Currently browsing posts about: WHO(World Health Organization)

The World Health Organization’s Europe branch has issued a brave new report: Tackling food marketing to children in a digital world: trans-disciplinary perspectives (2016)

I say brave because marketing to children is the food industry’s line in the sand.
Food and beverage companies will not stop marketing to children because doing so will hurt their bottom lines too much.

WHO Europe makes eight recommendations, all of them highly political:

1. Acknowledge States’ duty to protect children online with statutory regulation
2. Extend offline protections online
3. Define legal age, rather than leaving commercial interests to do so
4. Define marketing directed to children
5. Draw on existing legislation, regulation and regulatory agencies
6. Compel private Internet platforms to remove marketing of foods high in saturated fat, salt and/ or free sugars
7. Develop appropriate sanction and penalty mechanisms
8. Devise cross-border international responses

The report’s conclusion:

Children’s participation in digital media should not, however, be predicated on receiving digital HFSS [high in saturated fats, salt and/or free sugars] advertising. Digital marketing can amplify the power of earlier marketing practices by identifying and targeting more vulnerable populations with sophisticated analytics and creating engaging, emotion-focused, entertaining ways to reach children.

Nor should children’s digital participation be predicated on “devolving” consent to parents, which is akin to States expecting parents to completely prohibit their children from watching all television in order to avoid HFSS marketing, rather than implementing broadcast regulations.

Instead, States and supra-national actors should devise ways to allow children to participate in the digital world without being targeted by marketers with immersive, engaging, entertaining marketing of products that have been demonstrated to be injurious to their health.

Now if governments would just listen….

Cheers to the Pan American Health Organization/World Health Organization for releasing nutritional profile standards for making it easier for governments to distinguish fresh and minimally processed foods from ultraprocessed.  The idea here is to encourage populations to consume traditional diets (see press release).

Ultra-processed foods are defined as industrially formulated food products that contain substances extracted from foods (such as casein, milk whey, and protein isolates) or substances synthesized from food constituents (such as hydrogenated oils, modified starches, and flavors). Drawing on the best scientific evidence available, the model classifies processed and ultra-processed foods and beverages as having “excessive” amounts of sugar, salt and fat according to the following criteria:

• Excessive sugar if the amount of added sugars is 10% or more of total calories
• Excessive fat if the calories from all fats are 30% or more of total calories
• Excessive saturated fat if calories from saturated fats are 10% or more of total calories
• Excessive trans fat if calories from trans fats are 1% or more of total calories
• Excessive sodium if the ratio of sodium (in milligrams) to calories (kcal) is 1:1 or higher.

PAHO’s point in setting these standards is to encourage governments to:

• Restrict the marketing of unhealthy food and beverages to children (see PAHO Plan of Action for the Prevention of Obesity in Children and Adolescents)
• Regulate school food environments (feeding programs and food and beverages sold in schools)
• Use front-of-package (FOP) warning labels
• Define taxation policies to limit consumption of unhealthy food
• Assess agricultural subsidies
• Identify foods to be provided by social programs to vulnerable groups.

Yes!

Alas, not everyone is as enthusiastic as I am about the profiles.  The International Council of Beverages Associations released this statement:

We agree that obesity is a global health challenge, and ICBA and its members welcome the opportunity to work with PAHO and other stakeholders to pursue effective and practical solutions. There are some areas, however, where we believe that use of PAHO’s Nutrient Profile Model may not provide helpful guidance to consumers.  There is not current scientific consensus in all areas that the Nutrient Profile Model addresses. It will not be useful if families find that nearly 80% of the foods and beverages in their grocery carts are unacceptable. Such a radical message is not likely to be followed by most individuals…we encourage governments and scientific bodies to offer food and dietary recommendations and national policies that are based on the totality of scientific evidence and provide realistic, positive encouragement to consumers to have a real impact promoting healthful diets and preventing obesity and non-communicable diseases.

The PAHO profiles may need tweaking, but they are a great first step.  Now let’s see how they get implemented.

The World Health Organization has issued a statement of clarification of the significance of its International Agency for Research on Cancer (IARC) report on the increased risk for colorectal cancer from eating processed and red meat (see my post on this).

The latest IARC review does not ask people to stop eating processed meats but indicates that reducing consumption of these products can reduce the risk of colorectal cancer.

Got that?

The New York Times explains the meaning of this increased risk.  To understand it, you need to know the risk of colorectal cancer among people who never eat processed or red meat.

The main problem with the public health messages put out by the W.H.O. is that the agency did a poor job of explaining what its risk-ranking system really means…it’s based only on the strength of the overall research, not on the actual danger of a specific product…Even the most strident anti-meat crusader knows that eating bacon is not as risky as smoking or asbestos exposure. Smoking raises a person’s lifetime risk of developing lung cancer by a staggering 2,500 percent. Meanwhile, two daily strips of bacon, based on the associations identified by the W.H.O., would translate to about a 6 percent lifetime risk for colon cancer, up from the 5 percent risk for people who don’t enjoy bacon or other processed meats.

My interpretation: Can processed and red meats be included in healthful diets?  Yes, of course.  But for many reasons, people and the planet would be healthier if these foods were consumed in smaller portions, less often.

Yesterday, the World Health Organization’s International Agency for Research on Cancer (IARC) issued a warning about the carcinogenic potential of processed and red meat.  This, as you might expect, caused a media flurry.  CNN News asked me for a written comment.  They titled it “The other benefit to eating less red meat.”  Here’s what I wrote:

Meat producers do not like the “eat less meat” message. Consumers do not want to give up their bacon and hamburgers — delicious and also icons of the American way of life.

But these judgments should come as no surprise to anyone. Eating less processed and red meat has been accepted dietary advice since Ancel and Margaret Keys wrote their diet book for heart disease prevention, “Eat Well and Stay Well,” in 1959. Their advice: “restrict saturated fats, the fats in beef, pork, lamb, sausages …” They aimed this advice at reducing saturated fat to prevent heart disease. Federal committees and agencies have continued issuing such heart-disease advice to the present day.

Cancer entered the picture in the 1970s, when scientists began to link red meat — beef, pork, lamb — to the risk of cancers of the colon and rectum. Even after several decades of research, they had a hard time deciding whether the culprit in meat was fat, saturated fat, protein, carcinogens induced when meat is cooked to high temperatures or some other component.

In the mid-1990s, dietary guidelines committees advised eating lean meats and limiting intake of processed meats, still because of their high fat content. By the late 1990s, cancer experts said that red meat “probably” increases the risk of colorectal cancers, and “possibly” increases the risk of cancers of the pancreas, breast, prostate and kidney. The IARC report, based on more recent evidence, makes even stronger recommendations and favors carcinogens as the causative factors.

To put this in context: For decades, the meat industry’s big public relations problem has been that vegetarians are demonstrably healthier than meat eaters. People who do not eat red meat havemuch less of a chance of developing heart disease and bowel cancers than the average American.

More recently, the 2015 Dietary Guidelines Advisory Committee (DGAC) found diets “higher in red/processed meats…” to be associated with a greater risk of colorectal cancer, and it recommended dietary patterns and low in red and/or processed meats, but higher in vegetables, fruits, legumes, whole grains, lean meats/seafood and low-fat dairy — largely, but not necessarily exclusively, plant-based.

This is good advice for anyone.

Eating less red and processed meats has two benefits: a reduced risk for certain forms of cancer,and a reduced effect on climate change.

The DGAC deemed eating less red meat to be exceptionally beneficial to the environment as well as to human health. The IARC report strengthens the health component of the recommendation. The secretaries of USDA and Health and Human Services, however, have refused to allow environmental concerns to be considered in the 2015 dietary guidelines.

I mention the dispute over environmental “sustainability” in the dietary guidelines because largely plant-based diets are appropriate for all kinds of health concerns — obesity, type 2 diabetes, coronary heart disease and now, especially, colorectal cancer — as well as environmental concerns.

By eating less red and processed meats, you promote both your own health and that of the planet.

At issue then is how much red and processed meat is compatible with good health. The IARC commission ducked that question, although it cites evidence that as little as 100 grams (a quarter pound) of red meat a day, and half that much of processed meats, increases cancer risk by 15% to 20%.

Will an occasional hamburger or piece of bacon raise your risk that much? I don’t think so. But the evidence reviewed by IARC strongly suggests that if you do eat meat, eat less when you do, don’t eat meat every day, save processed meats for rare treats and be sure to eat plenty of vegetables.

Fortunately, this advice leaves plenty of room for delicious meals — just with meat taking up much less room on the plate.

Other comments

• The Washington Post–an excellent summary (I’m quoted)
• The National Cattlemen’s Beef Association
• The  North American Meat Institute
• USA Today on the World Series (I’m quoted)
• Wall Street Journal on the IARC report (I’m quoted)
• The Atlantic on meat industry lobbying (I’m quoted)
• Fortune magazine on the decline in meat consumption (I’m quoted)
• The Academy of Nutrition and Dietetics responds
• Dr. David Katz’s excellent commentary

The WHO’s International Agency for Research on Cancer (IARC) has just published a report from 17 experts from 11 countries who concluded that glyphosate (“Roundup”) is “probably carcinogenic to humans.”

The IARC Working Group found evidence that

Case-control studies of occupational exposure in the USA, Canada, and Sweden reported increased risks for non-Hodgkin lymphoma that persisted after adjustment for other pesticides…In male CD-1 mice, glyphosate induced a positive trend in the incidence of a rare tumour, renal tubule carcinoma. A second study reported a positive trend for haemangiosarcoma in male mice.  Glyphosate increased pancreatic islet-cell adenoma in male rats in two studies. A glyphosate formulation promoted skin tumours in an initiation-promotion study in mice.

Glyphosate has been detected in the blood and urine of agricultural workers, indicating absorption. Soil microbes degrade glyphosate to aminomethylphosphoric acid (AMPA). Blood AMPA detection after poisonings suggests intestinal microbial metabolism in humans. Glyphosate and glyphosate formulations induced DNA and chromosomal damage in mammals, and in human and animal cells in vitro. One study reported increases in blood markers of chromosomal damage (micronuclei) in residents of several communities after spraying of glyphosate formulations. Bacterial mutagenesis tests were negative. Glyphosate, glyphosate formulations, and AMPA induced oxidative stress in rodents and in vitro.

Organophosphate pesticides and herbicides have long been known to be toxic to mammals, but experts have been undecided about whether they cause cancer.

Glyphosate is the herbicide used in conjunction with glyphosate-resistant genetically modified crops.  These are widely planted in the United States (HT means herbicide tolerant).

In addition to causing widespread selection of resistant weeds, glyphosate may also cause cancer.

Add this to the list of scientific reasons for concern about widespread production of GMO crops.  Roundup is used on plants other than GMOs, but GMO corn, cotton, and soybeans use the most.

Note: The FDA has just approved new varieties of GMO apples and potatoes.  These do not use Roundup.

Next: watch Monsanto, the maker of Roundup, attempt to cast doubt on IARC’s scientific judgment.

Addition, March 22:  As an example of the level of the general discussion of GMOs and glyphosate, see this short video clip from French TV (in English) with Patrick Moore.  Mr. Moore, a former director of Greenpeace, has controversial views on climate change and GMOs.

Additions, March 23:

DTN/The Progressive Farmer quotes a Biotechnology Industry Organization representative as pointing out that IARC took the Séralini study seriously, immediately casting doubt on the quality of its literature review (but I can’t find any mention of this study in the IARC report).

Center for Science in the Public Interest urges the EPA to take this seriously.

Consumer Reports is concerned about the vast amounts of glyphosate used and thinks the government should monitor it.

Dr. Yoni Freedhoff sent me Canada’s Heart and Stroke Foundation’s  new position statement on Sugar, Heart Disease, and Stroke.

Its major recommendation is just like the one from the World Health Organization:

The Heart and Stroke Foundation recommends that an individual’s total intake of free sugars not exceed 10% of total daily calorie (energy) intake,and ideally less than 5%.

The Canadian government, the Foundation says, should:

• Ensure clear and comprehensive nutrition labelling of the free sugars content in the Nutrition Facts table of all packaged foods, grouping all sugars together when listingingredients on product packaging, and standardized serving sizes on the Nutrition Facts table.
• Restrict the marketing of all foods and beverages to children.
• Educate Canadians about the risks associated with free sugars consumption through public awareness and education campaigns.

Shouldn’t we be doing that too?

As Dr. Freedhoff puts it, it’s “Amazing how forceful and sweeping public health organizations can be when they don’t need to worry about upsetting their industry partners.”

While I’m on the topic of sugars (see yesterday’s post), the World Health Organization (WHO) has just called for public comment on proposed new guidelines for intake of “free” (added) sugars:

• Added sugar intake should be less than 10% of total calories per day (50 grams for a 2000 calorie-a-day diet)
• Intake below 5% of calories would confer additional benefits (25 grams)

Although the announcement casually mentions that the draft guidelines reaffirm a previous WHO sugar guideline from 2002, it just as casually fails to mention what happened to that guideline.

I, however, have perfect recall, particularly because I wrote about these events in the Afterword to the 2013 edition of Food Politics:

In the early 2000s, the World Health Organization (WHO) began work on a global strategy to reduce risk factors for chronic disease, obesity among them. In 2003, it published a research report that advised restricting intake of “free” (added) sugars to 10% or less of daily calories. Although this percentage was similar to that embedded in the USDA’s 1992 Pyramid (7–13% of calories, depending on total intake), sugar industry groups strenuously objected, enlisted senators from sugar-growing states to pressure the DHHS secretary to withdraw funding from WHO, and induced the DHHS chief counsel to send a critique of the report to WHO that had essentially been written by industry lobbyists. When released in 2004, WHO’s Global Strategy on Diet, Physical Activity, and Health omitted any mention of the background report or the 10% sugar recommendation.

“Strenuously objected” vastly understates what happened.

Why was the sugar industry so concerned?  One 12-ounce Coke or Pepsi contains about 40 grams of sugars.  Have one, and you’ve just about done your added sugars for the day.

WHO must either think that the research basis of the 10% sugar guideline is much stronger now (see references below), or that the political landscape has shifted so far in the direction of reducing sugar intake that governments will ignore industry groups this time.

I’m not so sure.  I think WHO needs all the help it can get with this one.

Submit comments here.  Now!

References

Reports commissioned by WHO

• Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies
• Effect on caries of restricting sugars intake: Systematic review to inform WHO guidelines

What happened to the previous guideline

• Waxman A. The WHO Global Strategy on Diet, Physical Activity and Health: the controversy on sugar. Development 2004;47:75–82
• Zarocostas J. WHO waters down draft strategy on diet and health. Lancet 2004;363:1373.
• Kaiser J.  The man behind the memos.  Science 2004;305:1552-1553.

I’ve just been sent a copy of  the opening address given by the Director-General of the World Health Organization, Dr Margaret Chan, to a Global Conference on Health Promotion in Helsinki on June 10.

Here is an excerpt from her extraordinary remarks:

Today, getting people to lead healthy lifestyles and adopt healthy behaviours faces opposition from forces that are not so friendly.  Not at all.

Efforts to prevent noncommunicable [chronic] diseases go against the business interests of powerful economic operators.

In my view, this is one of the biggest challenges facing health promotion…it is not just Big Tobacco anymore.  Public health must also contend with Big Food, Big Soda,and Big Alcohol.

All of these industries fear regulation, and protect themselves by using the same tactics.

Research has documented these tactics well. They include front groups, lobbies, promises of self-regulation, lawsuits, and industry-funded research that confuses the evidence and keeps the public in doubt.

Tactics also include gifts, grants, and contributions to worthy causes that cast these industries as respectable corporate citizens in the eyes of politicians and the public.

They include arguments that place the responsibility for harm to health on individuals, and portray government actions as interference in personal liberties and free choice.

This is formidable opposition. Market power readily translates into political power…

Not one single country has managed to turn around its obesity epidemic in all age groups.  This is not a failure of individual will-power. This is a failure of political will to take on big business…

I am deeply concerned by two recent trends.

The first relates to trade agreements. Governments introducing measures to protect the health of their citizens are being taken to court, and challenged in litigation. This is dangerous.

The second is efforts by industry to shape the public health policies and strategies that affect their products. When industry is involved in policy-making, rest assured that the most effective control measures will be downplayed or left out entirely. This, too, is well documented, and dangerous.

In the view of WHO, the formulation of health policies must be protected from distortion by commercial or vested interests.

Dr. Chan was courageous to say this so clearly.  Would that our health officials would be as brave.