Search results: Immunity

A reader, Philly Nassau, sent me the ingredient list of several “immune-boosting” supplements, in quotes because I am a supplement skeptic in general, and of immune supplements in particular (I favor eating healthfully and staying active).

Immune supplements claim to be “Nootropics and Brain Supplement for Memory, Brain Support, Clarity, Focus, Mood Boost, Anti Anxiety & Stress Relief.”  Nootropics?  These are defined as drugs or supplements capable of enhancing memory, concentration, or other cognitive functions and of preventing cognitive decline.  How I wish.

But first, the science.

• Gut-microbiota-targeted diets modulate human immune status.  “The data highlight how coupling dietary interventions to deep and longitudinal immune and microbiome profiling can provide individualized and population-wide insight. Fermented foods may be valuable in countering the decreased microbiome diversity and increased inflammation pervasive in industrialized society.”
• The Stanford press release on this paper. A fermented-food diet increases microbiome diversity and lowers inflammation, Stanford study finds.  Stanford researchers discover that a 10-week diet high in fermented foods boosts microbiome diversity and improves immune responses.
• The New York Times account: How Fermented Foods May Alter Your Microbiome and Improve Your Health.  Foods like yogurt, kimchi, sauerkraut and kombucha increased the diversity of gut microbes and led to lower levels of inflammation.

Beyond eating healthfully and including fermented foods in the diet, here’s what’s being said about diet and immunity.

• Immune health is a marketing opportunity: Given current events, it’s likely that there has been no greater focus on immune health amongst consumers than right now. The market opportunity in this space is staggering, with immunity supplements showing an explosive 72.3% growth in 2020.
• Euromonitor Immunity Report: How to appeal to the holistic health shopper:  As consumers search for holistic and natural ways to improve their immunity, Euromonitor has published a new white paper examining how brands can appeal in a competitive and confusing market…. Read more
• Is immunity really the top functional choice for consumers in a pandemic era?  It sounds pretty logical – the pandemic has prompted increased interest in immunity across F&B. But is it really top dog in the world of functional beverages – or are there other claims consumers are more interested in?… Read more
• Parents are looking for immune-boosting options for school kids. Grocery retailers and packaged food and beverage brands should brace for another significant shift in consumer shopping habits this month as many families with students returning to in-person school after a year or more of distance or hybrid learning look for more on-the-go, budget-conscious and immune-boosting breakfast and lunch solutions.
• Immunity in a glass: Orange juice bioactives may bolster immunity and reduce inflammation:  The micronutrients and other bioactives contained in a glass of orange juice is sufficient enough to shore up the immune response and tackle oxidative stress and inflammation, a review concludes…. Read more  
• Beyond immunity: What ‘superpowers’ do today’s consumers want from their beverages?  The pandemic has propelled immunity to the top of the functional beverage agenda. But that doesn’t mean interest in other functional beverages has disappeared. We ask the experts what trends are bubbling away beneath the pandemic headlines – and will become all the more important to everyday heros in the coming years…. Read more  
• Shiitake happens: Mushrooms to play key role in immunity nutrition and health, concludes report:  Concerns over immune health and the pandemic has thrust the humble mushroom into the spotlight as experts hail the fungi’s ability to interact with gut microbes that influence healthy immune and inflammatory responses…. Read more  

The FTC has imposed new advertising restrictions on Kellogg because of the Immunity claim on Rice Krispies.  The company is not to make claims about “any health benefit of any food  unless the claims are backed by scientific evidence and not misleading.”

Under a previous order dealing with Frosted Mini-Wheats, Kellogg was not supposed to make claims about benefits to cognition on any of its cereals or snack foods unless the company could prove that the claims were backed by real science. This new decision extends that ruling to include any claim at all.

OK, but I’m confused about several aspects of this decision:

• How come the FTC is doing this and not the FDA?  At some point years ago, regulatory responsibility was split between FDA and FTC.  Since then, the FDA regulates claims on food package labels, whereas the FTC regulates advertising claims.  I realize that food labels are a form of advertising, but it’s unusual and surprising for the FTC to get involved in FDA-regulated matters.
• As FoodNavigator also wonders, why didn’t the FTC fine the company and, instead, write a harsh letter? [see update below]
• Why is the FTC doing this?  Kellogg agreed months ago to withdraw its Immunity claim ( see my November 5 post about the withdrawal).  The Immunity boxes gradually disappeared from supermarket shelves and I haven’t seen one for a long time.

So what’s going on here?  Is the FTC getting serious about regulation (and about time, too)?  Or is FDA sitting back and letting the FTC do its enforcement work?

Could this be why the FDA hasn’t sent a warning letter to Mead-Johnson, the maker of the chocolate toddler formula with three health claims aimed at kids ages 1 to 3.  I posted about this product on April 26, but haven’t heard whether the FDA is doing anything about it.  Can the FTC be on this case but waiting for investigations to be completed before taking action?

Kellogg, it seems, is under fire on all fronts.  CSPI’s Margo Wootan sent me the recent decision by the Children’s Advertising Review Unit of the Better Business Bureau that Kellogg must stop advertising Pop-Tarts to kids:

CARU was concerned that the product packaging, which features berries and states “Made with Real Fruit” for several of Kellogg’s Pop-Tarts®  products that have fruit in their names, impliedly represents to children that the products contain substantial amounts of fruit.

In fact, according to CARU, Pop-Tarts contain less than 6% fruit and less than 2% of the fruit shown in the advertising. Kellogg claimed that its marketing was not aimed at kids, but lost that one.

It’s great that regulatory agencies like FTC and FDA (and voluntary agencies like CARU) are regulating but it’s hard to keep track of who is doing what.   Nothing to do but wait and see what happens next.  Stay tuned.

Update, June 8: CSPI’s Margo Wootan writes that FTC can’t impose fines because it does not have the authority to issue civil penalties.  Ted Mermin of Public Good Law concurs.  He says:

Companies fight hard to make FTC (and similar) orders as narrow as possible, in large part to avoid precisely the situation in which they are held responsible for violating an existing injunction/order.  Since (in the Commission’s view, at least) Kellogg hadn’t violated an existing order, the FTC did not have the authority to fine them without first going to the US Department of Justice to get DOJ to take the case (a matter of a 45 day delay, if DOJ takes it at all).  The burden of that delay (and of needing to get authority from DOJ in the first place) is precisely what is driving the congressional charge for enhanced FTC authority as part of the financial reform legislation.

If the House version of financial reform legislation had been in effect, the FTC would have had the authority to seek civil penalties (i.e., fines) and the outcome here might have been different.  As it was, the fact that Kellogg had stopped the practice…kept the Commission (at least the three commissioners in the “majority”) from focusing on any remedy other than injunctive relief–that is, a broadening of the existing order from the Mini-Wheats case, with the threat of that $16,000 per violation (and an expanded area of prohibited activity) running into the future.

Update, June 11: In an editorial titled “Snake oil for breakfast,” the New York Times explains why health claims matter so much.  If you can’t believe health claims, what part of the food label can you believe?:

Businesses have been making dubious claims about their products at least since the 17th century, when the British clergyman Anthony Daffy sold Daffy’s Elixir as a cure for scurvy as well as agues, gout, rheumatism, rickets, worms and other ailments. Hucksterism — no matter how implausible the claim — lives on…[for example] POM Wonderful claimed its pomegranate juice helps treat, prevent or cure hypertension, diabetes and cancer.  This might be par for the course for an era of swift-boating political ads and a torrent of television commercials plumping for myriad wonder drugs (sudden death may result). It leaves the consumer in a quandary: what part of the label can be believed?

My latest column in the San Francisco Chronicle deals with the immunity health claim on boxes of Kellogg Cocoa Krispies (see previous posts).  I’ve been writing the column for the last year at irregular intervals of about once every three weeks.  Beginning in January 2010, it has its own slot and will appear on the first Sunday of the month.  Here’s this one:

Q: It’s great that San Francisco City Attorney Dennis Herrera put a stop to the absurd “immunity” claim on Kellogg’s Cocoa Krispies, but how do companies get away with this?

A: I confess; I’m a health-claims junkie. I snatched up the immunity-claiming box of Cocoa Krispies the minute I saw it in a supermarket last August. I consider it a treasure: “Now helps support your child’s IMMUNITY.”

How does Cocoa Krispies perform this miracle? The cereal contains 25 percent of the daily value of antioxidant vitamins A, B, C and E per serving instead of the old 10 percent. Vitamins, Kellogg points out, play an important role in immunity.

Of course they do. All nutrients are involved in immune function. But is it remotely possible that Cocoa Krispies might protect your child against colds or swine flu? I wish.

Antioxidants present an unparalleled marketing opportunity. Kellogg does not have to prove that its cereals are protective. Immunity claims fall into a Food and Drug Administration regulatory gray area. “Supports immunity” is a “structure-function” claim, so called because it promises to support a structure or function of the human body. However you might interpret such claims, they do not really promise to prevent, treat or cure disease.

Congress expressly authorized structure-function claims when it deregulated dietary supplements in 1994. But that law did not apply to foods. Food companies wanted to use these claims, too. At first the FDA balked. When faced with further legislation and court overturns, the FDA gave up. Now it merely says that structure-function claims on supplements must be truthful and not misleading. The FDA says nothing about structure-function claims on food products. It mostly looks away when they appear.

“Misleading” is inevitably in the eye of the beholder. Herrera turns out to be a skeptic.

“The Immunity claims,” he said, “may falsely suggest to parents that cereals like Cocoa Krispies are more healthy for their children than other breakfast foods … [and] mislead parents into believing that serving this sugary cereal will actually boost their child’s immunity.” Kellogg, he said, must produce the evidence or have the claim subject to “immediate termination or modification.”

Faced with this threat and with ridicule in the press, Kellogg wisely decided to phase out the immunity-labeled Cocoa Krispies packages. Consider them collectors’ items.

Much is at stake. Ready-to-eat cereals produce more than $8 billion a year in sales. Kellogg spent about $32 million in 2008 to promote Rice Krispies cereals, and $4 million of that amount went to advertise Cocoa Krispies alone.

Shoppers care about health. If cereals can be advertised with special health benefits, more boxes will fly off the shelves. Food companies consider health claims essential for marketing their products.

This explains why so many companies are adding omega-3 fats, probiotics and antioxidants to so many foods. These ingredients make foods “functional,” meaning that the foods contain something beyond their usual nutritional value. Although little evidence shows that functional foods make healthy people healthier, companies can use functional ingredients to make health claims, no matter how far-fetched. These days, functional foods are about the only processed foods with increasing sales.

Kellogg has plenty of company with functional ingredients and health claims. See, for example, the claims on Nestlé (no relation) Juicy Juice products targeted to toddlers. One product adds antioxidants to “help support immunity.” The other adds omega-3s to “aid brain development.”

Think about it: Will feeding your toddler a sugary juice product really make her smarter? Face it. You are not supposed to think about it. You are supposed to buy – and feel good about doing so.

Absent the FDA, Herrera stepped into the breach. He does not care whether the claims are on Kellogg cereals or Juicy Juice cartons. If companies make such claims, he insists that they produce the evidence for them.

This will not be easy to do. It is one thing to find evidence that specific nutrients are involved in immune function. It is quite another to show that people who eat sweetened cereals or juices containing such nutrients are healthier than those who do not.

That is why the European Food Standards Agency denied hundreds of company petitions for health claims. The agency cannot find much evidence for the health benefits of foods with added functional ingredients. Its decisions have put European food marketers into crisis. How are they supposed to sell products without health claims?

As I keep saying, health claims are about marketing, not health. If it were up to me, I would remove all health claims from food packages. Foods are not drugs. Health claims cannot help but mislead.

So let’s congratulate Herrera for filling a regulatory gap. His colleagues – and the press – are doing their job on this one. FDA: Get to work!

Kellogg’s says it will phase out boxes of Cocoa and other Rice Krispies cereals with the IMMUNITY claim on them.

Withdrawn, November 4, 2009

The Immunity claim falls into an FDA regulatory grey area.  It is a structure-function claim, meaning that the product is supposed to support a structure or function of the human body – not treat or cure a disease. If Cocoa Krispies were a dietary supplement, the claim would be completely legal because Congress authorized structure-function claims for supplements when it passed the Dietary Supplement Health and Education Act of 1994.

Over the years, food makers complained that if supplements could use such claims, they could too.  At first, the FDA issued warning letters to food companies using structure-function claims.  It stopped after the courts ruled that food companies could make claims for the health benefits of their products on First Amendment grounds.

Now FDA says structure-function claims are OK to use as long as they are truthful and not misleading.  Misleading, of course, is in the eye of the beholder.  Evidently, the San Francisco city attorney thought this claim was misleading and demanded the evidence to back it up.  USA Today wrote about this on the front page (I’m quoted in it).

Wisely, Kellogg’s is going to find another design for its Rice Krispies packages.  Consider this particular box a collector’s item.

The lesson: In the absence of FDA action, food marketing is allowed to run rampant, and city and state attorneys are doing the FDA’s job.  Good for them.  And let’s hear cheers for the power of the press.

As the WHO/UNICEF report I posted yesterday makes clear, the marketing of infant formula—impossible for new mothers to avoid—interferes with breast feeding and, therefore, is a public health concern.

I posted about the Abbott Labs infant formula recall last week.

Here are some additional items I’ve collected on this topic.

I.  What the marketing looks like.

II.  Study finds no benefit of enriched infant formula on later academic performance: Children who are given nutrient or supplement enriched formula milk as babies do not appear to have higher exam scores as adolescents than those fed with standard formula, suggests a study published by The BMJ, leading researchers to argue renewed regulation is needed to better control infant formula promotional claims…. Read more

III.  IBFAN, the International Baby Foods Action Network, writes that it is:

launching a PETITION calling for an immediate halt to a new study  –  funded by the Gates Foundation and led by researchers from the University of California – that is randomly allocating infant formula to breastfeed in low-birth-weight babies in Uganda and Guinea-Bissau on assumption that this might prevent wasting and stunting.

The study, which has been cleared by ethics committees in the USA, Uganda and Guinea -Bissau – uses purchased ready-to-use infant formula made by Abbott, a US pharmaceutical corporation operating in 160 countries.  Abbott is a major violator of the International Code and is currently at the centre of a media storm in the USA because of contamination in its powdered formula. (NB. The formula used in the trial is liquid Ready-to-Feed).

IV.  IBFAN issued an earlier statement: The baby food industry’s destruction of an irreplaceable natural resource.

The International Code of Marketing of Breastmilk Substitutes was adopted forty years ago by the World Health Assembly, the world’s highest health policy setting body…Today 70% of countries have adopted laws based on the Code, however far too many are limited in scope and full of loopholes as a result of industry interference. As a consequence predatory marketing of baby food products continues throughout the world.  and the global Baby Food Drink Market is forecast to rise more than 30% in 5 years (from $68bn in 2020 to $91.5bn by 2026)….Aside from its crucial role in child survival (more than 800,000 children die each year because they are not breastfed and many more do not reach their full potential, ­­ breastfeeding is the most environmentally friendly way to feed an infant, resulting in zero waste, minimal greenhouse gases, and negligible water footprint. As a renewable natural food resource, mother’s milk makes an important contribution to local food and water security.…the baby food industry lost no time in exploiting the fear and confusion during the pandemic: falsely claiming their products build immunity; that their  ‘donations’ are humanitarian; encouraging the needless separation of mothers and babies and pretending that they are essential ‘partners’ who are genuinely working to address the problems.

V.  The Access to Nutrition Initiative (ATNI) assesses nine formula companies’ adherence to WHO recommendations.  Its report is here.

According to its press release,

Despite the World Health Assembly (WHA) adopting ‘The International Code of Marketing of Breast-milk Substitutes’ forty years ago and passing 18 associated resolutions since (collectively referred to as ‘The Code’), the BMS/CF Marketing Index 2021 found that none of the companies it assessed fully abides by The Code’s recommendations and most fall well short.

The summary: 

• Danone retained first place with a score of 68%, up from its 2018 score of 46%
• Nestlé, the market leader in sales value, retained its second place with a score of 57% – also a substantial improvement on its score of 45% in 2018
• KraftHeinz achieved the greatest improvement, ranking third, with a score of 38% compared to in 2018 when it didn’t score at all
• Reckitt (previously RB) substantially improved its BMS Marketing policies which led to a big jump in its score from 10% in 2018 to 32% in 2021 and climbing one place to fourth in the ranking.

VI.  A study: Conflicts of interest are harming maternal and child health: time for scientific journals to end relationships with manufacturers of breast-milk substitutes.  Pereira-Kotze C, et al.  BMJ Global Health. 2022 Feb;7(2):e008002. doi: 10.1136/bmjgh-2021-008002

The promotion and support of breastfeeding globally is thwarted by the USD $57 billion (and growing) formula industry that engages in overt and covert advertising and promotion as well as extensive political activity to foster policy environments conducive to market growth. This includes health professional financing and engagement through courses, e-learning platforms, sponsorship of conferences and health professional associations and advertising in medical/health journals…journal publishers may consciously, or unconsciously, favour corporations in ways that undermine scientific integrity and editorial independence—even perceived conflicts of interest may tarnish the reputation of scientists, organisations or corporations.  Such conflicts have plagued infant and young child nutrition science for decades.

Comment: As I mentioned yesterday, we now have more than enough evidence to put a stop to this.

What got my attention was this headline: The World’s Deadliest Pig Virus Creeps Closer to the U.S.

The Western Hemisphere registered its first outbreak of African swine fever virus in almost 40 years on July 28 at pig farms in the Dominican Republic. By September the devastating disease had been found in neighboring Haiti. Now the U.S., the world’s largest pork producer after China, is scrambling to keep the malady from washing ashore and shutting down its $7.7 billion pork export industry.

Unless you are a pig farmer, you probably don’t know much about this disease.  According to the USDA, 

African swine fever is a highly contagious and deadly viral disease affecting both domestic and feral swine of all ages. ASF is not a threat to human health and cannot be transmitted from pigs to humans. It is not a food safety issue…It has never been found in the United States – and we want to keep it that way.

Why?

ASF is a devastating, deadly disease that would have a significant impact on U.S. livestock producers, their communities and the economy if it were found here. There is no treatment or vaccine available for this disease. The only way to stop this disease is to depopulate all affected or exposed swine herds.

“Depopulate” is a euphemism for slaughtering the pigs.  Hence the concern about its likely entry into the U.S.

I get an almost daily newsletter, African Swine Fever Update with frequent updates on where the virus is doing its worst.

But now hopeful news: USDA’s ASF vaccine candidate successful in tests

USDA has been working on a vaccine and just announced its success.

Newly published USDA research, as highlighted in the journal Transboundary and Emerging Diseases, shows that ARS scientists have developed a vaccine candidate with the ability to be commercially produced while still maintaining its vaccine efficacy against Asian ASFV strains when tested in both European and Asian breeds of swine…The onset of immunity was revealed in approximately one-third of the swine by second week post-vaccination, with full protection in all swine achieved by the fourth week.

So, Covid vaccines for us, ASF vaccines for pigs. Let’s go for both!

I’m always interested in how the food industry tries to sell products to specific groups.  Here’s one of FoodNavigator’s Special Editions (collections of articles) on products the food industry is designing and trying to sell for older adults.

Special Edition: Healthy ageing: Food for an older population

Europe is ageing. By 2050 the population of over 65s is expected to reach almost 150m in the region. Gains are expected for products that cater to this older demographic by boosting immunity, as well as bone, joint, muscle, cognitive, heart, skin, eye and digestive health. FoodNavigator looks at some of the innovation strategies food makers are developing to meet the needs of older people.

• Keto for healthy ageing: F&B brands tap into ketone production with older generations in mind:  How are brands responding to growing demand for keto-friendly food and drink that supports healthy ageing?.. Read
• Nut supplier Importaco cracking the healthy ageing market: ‘Everybody is targeting older people’:  Nut and dried fruit supplier Importaco is leveraging innovation and deep consumer insight to build a portfolio of products targeting older people. We spoke to Teresa Cercós (PhD), Director General of Quality, Environment and Innovation, to learn more about the company’s long-term ambition to develop ingredients that support healthy ageing… Read
• Food for ageing populations: What, how and where will the elderly be eating in 2030?  What will the everyday diets of elderly people living at home in 2030 look like? Where and when will they consume their meals? And how will it reach their plates?.. Read
• ‘The narrative on ageing needs to evolve’: Barclays sees innovation opportunity in healthy ageing:  The food industry should do more to meet the nutritional needs of the ageing population, according to new research out from Barclays. This is, after all, a demographic that is only going to grow… Read
• Ajinomoto talks ‘nutrition without compromise’ and ‘first mover advantage’ in healthy ageing:  Ajinomoto has launched a nutrition strategy that the company believes will enable it to leverage its unique expertise in amino acids to deliver solutions that meet its two global strategic priorities: salt reduction and optimal protein intake for the ageing population… Read
• The role of citrus in brain health: ‘Citrus bioactive compounds improve general cognition’:  Eating citrus fruit and drinking citrus juices can have a positive impact on brain health, particularly during ageing, according to new research… Read
• Study finds microbiome ‘signature’ associated with healthy aging:  A large set of longitudinal data revealed a distinct gut microbiome signature that is associated with healthy aging and survival in the latest decades of life… Read
• Ketogenic drink boosts brain in cognitively impaired, says Nestlé study:  A Nestlé-produced ketogenic (kMCT) drink could improve cognitive function in individuals suffering from Mild Cognitive Impairment (MCI), the firm’s study suggests, as the product is set to be launched in Europe by the end of the year… Read

Food Safety News reports that the European Commission is getting increasingly upset about fraudulent claims that specific food and supplement products will boost immunity and help protect against Covid-19 or even cure it.

Alas, they will not.

The EC is worried about online advertisements.  Food Safety News reported more than 350 cases of such claims in June.  Now there are even more.

In the US, we mostly see this sort of thing—websites from the supplement industry telling you to take supplements.  Here  is what this one claims, with my comments in red.

Supplements can help you address nutrient insufficiencies or deficiencies in your diet—but can they help you fight COVID-19? Not as far as anyone knows.

While there hasn’t been specifically-targeted research to determine which—if any—nutrients should be FDA-approved to ward off the virus, [Indeed] supplements are an ideal way to keep your body and your immune system functioning at optimal levels. No, they are not.  Food works much better.

As a result, many physicians and other health and wellness experts recommend beginning a simple supplement routine to ensure your body has the nutrients it needs to stay healthy.  Many others do not, and neither do I.…The supplements you take during the COVID-19 pandemic may not be specifically developed to ward off the coronavirus. Right.  So don’t expect them to work.

Still, research has shown that they all play an important role in boosting the immune system, preventing respiratory damage, strengthening the body against viral infections, reducing inflammation—or all of the above.  This is true, but largely in experimental studies likely to have been funded by the supplement industry.

Obviously, I am not a fan of supplements.  There just isn’t much evidence that they do anything useful for healthy people, and healthy people are the ones most likely to be taking them.

With respect to Covid-19, the best preventive strategy is avoidance (masks, distancing, etc).

The best immune-boosting strategy is to eat a healthy diet–largely (but not necessarily exclusively) plant-based, balanced in calories, and with minimal amounts of ultra-processed junk foods.

And let’s all hope the vaccination comes soon and works like a charm.

Happy holidays.