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On July 30, Center for Science in the Public Interest (CSPI)—in collaboration with representatives of a long list of distinguished health and consumer organizations (see below)–wrote Martha Coven of the Domestic Policy Council and Ezekiel Emanuel of the Office of Management and Budget urging them to encourage the FDA to take more vigorous enforcement action against misleading health claims on food packages.

Their petition responds to comments by the FDA’s Michael Taylor (discussed in a previous post) in a July 19 article for the Atlantic Food Channel, titled “How the FDA is picking its food battles.”   In explaining why the FDA is backing off from doing anything about unsubstantiated health claims on food products, Taylor said:

FDA must pick its battles—and set its priorities—in a way that will best benefit the public health….We have no pre-market review authority over such claims, and, under prevailing legal doctrines concerning “commercial free speech,” the evidentiary requirements placed on FDA to prove that such claims are misleading are significant and costly to meet. Moreover, meeting them requires tapping the same team of nutritionists, labeling experts, and lawyers who are working on our other nutrition initiatives.

We’re also conscious of the cleverness of marketing folks, who, once we prove today’s claim is misleading, can readily come up with another one tomorrow. Going after them one-by-one with the legal and resource restraints we work under is a little like playing Whac-a-Mole, with one hand tied behind your back.

So, we must make choices….especially considering the other high-priority nutrition and food safety initiatives that compete for FDA’s finite resources. We’ll consider all possibilities, but, in the meantime, we call on the food industry to exercise restraint, and we welcome the scrutiny CSPI and the media give to this issue.

Clearly, I was not the only one dismayed by this statement, which appears to be an open invitation to food companies to do whatever they like with health claims.  Indeed, Taylor’s statement reminded me of the Bush Administration’s FDA which, in 2003, announced that it had lost so many first amendment  health claims cases in court that it no longer intended to fight them.

But Taylor’s statement is also an open invitation to food advocates to get busy, as CSPI and the other signers of this letter have now done. The letter, dated July 30, 2010, is a follow up to a June 11 meeting on FDA/USDA Food Labeling Reform Efforts:

At Zeke’s suggestion, we are attaching a Priority List/Timetable Chart that provides an overview of the recommendations we made at our meeting and delineates how those recommendations intersect. As we discussed:

• We commend the Food and Drug Administration (FDA) for increasing the number of enforcement actions it has taken against misleading food labeling, and we urge the agency to increase those efforts. We also commend the FDA’s initiative to develop a system for disclosing key nutrition information on the fronts of food labels. However, we emphasize that the existing Nutrition Facts panel must also be modernized. In particular, nutrition information must be based on up-to-date serving sizes, a Daily Value for added sugars must be established and added to the existing Nutrition Facts panel, and “Calories per serving” must be displayed more prominently. Revisions to the Nutrition Facts panel and the development of a front-of-pack disclosure system are closely intertwined and should be developed concurrently.

• We urge the Domestic Policy Council to ask the FDA to ensure that any front-of-pack labeling scheme is not undercut by deceptive health-related claims on the fronts of food packages. Such claims, if unabated, will divert attention from any front-of-pack scheme the FDA develops. Since our meeting, the Federal Trade Commission (FTC) issued a consent order prohibiting claims that a food product could strengthen immunity because the claim lacked sufficient clinical evidence. Such claims are called “structure/function” claims by the FDA. The FDA should take a consistent position regarding the use of those claims. In addition, the FDA should address claims exaggerating the presence of healthy ingredients stressed in the U.S. Dietary Guidelines such as whole grains, fruits, and vegetables. For example, failure to remedy claims such as “Made with real fruit” on products that contain little fruit will detract from a declaration of sugar content that the FDA may specify in a front-of-pack labeling scheme, thus frustrating the Administration’s attempts to reduce childhood obesity.

• One way to remedy exaggerated claims for healthy ingredients (other than prohibiting them completely) is for the FDA to revise the ingredient list to require that the percentage of key ingredients such as fruit be disclosed in a clear, easily readable manner. FDA could also require that ingredient lists group all sources of added sugars to provide consumers with a clearer indication of the amount of added sugar in a product. The First Lady has recognized that ingredient labeling reform is an integral part of the Administration’s broader efforts to combat childhood obesity. The U.S. Department of Agriculture (USDA) is already working on new formats for ingredient labeling. We support those efforts and request the Council to encourage the FDA to follow USDA’s approach.

• In regard to a timetable, the recommendations we have made are closely intertwined with efforts already ongoing at the FDA. In some cases, they are necessary to ensure that those ongoing efforts by FDA succeed. We, therefore, urge the Council to recommend that the FDA expand its food labeling reform initiatives to include these additional issues and address them concurrently. Additional efforts that complement existing FDA labeling reform initiatives should commence as soon as the first set of initiatives is published in the Federal Register. All initiatives should be finalized by October 2012. This request is based on the fact that the FDA implemented the Nutrition Labeling and Education Act of 1990 in two years. The reform efforts we request are more limited than the requirements of the 1990 Act, and the FDA should be able to accomplish them by 2012 based on the agency’s previous performance on such matters.

• Rep. DeLauro, Chair of the House Agriculture Appropriations Subcommittee, asked the FDA how many FTEs the agency would need to issue regulations to revise the Nutrition Facts panel, increase the prominence of calories per serving, require caffeine labeling, and establish a daily value for added sugars, as well as other issues. The FDA stated that approximately “10-12” additional FTE’s would be necessary to address such concerns. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations for 2005: Hearings Before a Subcomm. of the House Comm. on Appropriations, 108th Cong. 2d Sess. 323 (2004). While the FDA’s response at the time involved some issues not covered by our current requests, we believe that the FDA’s estimate is still reasonable, and we urge the Council and the Office of Management and Budget to work with the FDA to ensure that the FDA devotes additional resources to this effort.

We welcome the opportunity to assist the Administration and look forward to continuing our dialogue.

The letter is signed by Bruce Silverglade, Director of Legal Affairs, CSPI and representatives of Consumers Union, American Public Health Association, American Medical Association,  American Cancer Society Cancer Action Network, American Heart Association,  American Society of Bariatric Physicians, American Diabetes Association,  American Dietetic Association, Alliance for Retired Americans, Society for Nutrition Education, American Institute for Cancer Research, and Directors of Health Promotion and Education.

Let’s hope the FDA pays attention and gets busy on these issues.

It’s been a busy summer with three books just out, all three in paperback or Kindle editions.  Click on Books above or the covers in the upper right-hand corner of the site to get information about them, or the ones below to see what Amazon has to say about them.

To be published August 4: the University of California Press paperback edition of Pet Food Politics: The Chihuahua in the Coal Mine.

In June, University of California Press issued the revised edition of Safe Food: The Politics of Food Safety, with a new introduction and concluding chapter that bring everything up to date since the book first came out in 2003.  I can’t help commenting that at the time the book went to press in December, the Senate had not yet passed the food safety bill.  Guess what?  It still hasn’t.

And in May, Free Press/Simon & Schuster issued Feed Your Pet Right: The Authoritative Guide to Feeding Your Dog and Cat.

Enjoy!

My monthly Food Matters Q and A column in the San Francisco Chronicle appears this weekend:

Are 8 glasses of water a day really necessary?

Q: It’s such a hot summer and I’m sweating all the time, but I don’t feel thirsty. Do I have to force myself to drink eight glasses of water a day?

A: San Franciscans: Please, no complaints about summer fog. Where I live, it’s hot and humid, and staying hydrated takes work.

Everybody needs water to replace the amounts lost through breath, sweating and excretions. In comfortable temperatures, the amounts lost conveniently come out to about a quart of water for every thousand calories consumed. If you eat 2,000 calories a day, you need about 2 quarts of water.

But water equivalents – juice, coffee, tea, soda and anything else with water in it, including food – work just as well. Watermelon is called watermelon for a reason. It is mostly water and perfect for hot summer days.

Mostly, you don’t have to keep track of how much liquid you drink. Thirst takes care of it. If you need water, you feel thirsty and you get something to eat or drink. Problem solved.

But thirst doesn’t work very well at times when it is most needed – in very hot weather, at high altitudes or during heavy exercise. People in hot climates, mountain climbers and athletes have to force themselves to drink.

How can you tell when you need water? This is easy. Look at your urine. If you are dehydrated, your urine is bright yellow and smelly. If you are getting enough water, your urine is pale and practically odorless.

Except for these exceptions, hardly anyone needs to worry about how much water to drink. That “hardly anyone,” however, also includes children and the elderly, who tend not to regulate water balance very well. Beyond these exceptions – as you shivering San Franciscans can attest – thirst works well as a guide to how much to drink.

Q: A young woman I know got a nasty combination of altitude sickness and electrolyte imbalance when she was hiking in the Sierra Nevada. She sipped water constantly, ended up drinking too much, and got so sick from lack of salt that she had to be airlifted out. Are those Gatorade-like drinks that replenish electrolytes any better than plain water when you are hiking or exercising hard?

A: Those drinks might help, but your friend also must not have been eating much on that hike. Foods are excellent sources of electrolytes.

Electrolytes are minerals like sodium, potassium and chloride that help balance blood acidity. They are lost in sweat, which is why sweat tastes salty. Our bodies have plenty of electrolytes. Salt, for example, is usually eaten in great excess. Normal sweat losses don’t matter much, unless we are vigorously exercising or sweating profusely.

But sweating is easy to miss at high altitudes because it evaporates so quickly. The higher the altitude, the easier it is to overlook fluid and electrolyte losses.

High altitude also disrupts normal appetite, so climbers don’t feel hungry or thirsty. Elite climbers know to pack lightweight foods and supplements made especially for that purpose, and to force themselves to eat and drink frequently.

Drinks advertised as electrolyte supplements do indeed contain electrolytes. Gatorade Orange Sports Drink, for example, contains water as the first ingredient, followed by sugars (sucrose syrup, high-fructose corn syrup), flavors and three sources of electrolytes – salt (sodium chloride), sodium citrate and monopotassium phosphate – along with color additives and thickeners.

If you are an athlete working out for an hour or more, Gatorade might replenish your sodium, potassium and chloride more quickly than food can, but not by much. An 8-ounce Gatorade serving provides just 1 percent of the daily value for potassium (30 milligrams) and 5 percent of the daily value for sodium (110 milligrams).

Gatorade is a sweetened drink supplemented with a few salts, but with less sugar and fewer calories than a regular soft drink. On the basis of electrolytes, PepsiCo, its parent company, markets Gatorade as a better choice than any other drink, including water. Nothing, says PepsiCo, rehydrates, replenishes and refuels athletes better. According to Advertising Age, the company backs up that contention with a hefty advertising budget – $118 million in 2009.

Studies do show that replenishing electrolytes is a good thing to do at high altitude or during any other extreme activity. But hikers can do this with food or supplements without having to carry additive-laden sugary drinks in a backpack.

An average carrot, for example, provides 230 milligrams of potassium and 50 milligrams of sodium. Many other vegetables have similar electrolyte profiles. Nobody wants to carry heavy foods up a mountain, which is why sports shops sell dehydrated foods and special supplements for high-altitude climbers.

It’s a good idea to drink water at high altitude, but also to eat plenty of good food at regular intervals.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/07/30/FDD51EK7K0.DTL

This article appeared on page K – 5 of the San Francisco Chronicle

I’ve been sent a press release from the Institute for Agriculture and Trade Policy in Minneapolis to announce the creation of its new Healthy Food Action website.

The website, says IATP:

makes it simple for health professionals—nurses, dieticians, physicians, public health workers, social workers and others—to engage in major public policy debates that affect our food system. It provides both vital information and easy-to-use tools to contact legislators, government officials and companies.

“Will make it simple” seems more like it.  At the moment, the site seems to be devoted exclusively to the issue of arsenic in poultry feed.  Eventually, it promises to take on other issues such as antibiotics in food animals and the Farm Bill.

Ah yes, the Farm Bill.  It’s none to early to get started on the next one.  Sites like this could help once they get into full swing.

The Institute for Agriculture and Trade Policy works locally and globally at the intersection of policy and practice to ensure fair and sustainable food, farm and trade systems.

The Berkeley Media Studies Group has just released a “Framing Brief” with “how-to” advice for breastfeeding advocates.  The Brief argues that babies’ health is not a sufficient reason to get moms to breastfeed.

Instead, advocates need to help create environments that support breastfeeding.

This  and a previous report on breastfeeding issues, “Talking about Breastfeeding,” were commissioned by the California WIC Association with support from The California Endowment.

That these reports come none too soon is evident from a recent commentary that the International Code of Marketing of Breastmilk Substitutes (“the Code”) has become ineffectual.

The Code is an international agreement about what infant formula companies can and cannot ethically do to promote their products, based on substantial research that infant formula marketing undermines breastfeeding.

According to the study in the Archives of Diseases of Children, the Code has become

mired by a series of alleged violations and boycotts, which are counter productive to the code’s goal….[These include an] unrelenting series of disputes, predominantly relating to alleged violations of the code, which have provoked high profile acrimonious exchanges, boycotts and legal proceedings…[leading] to an atmosphere of mistrust that has now become embedded between key agencies.

The author focuses on disputes between the non-governmental group Baby Milk Action and infant formula manufacturer Nestlé (no relation).  He recommends that an  “ombudsman” or some other independent body be given authority “to arbitrate and ensure that actions taken by respective parties are in keeping with the spirit of the code.”

This is not a bad idea—if the body is truly independent. Take a look at the Baby Milk Action website and judge for yourself whether you think the group makes a compelling case for Code violations.  Some of them seem pretty obvious to me.

As I recount in Food Politics, infant formula companies have a long pre-Code history of putting sales before infant health.  Almost everyone I know thinks the situation has improved post-Code, but not nearly enough.

As I explain in What to Eat, formula companies have a business-model problem: there are only so many infants born each year and they only use formula for a limited time.

The companies only have two choices for growth: recruit more babies onto formula or extend the period of formula feeding.  The first strategy was well documented pre-Code and continues to be documented.  The second is illustrated by the now withdrawn product, chocolate toddler formula Enfagrow (see previous posts).

Breastfeeding advocates: read the new reports and get busy!

Update, July 31: Patty Rundall of Baby Milk Action has written a rebuttal to the commentary.  Other ideas?  You can forward them to her at prundall@babymilkaction.org.

Anti-tobacco advocates have been worried for years that concerns about obesity would draw funding away from anti-smoking initiatives (see previous posts).  Their fears are justified, as described in today’s New York Times and in a recent editorial in the New England Journal of Medicine.

Years of experience have taught anti-smoking advocates that countering the marketing efforts of cigarette companies required constant vigilance.  It also taught them that cigarette companies take immediate advantage of any weakening of resistance to their efforts.

Cigarettes remain the leading cause of preventable deaths among Americans.  Cigarette marketing aimed at children remains a national—and international—public health scandal.

Health should not be a zero-sum game.  Anti-obesity advocates have much to learn from anti-smoking advocates.  How about joining forces to improve the health of Americans?

I love food posters.  Thanks to Food Safety News for the heads up about the National Library of Medicine’s exhibit of marvelous food posters from World Wars I and II.  Many of these can be seen online at the Smithsonian’s site.  The exhibit was curated by Cory Bernat, who comments on it and also has a collection posted on the web (I’ve seen it and it’s wonderfully downloadable, but seems to have a bandwidth problem at the moment).  Enjoy!

Taking about raw milk stirs up a can of worms, with plenty of ideology governing opinions on all sides.  My posting of Bill Marler’s list of recent raw milk outbreaks a couple of days ago elicited much heat and one appropriate question: How do raw milk outbreaks compare to outbreaks from Pasteurized milk.

People must be asking Marler the same question, because he has just answered it.   Outbreaks from pasteurized milk products do occur, but they are rare, especially because far more people drink Pasteurized than raw milk.    Here is his summary table.  He puts the supporting documentation on the real raw milk facts website.

And here is the CDC’s Q and A on raw milk.

My view: yes, people should have the right to drink raw milk if they want to, but they need to know—and take responsibility for—the risks.  And everyone who produces raw milk should use a HACCP (preventive control) plan and stick to it in letter and in spirit.

Addition: I’ve just been sent links to three Los Angeles Times stories about a raid (with drawn guns, yet) on a Venice grocery store selling raw milk.  A long piece explains what this is about and includes a video of the raid.  A third story talks about the debates about raw milk, also with a video.