Posts dated: October2010

The most thoughtful comments I’ve seen on the proposal to block food stamp recipients from buying sodas come from Andy Fisher’s post on Civil Eats.

Mr. Fisher is currently a Kellogg Food and Society Fellow with the Institute for Agriculture and Trade Policy in Minneapolis.  He is the Co-Founder/Executive Director of the Community Food Security Coalition (CFSC).

I have added the red-highlighted emphases:

Banning Soda for Food Stamps’ Recipients Raises Tough Questions

October 8th, 2010  By Andy Fisher

On Thursday, New York City Mayor Michael Bloomberg announced that he had asked the US Department of Agriculture to allow the city to exempt soda from the permitted list of items its 1.7 million food stamp recipients can purchase with their benefits. This ban would last for two years, enough time to assess its effects and determine whether the ban should be continued on a permanent basis. New York City food stamp recipients spend an estimated $75 million to $135 million of their $2.7 billion in food stamps annually on soda, according to AP.

Anti-hunger and public health advocates at odds over proposal

Public health advocates contend the obesity epidemic is costing the US hundreds of billions of dollars per year in increased health care costs, and sugar sweetened drinks are a major factor.   They correctly note that low income persons tend to have higher rates of diet related diseases than the general public: poor New Yorkers have twice the rate of adult-onset diabetes than compared to the wealthiest. Mayor Bloomberg noted, “Sugar-sweetened drinks are not worth the cost to our health, and government shouldn’t be promoting or subsidizing them.”

On the other hand, anti-hunger advocates argue that food stamp recipients should have the same freedom of choice at the supermarket checkout counter as any middle class person. Exercising that freedom is a matter of personal dignity that the poor all too often are not afforded. Restricting soda is the first step in a slippery slope toward further demeaning regulations on what food stamp recipients can buy.  They correctly point out that poor people often can’t afford produce, as nutritious foods tend to be more expensive per calorie than less healthy food.

The anti-hunger community is correct that historically, as a nation, we have treated the poor paternalistically. American social, educational and health policy is littered with countless examples of this failed approach. Regulating what food stamp recipients can and can’t buy with their benefits puts forth the message that they are not capable of making good decisions, and the government needs to set forth boundaries to protect them from their own poor choices. To the contrary, some studies have shown that food stamp recipients actually buy more nutritious food per dollar than non-food stamp recipients.

Anti-hunger advocates are also right that poor people typically can’t afford nutritious foods. Highly processed foods, such as ramen, fill up a belly more cheaply than broccoli and whole wheat pasta.  In our food system, high calorie foods with low nutritional value are cheaper than nutrient dense foods. For example, a 12 pack of 12 ounce cans of Coke (144 oz) at Kroger’s costs $2.79 on sale, while a half gallon (64 ounces) of Minute Maid orange juice (also a Coca Cola Inc. product) is $2.49. The bad choice is the cheap choice.

On the other hand, public health groups are dead-on accurate that it is irresponsible public policy to be subsidizing with tax dollars the purchase of unhealthy products that will burden society with increased health care costs in the future.  As a nation, we’re subsidizing soda companies $4 billion annually through the food stamp program. In return, decades later, the public will be stiffed with the hospital bill for billions of dollars more for extra health care costs from these poor dietary choices.

Thorny issue raises questions

Why are anti-hunger advocates in the absurdly precarious position of protecting the right of poor people to drink soda? Do I have a right as an American to poison myself with “soft” drinks that can dissolve the rust off a car? Does it matter whether I use my own money or tax dollars?  Should freedom of choice apply to products of marginal utility if not harmful products?

Why does it cost Coca-Cola more to produce a half-gallon of orange juice than a half gallon of Coke? How do we reverse this situation, such that healthful products are more affordable and unhealthy products are more costly?

Are food stamps an income support program- or as the program’s new name indicates, a Supplemental Nutrition Assistance Program? If it is a “supplemental nutrition” program, then shouldn’t USDA define which products are nutritious based on Institute of Medicine standards, and limit purchases to these products? USDA does this with the Women Infants and Children (WIC) program, which is widely touted for saving billions in health care costs.

If food stamps are an income support program, and anti-hunger advocates want to maximize poor people’s freedom of choice, then why shouldn’t food stamps be distributed as cash rather than as a debit card good for food purchases? Doesn’t receiving cash maximize a person’s dignity as it bestows trust upon that person that he or she will make the right choice with their money?  Would food stamps not then become a welfare program, and be subject to the negative public perception of welfare?

The real story behind food stamps is that it is neither a nutrition program nor an income support program. It is a massive subsidy for the food retailers, grocery manufacturers, and industrial growers. That is why commodity groups, the Grocery Manufacturers of America and the Food Marketing Institute all line up behind the food stamp program every five years when the Farm Bill is being debated. They know the extra buying power food stamps provides to low income Americans will end up in their pockets.

In their noble effort to reduce human suffering and to improve the livelihood of the 41 million Americans on food stamps, anti-hunger advocates are caught in an ever-tightening bind. They frame food stamps as a nutrition program, because a nutrition program has more public support and more powerful allies in Congress than a welfare or income support program. Yet, burgeoning rates of chronic diseases and the growing presence of the public health community as a player in federal food and farm policy, translates into increased accountability for the nutritional impact of the food stamp program.

What boat are both camps missing?

There is one very important point neither the anti-hunger nor the public health advocates are making. Our tax dollars, especially the $80-90 billion spent annually on federal food programs, are a powerful force in shaping the food system. Food stamps, like school meals and WIC, should be the cornerstone of a food system that is grounded in principles of environmental sustainability, social justice, and health. Directed toward the small farm economy, community-oriented retailers, brokers, and processors, even a modest percentage of these funds could ignite a transformation of our food system.

Consider this. While nationally food stamp recipients are spending $4 BILLION per year on soda, in 2009, only $4 MILLION of food stamps were redeemed at farmers markets. This difference is shaped by the fact that USDA has not equipped farmers markets with free debit card terminals (which are needed to accept food stamp benefits), and prohibited federal nutrition education programs to promote farmers markets. Does this mean the Department of Agriculture values soft drinks one thousand times more than farmers markets?

Mayor Bloomberg has proposed only half the solution. USDA should grant him the waiver he requests if and only if New York City agrees to redirect the $75-$135 million that would have otherwise been spent on soda to programs that encourage food stamp recipients to purchase locally grown foods at farmers markets, community supported agriculture farms, and other community-oriented venues.

Jeffrey Koplan (Emory) and Kelly Brownell (Yale) have a commentary in JAMA (October 6) titled “Response of the food and beverage industry to the obesity threat.”   They describe how the food and beverage industries:

• Associate their products with health
• Frame the issues to emphasize balance or physical activity
• Pick and choose the science
• Reformulate products to make them appear healthier
• Defend themselves and attack critics

Sound familiar?  For details, see  Michele Simon’s excellent book, Appetite for Profit: How the Food Industry Undermines Our Health and How to Fight Back (Nation Books, 2006).

Addition, October 10: Lori Dorfman of the Berkeley Media Studies Group reminds me about its 2007 Framing Brief, “Reading between the lines: understanding food industry responses to concerns about nutrition.”  This group’s publications are always terrific resources for educating and taking action on food issues.

New York City is serious about trying to reduce rates of obesity and the expensive and debilitating conditions for which obesity raises risks.  Its latest move?  It is asking the USDA for a Food Stamp waiver for two years during which recipients would not be allowed to use their benefit cards to buy sodas.

I hardly know where to begin on this one.  I learned about this from the front page of this morning’s New York Times and from reading the accompanying op-ed by city Health Commissioner Tom Farley and New York State Health Commissioner Richard Daines.

This is an old, old idea that has been consistently rejected by USDA and by public health advocates for the poor.  It is based on the commonly held notion—never conclusively demonstrated by independent data—that recipients of Food Stamps (now called SNAP, the Supplemental Nutrition Assistance Program)–make worse food choices than everyone else.

New York City, according to the Times account, has 1.7 million people who receive SNAP benefits.  The rationale for banning soda purchases?

City statistics released last month showed that nearly 40 percent of public-school children in kindergarten through eighth grade were overweight or obese, and that obesity rates were substantially higher in poor neighborhoods. City studies show that consumption of sugared beverages is consistently higher in those neighborhoods….Anticipating such criticism, Dr. Farley and Dr. Daines said that the food-stamp program already prohibited the use of benefits to buy cigarettes, beer, wine, liquor or prepared foods.

The op-ed points out:

Every year, tens of millions of federal dollars are spent on sweetened beverages in New York City through the food stamp program — far more than is spent on obesity prevention. This amounts to an enormous subsidy to the sweetened beverage industry.

I asked for data on soda purchases by New York City SNAP recipients, and was sent the city’s waiver request to USDA:

An estimated $75 to $135 million dollars of SNAP funds were spent on sweetened beverages in New York City (NYC) alone in 2009 [Based on Nielsen beverage market data for 2009, the prevalence of SNAP participants in NYC, and prior studies of SNAP purchasing behavior].   This use of federal funds to purchase a group of products that are leading contributors to the diabetes and obesity epidemics (and whose extensive consumption contradicts the USDA’s own recommended dietary guidelines) far outstrips current federal funding for prevention of these health problems.

I am, as readers of this blog well know, no fan of sodas.   If people want to do something about controlling body weight, the best place to begin is by cutting out sodas.  Soft drinks contain sugars and, therefore, calories, but nothing else.  As the Center for Science in the Public Interest has long maintained, sodas are liquid candy.   And I am on record as favoring soda taxes (see previous posts) as a strategy to discourage use, especially among young people.

But if I were in charge of Food Stamps, I would much prefer incentives: make the benefit worth twice as much when spent for fresh (or single-ingredient frozen) fruits and vegetables.

How far will the city get with this request?  I can’t wait to find out.  If you want to watch lobbying in action, keep an eye on this one, as I certainly will.

As for this proposal?

I can’t quite get my head around this one.  According to USA Today (October 5), some makers of alcohol drinks have joined the “pink” campaigns to raise awareness of breast cancer and more research.

Chambord’s website notes that its Pink Your Drink campaign has raised more than $50,000 in donations for the Breast Cancer Network of Strength and other patient groups.

Mike’s Hard Lemonade has given $500,000 over the past two years to the Breast Cancer Research Foundation, company President Phil O’Neil says. The company was inspired by the loss of an employee named Jacqueline who died after a long battle with breast cancer.

But alcohol is clearly implicated as a cause of breast cancer.  USA Today discusses that connection—to imbibe or not—in another article in the same issue.

Alcohol raises complicated public health issues for women.  On the one hand, moderate drinking reduces the risk of heart disease.  On the other, it raises the risk of breast cancer.

That is why dietary guidelines suggest no more than one drink a day for women, with a drink defined as 5 ounces of wine, 12 ounces of beer, and 1.5 ounces of hard liquor.

But alcohol companies using donations to pink causes as marketing?  Could we expect breast cancer research sponsored by alcohol companies to focus on the relationship of alcohol to breast cancer?  Is this any different than cigarette companies paying for lung cancer research?

Ethics, anyone?

Nick Freudenberg, Amy Kwan of the City University of New York School of Public Health at Hunter College and Kristen Mancinelli of City Harvest have produced a report on the state of school food in New York City: Recipes for Health: Improving School Food in New York City.

The report is about the “vibrant and fast-growing school food movement in NYC.” It:

• Describes the various programs and activities that are transforming the food environment in city schools.
• Explains how the school food system works in New York City.
• Highlights recent improvements made by the Department of Education and other agencies to address food quality and nutrition concerns.
• Describes the continuing challenges the city faces in providing ideal school meals.
• Explains how to take action to support systemic improvements to the school food environment.

If this can be done in New York City, it can be done anywhere.  Get to work!

My first-Sunday-of-the-month San Francisco Chronicle Q and A column, Food Matters, is out.  This month it’s about figuring out what “whole wheat” labels mean on food packages.

Q: I pay $4 for multigrain or whole wheat breads because I’ve heard white bread isn’t as healthy. But when I compare nutrition labels, $2 white breads look much the same. Are they?

A: My Talmudic answer: yes and no. You are asking about commercial sliced breads. Bread may be the staff of life, but you would never know it from reading the ingredient lists of most commercial products.

Commercial breads are indeed much the same, with only a few differences that matter.

To decide whether these have anything in them worth eating beyond their calories, you must inspect labels to make sure the first ingredient is whole grain, the total number of ingredients is small and devoid of unpronounceable chemicals, the fiber content is at least 2 grams per 1-ounce serving and the label says 100 percent whole wheat. Anything less is reconstituted white bread with occasional pieces of the original grain added back.

And then there is taste. Artisanal breads begin with just four ingredients – flour, water, salt and yeast – and turn them into loaves so crusty, chewy and fragrant that you cannot stop eating them. If they have some whole grain in them, even better.

But handmade breads take forever to make and quickly go stale. Commercial bakeries deal with these problems by rushing the bread-making process and compensate for the loss of flavor by adding stabilizers, dough softeners and preservatives, and covering up the chemical tastes with sweeteners. Breads with 30 or more ingredients are not unusual and violate my rule: Never buy processed foods with more than five ingredients.

To compare breads, you must read labels. Bread companies do not make this easy. Some list the serving size as one slice, some two, and their weights can vary by twofold. When you convert everything to ounces, the nutrient content of supermarket breads looks much alike.

An ounce provides 70 to 80 calories, a trivial difference. The grain is what counts.

Wheat grains have three components – the nutrient-rich bran and germ (“chaff”), and the endosperm, which is mostly starch and protein. One hundred percent whole wheat flour contains all three in the same proportion as in the original grains.

White flour contains about 80 percent of the original components. It is mostly endosperm.

Nutrients in the chaff are lost, so bakers are required to replace the five nutrients least likely to be available from other foods: niacin, riboflavin, thiamin, folic acid and iron. The others are not replaced.

Neither is fiber. White flour contains only trace amounts of fiber.

Because high-fiber diets promote healthy bowel function and appear to reduce risks of heart disease and bowel cancers, dietary advice is to eat at least three daily servings of whole grains – 3 ounces of 100 percent whole wheat bread, for example.

Food labeling rules do not make it easy to figure out fiber content. Some white breads list 1 gram of fiber, but watch out for serving size. It takes two slices to reach half a gram, which can be rounded up to 1.

Whole wheat bread with 2 grams of fiber per 1-ounce slice may have four times as much fiber as white breads. But watch out for breads listing 3 grams fiber; their slices may weigh nearly 2 ounces.

In response to dietary advice, commercial bakeries have introduced whole grain breads acceptable to white bread eaters. These grind the wheat bran super fine, add extra dough conditioners to keep the bread soft, and toss in some bran or cracked wheat to make the bread look like whole wheat. Check for fiber grams and the position of chaff ingredients on the list. The further down the list, the smaller their contribution.

And where is the Food and Drug Administration to help with whole grains? Alas, the FDA has not set rules for grain content. It permits manufacturers to make statements such as “100 percent whole grain” as long as the statement is true and does not imply that the food is an “excellent source.”

The FDA’s nonbinding guidance says anything labeled “100 percent whole grain” must contain all three components of the original wheat seed, in proportion.

This regulatory gap permitted creation of the industry-sponsored Whole Grain Council. The council issues a certifying stamp in two forms: 100 percent and Basic. One hundred percent means all grains are whole. But the more prevalent Basic stamp allows refined grains and disproportionate additions of bran or germ.

This article appeared on page K – 3 of the San Francisco Chronicle.

Note: E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.  Read previous columns at sfgate.com/food.

The Center for Food Safety reports that a Federal Appeals Court has overturned an Ohio state ban on label statements such as “rbGH Free,” “rbST Free” and “artificial hormone free” on milk from cows that have not been treated with genetically modified bovine growth hormone (a.k.a. bovine somatotropin, or rbST).

In ruling on the case, IDFA et al v. Boggs, the court said:

The district court held that the composition claims were inherently misleading because “they imply a compositional difference between those products that are produced with rb[ST] and those that are not,” in contravention of the FDA’s finding that there is no measurable compositional difference between the two.

This conclusion is belied by the record, however, which shows that, contrary to the district court’s assertion, a compositional difference does exist between milk from untreated cows and conventional milk (“conventional milk,” as used throughout this opinion, refers to milk from cows treated with rbST). As detailed by the amici parties seeking to strike down the Rule, the use of rbST in milk production has been shown to elevate the levels of insulin-like growth factor 1 (IGF-1), a naturally-occurring hormone that in high levels is linked to several types of cancers, among other things. The amici also point to certain studies indicating that rbST use induces an unnatural period of milk production during a cow’s “negative energy phase.” According to these studies, milk produced during this stage is considered to be low quality due to its increased fat content and its decreased level of proteins.

The amici further note that milk from treated cows contains higher somatic cell counts, which makes the milk turn sour more quickly and is another indicator of poor milk quality. This evidence precludes us from agreeing with the district court’s conclusion that there is no compositional difference between the two types of milk.

The court also said:

Like composition claims, production claims such as “this milk is from cows not supplemented with rbST” are potentially misleading because they imply that conventional milk is inferior or unsafe in some way. But neither the FDA nor any study has conclusively shown that to be the case.

Want to bet that this one goes to the Supreme Court?

At current exposure levels, is BPA toxic or not?  The question turns out to be difficult to answer for two reasons: science and politics.  Science does not have an easy way to determine the health effects of exposures to very low doses of chemicals, and the plastics industry does everything it can to minimize risks.

A recent study says that human exposure to BPA is much higher than previously estimated, not least because many of the sources of this estrogen disrupting chemical have not yet been identified.   The authors of the study, according to FoodQualityNews, want the chemical registered so that exposures can be assessed.  They also call for immediate action to reduce exposures.

In contrast, FoodProductionDaily reports that the European Food Safety Authority (EFSA) has just ruled that current exposure levels are safe.  Its expert panel reviewed  hundreds of studies of BPA’s effects over a six-month period.  The committee could find no new evidence for setting a lower level for the Tolerable Daily Intake, now established at 0.05 mg/kg/body weight.  But at least one member of the committee disagreed and viewed the evidence as less certain.  As FoodProductionDaily explains:

Bisphenol A is a chemical used as a monomer in polycarbonate plastic and epoxy resins – two food contact materials used in the manufacture of baby bottles and food and drink can linings respectively. Its continued use is a matter of fierce debate, with scientific evidence divided on the issue. In January 2010, the US Food and Drug Administration (FDA) said the substance was safe at current exposure levels. It also recommended that children and pregnant women reduce their exposure to the substance and that industry should seek to develop BPA-free materials for use in food contact materials.

As might be expected, the plastics industry is delighted with the EFSA decision.  FoodProductionDaily quotes a representative of the chemical industry:

Consumers around the world can be reassured that EFSA’s intense scientific scrutiny continues to reaffirm the safety of BPA in food contact applications, and again concludes that established safe intake levels for BPA provide a sufficient margin of safety for protection of consumers, including for infants and young children.

Aren’t you reassured by this?

Glass baby bottles, anyone?

Update, October 4:  France and Denmark say that unless EFSA requires lifting their bans on BPA, they intend to keep the bans.