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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.

I still quaintly read the paper copy of the New York Times so I know that the left column of yesterday’s  front page—judged by the editors as the second most important story of the day—was devoted to yet another exposé of supplement fraud.

The New York State attorney general did some sophisticated testing.  His report concludes that major supplement retailers—GNC, Target, Walgreens and Walmart—are selling herbal supplements that do not contain what the labels say they contain or contain unlabeled ingredients that could be allergenic.

The examples are either amusing or shocking, depending on point of view:

• A popular store brand of ginseng pills at Walgreens, promoted for “physical endurance and vitality”…contained only powdered garlic and rice.
• At Walmart…ginkgo biloba, a Chinese plant promoted as a memory enhancer, contained little more than powdered radish, houseplants and wheat — despite a claim on the label that the product was wheat- and gluten-free.
• Three out of six herbal products at Target — ginkgo biloba, St. John’s wort and valerian root, a sleep aid — tested negative for the herbs on their labels. But they did contain powdered rice, beans, peas and wild carrots.
• And at GNC…it found pills with unlisted ingredients used as fillers, like powdered legumes, the class of plants that includes peanuts and soybeans, a hazard for people with allergies.

I’ve been writing about this kind of thing for years, but two aspects of this story are news.

• First, the state is doing what the FDA ought to be doing if its hands weren’t tied by DSHEA, the Dietary Supplement Health and Education Act of 1994.  That act essentially deregulated dietary supplements.
• Second, these are not some fly-by-night supplement sellers.  They are major retailers.  The supplement industry’s argument that only a few unscrupulous small supplement makers are cheating on ingredients doesn’t work in this case.

Why don’t people stop taking supplements when they hear things like this?

The major proven benefits of supplements are their placebo effects.  The actual ingredients make no difference.

The obvious conclusion is that if you must buy supplements, buy the cheapest ones.  But that doesn’t work either because more expensive supplements produce stronger placebo effects.

Placebo effects are great things, and I’m for them.  But caveat emptor.

Related documents

• The 2013 New York Times article that led to all this
• The attorney general’s cease-and-desist letters
• What’s in those supplements?
• Letters Outlining What Was Found in Herbal Supplements

It may be the season to be jolly, but not with prepackaged commercial caramel apples.  They may be contaminated with potentially fatal Listeria.  Not good.

The CDC says:

Out of an abundance of caution, CDC recommends that U.S. consumers do not eat any commercially produced, prepackaged caramel apples, including plain caramel apples as well as those containing nuts, sprinkles, chocolate, or other toppings, until more specific guidance can be provided.

As of December 18, 2014, a total of 28 people have been reported as infected with the outbreak strains of Listeria monocytogenes.

• Five people have died–from eating caramel apples.
• 26 have been hospitalized, in 10 states.
• Nine cases are in a pregnant woman or her newborn infant.
• Three children have meningitis.
• 83% of the 18 ill people said they ate commercially produced, prepackaged caramel apples.
• None of the 18 ill people said they ate plain apples, or plain caramel candy.

Here’s the Epi chart of reported cases:

Food safety attorney Bill Marler checked FDA records for previous recalls of apples potentially contaminated with Listeria.  His list:

• December 11, 2014 – Giant Eagle issued a recall of Giant Eagle Apple Pistachio Salad and Apple Pistachio Salad with Chicken due to potential Listeria monocytogenes contamination. To date, Giant Eagle has received no reports of customer illnesses associated with this recall.
• November 14, 2013 – Crunch Pak® of Cashmere, Washington is voluntarily recalling 5,471 cases of Crunch Pak® Apple Slices due to a possible health risk from Listeria monocytogenes.
• November 7, 2013 – Garden-Fresh Foods has initiated an expansion of previous recalls of fresh ct vegetables, ready-to eat salads, slaws, dips and spreads.
• December 8, 2012 – Freshway Foods is voluntarily recalling 6,671 pounds of sliced apples.
• August 10, 2012 – Missa Bay, LLC, a wholly owned subsidiary of Ready Pac Foods, Inc., of Swedesboro, New Jersey is voluntarily recalling a total of 293,488 cases and 296,224 individually distributed units of fruit, vegetable, and sandwich products containing apples.
• August 6, 2012 – Reichel Foods, Inc. of Rochester, Minnesota is voluntarily recalling a limited amount of Dippin’ Stix Sliced Apples & Caramel with Peanuts.

The moral: when it comes to food safety, no food source is sacred.

Add this to your list of food safety hazards to avoid.

Have a food-safe holiday season!

Former USDA Secretary Dan Glickman has just been named chairman of the board of the Foundation for Food and Agriculture Research (FFAR).

Research on agriculture has long been the underfunded stepchild of the federal research enterprise.  The 2014 budget gave USDA under $3 billion in total to fund all of its in-house research units and their granting operations: Agricultural Research Service, National Institute of Food and Agriculture, Economic Research Service, and Agricultural Statistics Service.

This may seem like a lot, but NIH gets $30 billion a year.

The 2014 farm bill contained a provision aimed at raising money for agricultural research.  It provided $200 million (peanuts in federal dollars) to establish FFAR, which will operate as a non-profit corporation to obtain matching funds from private industry.

The members of the board were announced a couple of weeks ago.

It should be no surprise that many of the board members represent industry.  Industry nominated 7 of the members.  The other 8 were selected from a list provided by the National Academy of Sciences.

Now the board has to raise at least $200 million from industry, presumably with no strings attached.

Here’s the foundation’s dilemma: if industry funding has no strings—earmarks for certain research projects, for example—why would industry want to contribute?  But if the contributions do come with strings, they create conflicts of interest.

This will be fun to watch.  Stay tuned.

A reader writes:

Willingboro, NJ School Board has taken action effective for the 2013-2014 school year to discard a school meal rather than feed a student, if their parents cannot, or haven’t arranged to, refill their student’s lunch account.

Take a look at this letter from the school board administrator announcing discontinuation of humanitarian meals:

If a student goes through the food service line and it is discovered that the student does not have the required funds for a meal, the Chartwells Food Service representative has been instructed by the Willingboro Board of Education to withhold the meal from the student, with the understanding that such meal cannot be re-served and must be discarded.

I was appalled by the letter.  Hungry kids need to be fed.  They can’t learn if they are hungry.

But before going on a rant, I consulted my go-to, school-food guru, Kate Adamick of Cook for America.  She explains the fiscal realities of current school-food policies:

The truth is that there are many, many school districts that do not feed kids whose parent will not pay for them.  Some, as seems to be the prior practice of the Willingboro district, offer a “humanitarian” meal (typically, a peanut butter sandwich and a carton of milk), though that is by no means required of them and by no means universal.

Of course, students who qualify for free meals under the USDA regulations cannot be refused free school meals (provided that the proper paperwork has been filled out on their behalf or that they qualify under other regulatory or statutory provisions).

The refusal to feed everyone, regardless of whether they pay, has become a more pressing issue in recent years, both because the number of families who don’t qualify for free meals but can’t afford to pay for them has increased at the same time the school food budgets have become tighter…Many school districts are truly struggling to keep their financial heads above water….

The REAL answer is for the federal government to provide free meals for all kids.  I doubt, however, that will come to pass in our lifetime.

Here’s how this system works:

• Unlike other aspects of school education, the government requires school-meals programs to be self-supporting.  They must at least break even or do better, which is not so easy given current reimbursement rates.
• The government reimburses schools for federally supported school meals based on the number of participants.
• Parents often cannot or do not want to fill out the paperwork.
• This leaves schools with a dilemma.  If they provide free meals, they lose money.

Some school districts, like the one in New York City, do everything they can to make the system work so that hungry kids get fed.   Willingboro’s school board has chosen to follow the rules to the letter, regardless of the effects of this decision on kids in its schools.

Universal school meals would solve many of the problems caused by current school food policies (for evidence, see Janet Poppendieck’s Free for All: Fixing School Food in America).

Ready to join the universal school meals movement, anyone?

Ordinarily, writing about bills introduced and passed in either the House or the Senate isn’t worth the trouble because they are so likely to be changed later on in the legislative process.

But this one is over the top.  House Republicans, joined by not one Democrat, passed H.R. 2642 — New Federal Agriculture Reform and Risk Management Act of 2013 — its version of the farm bill yesterday.  The shocker?  For the first time since the 1970’s, the farm bill is not linked to food stamps (SNAP), thereby breaking the deal between urban and rural America.

This bill now has to be reconciled with the one passed by the Senate last year, which does include food stamps.  This seems unlikely.  The President has already said he won’t sign it (see the Obama administration’s statement of policy on H.R. 2642).

So this is about politics, not governing the country.

The House bill:

• Repeals the 1938 and 1949 permanent farm laws
• Makes Title I — the commodity title — permanent law, if the bill can make it through conference and get President Barack Obama’s signature.
• Allows virtually unlimited crop insurance subsidies and price guarantees.
• Maintains the highly unpopular (with sugar users) sugar tariff program.
• Authorizes about $200 billion to pay for all this over ten years.
• Saves $12 billion over 10 years, according to the Congressional Budget Office’s estimate (much less than the House claims).
• Expands subsidies for crop insurance to cotton, rice, peanuts, and vegetables (well, at least that)
• And, according to the New York Times, requires additional economic and scientific analyses before putting food safety laws into effect.

House Republicans know this bill isn’t going any further.  Hence: politics.  Their purpose?  Leaving food stamps vulnerable to severe restrictions and budget cutting.

Joel Berg of the New York City Coalition Against Hunger issued this statement:

Today’s vote is the latest smoking gun that the House Majority isn’t truly interested in deficit reduction, they’re interested in supporting special interest groups over hungry Americans. The Farm Bill passed by the House of Representatives today is a disgrace and an embarrassment to the American people…Recent Farm Bills have represented the worst of American politics. It’s time to pass a Farm Bill that represents the best.

Good luck with that.

Addition, July 13: Gail Collins’ column in the Times on this fiasco is the best I’ve seen.

So the farm bill got divided…As Ron Nixon reported in The Times, the rate of error and fraud in the agricultural crop insurance program is significantly higher than in the food stamp program. Also, the agriculture part has a lot of eyebrow-raising provisions, like the $147 million a year in reparations we send to Brazil to make up for the fact that it won a World Trade Organization complaint about the market-distorting effects of our cotton subsidies.

And while food stamps go to poor people, most of the farm aid goes to wealthy corporations.

Addition, July 16: I forgot to post the New York Times editorial on the topic.

Now that coalition has been sundered, and the future of food stamps is threatened. If the program is not returned to the five-year farm bill, it will have to be financed through annual appropriations, which puts it at the mercy of the Republicans’ usual debt-ceiling stunts and government shutdown threats. House leaders said they would submit a food stamp bill “later,” but that will probably include the right wing’s savage cuts andunprecedented incentives for states to shut out poor families. Neither will get past the Senate or the White House.

My monthly, first Sunday, food matters column for the San Francisco Chronicle:

Q: I read that the new farm bill is going to establish a checkoff program for organics. What’s that? Is this good for organics?

A: As with everything in food politics, the answer depends on who you are. If you are a big producer of organic foods, it’s good news. If you are small, it may cost you more than it’s worth. And if all you want is to buy organic foods at a price you can afford, it could go either way.

Let’s start with the farm bill, which still has many hurdles to jump before it gets passed. The bill ties agricultural policy to food stamps (which take up 80 percent of the budget), favors large industrial farms over small, and only occasionally tosses in a token program to promote public health or environmental protection.

One such token is the organic checkoff. Both the Senate and House have amended the farm bill to permit organic producers and handlers to form a marketing and promotion program, commonly known as a checkoff.

Fee required

The way this works is that if the amendments survive, the bill passes and organic growers agree on the program – all iffy at the moment – the Department of Agriculture will require every producer and handler of certified organic foods to pay a fee per unit sale (the checkoff). The fees go into a common fund to be used for research and marketing of organic foods in general.

The USDA currently administers 19 checkoff programs. The best known are beef (“it’s what’s for dinner”), milk (“got milk?”) and eggs (“the incredible edible”). Others cover foods such as blueberries, Hass avocados, mangos, peanuts, popcorn and watermelon.

In these cases, the industry or its representatives voted for the programs. They are administered by the USDA but the industry pays for them.

Checkoff funds are allowed to be used for advertising, consumer education, foreign market development and research. They cannot be used for lobbying, although the distinction between promoting a product to consumers and extolling its virtues to lawmakers can be subtle.

The Organic Trade Association, which represents hundreds of organic producers but is dominated by the big ones, has lobbied for this program since 2010. The association is concerned that consumers cannot currently tell the difference between “natural,” a term that is unregulated, and “certified organic,” which is highly regulated, requires inspection and is more expensive to produce.

Mostly, the association wants to increase market share. Sales of organic foods in the United States have been growing by about 10 percent annually and reached $35 billion last year, but this amount is minuscule in comparison to total food sales. The growth potential of organic foods is enormous.

The congressional go-ahead is a triumph for the association, which convinced a majority of the Senate and House that the public wants the farm bill to support organics.

Opposing viewpoint

That many producers of conventional foods and their friends in Congress do not like organics is an understatement. They resent that consumers are willing to pay premium prices for organics. They consider organics to be a slap in the face – a personal assault on conventional agricultural practices.

They cite many reasons why the organic checkoff should not be allowed. For one thing, it is distinctly different from all other commodity checkoff programs – “organic” is a production process, not a food.

Because farmers are allowed to pay fees into only one checkoff program, the growers of organic blueberries would have to choose between the one for organics and the one for blueberries.

Questioning the cost

Critics of the entire concept of checkoff programs say all they do is increase food prices by passing the costs of promotion on to consumers.

Small organic producers and handlers are also leery. They object to having to pay fees for something that is not guaranteed to do them any good. Evidence for the benefits of checkoff programs is mixed. Some farmers benefit, while others do not.

And because checkoff funds are not allowed to be used for advertising that implies disparagement of other foods or production processes, small organic producers fear that marketing will focus exclusively on whether or not a product is certified and will be used to promote any organic product, including junk food. The rules will not allow promotion to focus on the benefits of organics to health or the environment.

Checkoffs are about marketing. They are not about health, sustainability, human welfare or any other value cherished by today’s food movement. Much as I favor organic over conventional production methods, I’m hoping organic producers will think carefully before approving a checkoff.

My NYU Food Policy class meets tonight and we’ll be talking about the farm bill and Dan Imhoff’s most helpful book Food Fight: The Citizens’ Guide to the Next Food and Farm Bill.

To review what’s up with the 2012 farm bill:

Congress updates farm bills every five years or so.  It passed the last one in 2008, with an expiration date at midnight on September 30, 2012.  This was the first time Congress ever set an expiration date to land in the midst of a presidential election.  This was asking for trouble.  Congress is paralyzed in election years.

That date has now come and gone.

But in June 2011, the Senate passed its version of the bill: The Agriculture Reform, Food and Jobs Act of 2012.

The House, however, was unable to come to agreement on its version: The Federal Agriculture Reform and Risk Management Act of 2012.

Why?  Election-year politics and disagreements about whether and by how much the SNAP (food stamps) budget should be cut.  More than 80% of farm bill spending goes to SNAP benefits—a whopping $72 billion last year–making it a prime target for budget cutting.

This situation puts us in farm bill limbo.

The significance of limbo is best explained by the National Sustainable Agriculture Coalition (NSAC).

• Without a new farm bill, commodity (corn, soybean, etc) support programs revert to permanent law contained in the farm bills passed in 1938 and 1949.  Why?  Because unlike subsequent bills, these did not have expiration dates.
• The old laws reintroduce much higher support prices (through certain loans instead of payments), require much smaller crop production, and lead to much higher consumer prices.  They do not include  support for soybeans, other oilseeds, peanuts, or sugar, making them woefully out of date.
• Limbo has no effect on SNAP or crop insurance.  Congress covered SNAP with a resolution for continued funding through March 2013.  The Federal Crop Insurance Act effectively authorizes crop insurance permanently.
• Dairy programs are in turmoil.  Milk payments to farmers ended in September.  The dairy price support program ends on January 1.   Under the 1949 law, government-supported prices would be about four times higher than current law and about twice as high as current market prices.
• The Agricultural Appropriations Act extended some—but not all—conservation programs through 2014.
• The permanent law does not support the hard-won programs that encourage fruit and vegetable production: organic, farmers’ market, beginning farmer, socially disadvantaged farmer, or specialty crop programs.  These now have no funding.

This leaves Congress with three options between now and January:

• Finish the current process and pass a bill (unlikely since it only has a few weeks to do this)
• Vote to extend provisions through the 2013 crop year, or
• Start from scratch all over again in a much tighter budget environment—the infamous “fiscal cliff.”

As NSAC explains:

The farm bill is the nation’s major food and agricultural policy vehicle and is about much more than the big ticket items: food stamps, crop insurance, and commodity support.  The farm bill is also about conservation and environmental protection, rural economic and community development, food system reform and agricultural research.

With no new farm bill or extension, the programs that address rural and urban job creation, natural resource conservation, renewable energy, and improved production and access to healthy food are in big trouble.

This is a big mess, and a serious result of dysfunctional government.  It will be interesting spectator sport to see how Congress handles it.

Will Congress find a way to bring agricultural policy in line with health policy?

Or will Congress simply do whatever is most expedient, given the budgetary mess it has also created.

It’s too bad so much is at stake.