be the limit.

According to Politico Pro Agriculture

It was three months ago today that the White House first received FDA’s final rules for calorie labels on menus and vending machines, and by the Office of Management and budget’s own rules, that means time is up. Interagency review at OMB is supposed to take no more than 90 days before the final release of a measure, though that timeframe is often extended with little explanation on more controversial initiatives. While OMB is always mum on its schedule for rule reviews and releases, the end of the standard review period is sometimes a hint that something will be coming, if not today — the day before a long weekend — then soon. In the meantime, brush up on the issue here: http://politico.pro/1mKNcFr and here: http://politico.pro/1lzZLDe

In the meantime, the USDA has done some research and come up with some interesting findings:

Among people who eat out, the ones most likely to use nutrition information on menu boards are those who:

• Eat out less frequently
• Have other healthy behaviors (such as having dark green vegetables at home).
• Rate their diets as good.
• Are women.
• Participate in SNAP.

SNAP participants?  Really?  If true, SNAP participants are more eager for calorie information than the general population, and good for them!

These results explain much about the confusing findings from studies of New York City’s menu labeling law.  These generally find no overall effect although calorie labels have a big effect on people who are conscious of health to begin with (me, for example).

FDA: how about getting out the final rules?  Then we can sit back and watch USDA economists compare what’s happening to these baseline results.