Currently browsing posts about: Chocolate

I’m in Mexico City doing talks for El Poder del Consumidor, the advocacy group in part responsible for Mexico’s soda tax.  I had some time to be a tourist yesterday afternoon and got to see the Diego Rivera murals at the Palacio Nacional.

These are enormous, and stunning.  They deal with the history of Mexico in conflict and in peace.  Look closely, and you see Rivera’s deep respect for Mexico’s traditional food culture.

Along the corridor flanking the main mural, for example, is a painting above a plaque listing what the world owes Mexico—corn, obviously—but also beans, tobacco (oops), chocolate, hemp, and tomatoes.

Other panels also deal with corn—in this one, production.

Another shows how corn is used.

The corner panel at the end of the corridor is devoted to chocolate.

Along the way, quieter panels display the harvest of fruits and vegetables.

Leave the Palacio, cross the Zócolo, and you come to the Coca-Cola bar and toy store.

A brief look at Mexico’s food culture, then and now.

In case you were wondering why food companies would bother to sponsor research, consider CocoaVia, a chocolate derivative.

At the New York Times’ Food for Tomorrow conference last week, Mars, Inc., gave out samples of CocoaVia cocoa extract.

Here’s the one with sweetened dark chocolate.

And here’s the health claim.

Mind you, “Promotes a healthy heart by supporting healthy blood flow” is not an FDA-approved health claim.  CocoaVia is being marketed as a dietary supplement, not a food.   The label says it’s a “daily cocoa extract supplement,” and has a Supplement Facts label rather than the Nutrition Facts label used for foods.

It’s interesting that Mars, Inc. originally marketed CocoaVia as chocolate bars.  The FDA considers candy bars to be foods, labeled with Nutrition Facts.

But by marketing CocoaVia as a supplement, Mars, Inc. can take advantage of the permissive marketing allowed by the Dietary Supplement Health and Education Act of 1994.  This act allows “structure/function” claims on supplements like the one used by CocoaVia.  By marketing CocoaVia flavanols as supplements, Mars, Inc. does not have to adhere to the FDA’s more restrictive requirements for health claims on food packages.

I’m surprised that Mars, Inc. is using the supplement route because the company has gone to a lot of trouble to establish a scientific basis for a health claim for its processed cocoa flavanols.

Is it possible that Mars, Inc. thinks the cocoa flavanol claim won’t hold up to FDA scrutiny.

Here again are the three studies funded by Mars, Inc. (I posted them as examples of industry-funded studies with results favorable to the sponsor’s interest).

1. Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial, by Daniela Mastroiacovo, Catherine Kwik-Uribe, Davide Grassi, Stefano Necozione, Angelo Raffaele, Luana Pistacchio, Roberta Righetti, Raffaella Bocale, Maria Carmela Lechiara, Carmine Marini, Claudio Ferri, and Giovambattista Desideri.  Am J Clin Nutr 2015; 101:538-548 doi:10.3945/ajcn.114.092189.

• Conclusion: These data suggest that the habitual intake of flavanols can support healthy cognitive function with age.
• Sponsor: Mars, Inc.

2.  Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Christian Heiss & Roberto Sansone & Hakima Karimi & Moritz Krabbe & Dominik Schuler & Ana Rodriguez-Mateos & Thomas Kraemer & Miriam Margherita Cortese-Krott & Gunter G. C. Kuhnle & Jeremy P. E. Spencer & Hagen Schroeter & Marc W. Merx & Malte Kelm & for the FLAVIOLA Consortium, European Union 7th Framework Program.  AGE (2015) 37: 56 DOI 10.1007/s11357-015-9794-9

• Conclusion: CF [cocoa flavanol] intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
• Funding: …Additional funding was provided by an unrestricted grant by MARS, Inc…MARS, Inc. provided the standardized test drinks used in this investigation. HS is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities.

3.  Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].

To publicize this research, Mars, Inc.

• Issued a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”
• Placed this ad in the September 27, 2015 New York Times. 

• Gave out samples to participants at the New York Times’ conference.

My interpretation: Mars, Inc. must expect to make some serious money on this supplement—more than enough to pay for all the research and marketing.

As for whether cocoa flavanols really do support healthy blood flow, or whether this is just the standard hyperbole only to be expected from supplement marketers, I’m reserving judgment until I see the results of independently funded studies.

Sunday’s New York Times carried this full-page advertisement.

The ad is from Cocoa Via, a company owned by Mars.  It quotes a dietitian stating that cocoa flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”

The ad directs you to the full story at nytinmes.com/cocoavia (where you see more ads).

I posted the science behind this ad earlier this month in my collection of industry-funded studies with results favorable to the sponsor’s interests.  To repeat:

Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
• Comment: Lest the “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”

Now we have a full-page ad in the New York Times.

Here’s what the ad does not say:

• CocoaVia is owned by MARS, Inc (this appears nowhere in the ad).
• Flavanols are usually destroyed during normal cocoa processing.
• Most chocolate contains few flavanols; CocoaVia’s process preserves some of the flavonols in very dark chocolate.
• Flavonol-rich or not, chocolate candy is not a health food.

Like most conflicted research, this is about marketing—hence, the ad—not science.

Here’s the latest collection of 5 studies funded by food companies or trade associations, all with results that favor the sponsor’s interests.  I’ve just reviewed them and found a couple of duplicates, so this is a corrected score.  The correct score is 55 industry-funded studies with positive results vs. 3 with results unfavorable to industry—since mid-March.

I’m particularly interested in the unfavorable category.  If you run across any, please send.

Jejunal Casein Feeding Is Followed by More Rapid Protein Digestion and Amino Acid Absorption When Compared with Gastric Feeding in Healthy Young Men. Joanna Luttikhold, Klaske van Norren, Nikki Buijs, Marjolein Ankersmit, Annemieke C Heijboer, Jeannette Gootjes, Herman Rijna, Paul AM van Leeuwen, and Luc JC van Loon. J. Nutr. 2015; 145:2033-2038 doi:10.3945/jn.115.211615.

• Conclusions: Jejunal feeding of intact casein is followed by more rapid protein digestion and AA absorption when compared with gastric feeding in healthy young men. The greater postprandial increase in circulating EAA concentrations may allow a more robust increase in muscle protein synthesis rate after jejunal vs. gastric casein feeding.
• Funding: Supported by Nutricia Research, Utrecht, Netherlands. J Luttikhold was employed by Nutricia Research; K van Norren is a guest employee of Nutricia Research; and LJC van Loon has served as a consultant for Nutricia Research.  [Note: Nutricia Research is a subsidiary of Danone].

Higher Total Protein Intake and Change in Total Protein Intake Affect Body Composition but Not Metabolic Syndrome Indexes in Middle-Aged Overweight and Obese Adults Who Perform Resistance and Aerobic Exercise for 36 Weeks. Wayne W Campbell, Jung Eun Kim, Akua F Amankwaah, Susannah L Gordon, and Eileen M Weinheimer-Haus. J. Nutr. 2015; 145:2076-2083 doi:10.3945/jn.115.213595.

• Conclusions: In conjunction with exercise training, higher TPro [total protein] promoted positive changes in BC [body composition] but not in MetS [metabolic syndrome] indexes in overweight and obese middle-aged adults. Changes in TPro from before to during the intervention also influenced BC responses and should be considered in future research when different TPro is achieved via diet or supplements.
• Funding:  Supported by the US Whey Protein Research Consortium (to WWC) among others.  WW Campbell was a member of the National Dairy Council Whey Protein Advisory Panel while the research was being conducted.

Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management.  France Bellisle.  Current Obesity Reports March 2015, Volume 4, Issue 1, pp 106-110 10.1007/s13679-014-0133-8

• Conclusion: While many of the existing studies cannot identify any causal links between use of LES [artificial, low-energy sweeteners] and appetite for sweetness, randomized trials in children and adults suggest that use of LES tends to reduce rather than increase the intake of sugar-containing foods and to facilitate, rather than impair, weight loss.
• Conflict: Parts of [this study] are extracted from a non-published document for which the author received an honorarium from the International Sweeteners Association (ISA).  France Bellisle is a member of the Scientific Advisory Board for General Mills and has received travel reimbursement and honoraria for contributions in scientific congresses from Mondelez, ISA, and General Mills.

Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Christian Heiss & Roberto Sansone & Hakima Karimi & Moritz Krabbe & Dominik Schuler & Ana Rodriguez-Mateos & Thomas Kraemer & Miriam Margherita Cortese-Krott & Gunter G. C. Kuhnle & Jeremy P. E. Spencer & Hagen Schroeter & Marc W. Merx & Malte Kelm & for the FLAVIOLA Consortium, European Union 7th Framework Program.  AGE (2015) 37: 56 DOI 10.1007/s11357-015-9794-9

• Conclusion: CF [cocoa flavanol] intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
• Funding: …Additional funding was provided by an unrestricted grant by MARS, Inc…MARS, Inc. provided the standardized test drinks used in this investigation. HS is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities.

Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
• Comment: Lest the implicit (but never stated directly) “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”

Ebola is much in the news, and for good reason.  It is highly contagious, difficult to contain, and deadly.

In food studies, we say that food is a lens through which to view the most important problems of society.  Here are some thoughts on the food politics of Ebola.

Dietary Supplements for Ebola Prevention or Treatment

The Council for Responsible Nutrition, the trade association for supplement manufacturers, has found it necessary to issue an advisory on use of dietary supplements to prevent or treat Ebola infections.

The American Herbal Products Association (AHPA), the Consumer Healthcare Products Association (CHPA), the Council for Responsible Nutrition (CRN), the Natural Products Association (NPA), and the United Natural Products Alliance (UNPA) are therefore endorsing the following unified advisory for marketers and retailers, as well as for consumers of dietary supplements:

• Marketers and retailers of dietary supplements are urged to refuse to stock or sell any supplements that are presented as treating or curing Ebola virus disease, or preventing Ebola virus infection.
• Marketers and retailers should refrain from promoting any dietary supplement as a cure or treatment for Ebola virus disease.
• Anyone who believes they may have Ebola virus disease or may have come in contact with the Ebola virus should contact a healthcare professional immediately. The Centers for Disease Control and Prevention has more information on Ebola virus disease and the proper actions to take if you suspect you are ill.

The knowledge that no known treatment exists for Ebola has not stopped supplement manufacturers from advertising the benefits of their products for this infection.

FDA Warning Letters

The FDA has stepped in and issued warning letters to three manufacturers marketing their products as possible treatments or cures.  The FDA letters, which make interesting reading, went to:

• Natural Solutions Foundation
•  Young Living
• dōTERRA International LLC

Marketing of Nutritional Supplements

A simple Google search of “supplements Ebola” turned up this kind of information this morning:

The Ebola virus can be destroyed naturally – despite what you’ve been told To date, not a single virus has been tested that is not inactivated (killed) by a large enough dose of vitamin C (ascorbic acid). Many other antioxidants have similar virucidal effects, but vitamin C appears uniquely to be of greatest potency and clinical efficacy, as its simple chemical structure allows for it to be disseminated throughout the body with little restriction… Vitamin C is both very potent and optimally bioavailable in accessing any viral infection.

And this:

The substances in the Natural Allopathic protocol for Ebola offer a power unequalled in the world of medicine that we can harness to save many lives of people infected with Ebola…. Magnesium salts, sodium bicarbonate (baking soda), iodine, selenium and vitamin C are concentrated nutritional medicinals that have been used in the direst of medical circumstances…The core of the Natural Allopathic protocol redefines the way emergency room and intensive care should be practiced on Ebola patients with proven fast-acting, safe, concentrated and mostly injectable nutritional medicines. If the Ebola infection truly gets out of hand, it is comforting for parents to know that they can legally administer these same medicinals if infected people are treated at home. All of the Natural Allopathic Medicines can be also taken orally or used transdermally (topically) to almost the same effect if treatment is started early enough.

How Can Supplement Makers Do This?

The ability of supplement manufacturers to claim health benefits for their products, and mostly get away with it, is a result of congressional action in passing the Dietary Supplement Health and Education Act of 1994 (DSHEA), which essentially deregulated these products.

Twenty years later, the supplement industry is deeply divided between responsible and irresponsible manufacturers, both allowed by law.

As the president and CEO of one supplement company puts it,

The industry of 1994, roughly $8 billion in sales, has experienced compounded double-digit growth every year since DSHEA became law…DSHEA opened the door to growth, innovation, new science, new discovery and a nation of wanting consumers enchanted with the thought that there are natural solutions to their individual health needs…20 years later, it’s time to take a hard look at what DSHEA doesn’t provide to the industry today. The barrier to entry into this industry continues to have no hurdles; DSHEA does not define the boundaries of consumer trust… The generations of today, and the generations of tomorrow will demand transparency, they will demand efficacy, and they will demand quality and safety from all of us.

Clearly, they aren’t getting that now.

Other Connections to Food Politics

Chocolate

Politico writes:

EBOLA THREATENS WORLD’S CHOCOLATE SUPPLY:  Ivory Coast, the world’s largest producer of cacao, the raw ingredient in M&Ms, Butterfingers and Snickers Bars, has shut down its borders with Liberia and Guinea, putting a major crimp on the workforce needed to pick the beans that end up in chocolate bars and other treats just as the harvest season begins… the outbreak already could raise prices…Prices on cocoa futures jumped from their normal trading range of $2,000 to $2,700 per ton, to as high as $3,400 in September over concerns about the spread of Ebola to Côte D’Ivoire.

Food safety

Food safety lawyer Bill Marler points out that Ebola started out as a foodborne illness.    Its most likely source was infected bushmeat that transferred the virus to human handlers.

Following standard food safety procedures is always a good idea while hoping that health officials get this epidemic under control.

The FDA is collecting opinions on a dairy industry petition to change the standard of identity for milk.  The dairy industry wants to be able to add artificial sweeteners to chocolate- and strawberry-flavored milk without saying so on the front panel of the package.

Why is the dairy industry doing this?  Because it believes that:

Labels such as “reduced calorie” or “no added sugar” are a turn-off to kids who might otherwise reach for flavored milk with non-nutritive (artificial) sweeteners at the school cafeteria or from the grocery store cooler.

As if kids should be reaching for milk with artificial sweeteners.  

The FDA wants to hear from YOU about this.  It wants your comments on these questions (my translation):

• If the label just says Chocolate Milk, will consumers understand that the milk is artificially sweetened?
• Are descriptions like “reduced calorie” really unattractive to children?
• Will it be hard for consumers to figure out whether a product contains sugar or an artificial sweetener?

Go to www.regulations.gov. Search for docket number FDA-2009-P-0147. 

Nutrifluff is my word for sensational research findings based on one, usually highly preliminary, study.

The best nutrifluff I’ve seen in ages is this article in the august New England Journal of Medicine: “Chocolate Consumption, Cognitive Function, and Nobel Laureates.”

The author counted the number of Nobel laureates per capita from Wikipedia and and computed the number for every 10 million people. 

He obtained data on per capita yearly chocolate consumption in 22 countries from several sources and ran the correlation.

Bingo!  Chocolate consumption correlates with the number of Nobel prize winners.

Correlation, alas, is not causation, but who cares?

Everybody loves chocolate.  Enjoy! (In moderation, of course).

I consider the results of studies showing remarkable health benefits attributed to single foods or single nutrients to be “nutrifluff”—fun, but not necessarily meaningful unless you are eating a healthy diet anyway.

Here are four recent examples:

Dark chocolate reduces heart disease risk: Everybody loves this one—an excuse to eat chocolate (but only the dark, bitter kind, alas).  This comes from a Cochrane meta-analysis of studies on the role of flavonols in blood pressure.  It concludes that chocolate eating is associated with a small reduction in blood pressure of 2 to 3 mm Hg—but only in short-term trials.  How many of the studies were sponsored by chocolate companies?  The report doesn’t say.

Apple peel extracts reduce blood pressure: Apples also have flavonols.  These were test-tube studies.  Note: Eating fruits and vegetables in general is associated with lower blood pressure.

Walnuts boost semen quality: Here’s a fun one.  Eat 75 grams of walnuts a day, and you improve your sperm vitality, motility, and morphology, at least if you are age 21 to 35 (and male).  This one was sponsored by the California Walnut Commission.  One report on this study has the best title ever: “Nuts for your nuts.”

Goji berries promote immune function in the elderly: This one, done by researchers working for Nestlé  (no relation), tested daily supplements of “lacto-wolfberry” on immune responses to influenza vaccine.  I’m assuming Nestlé must be planning to market this supplement.

What does all this tell us?  These kinds of studies confirm that eating fruits and vegetables is good for health (I think we might have known that already).

But the main (perhaps only) reason for doing such studies is for marketing purposes, which is why food companies sponsor them.