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By congressional fiat, federal agencies must revise the Dietary Guidelines every five years. This is one of those years.   The 2010 Dietary Guidelines Advisory Committee has been meeting for a couple of years and is now nearly done.

Some unnamed person from the American Society of Nutrition must be attending meetings.  The society’s Health and Nutrition Policy Newsletter (April 22) provides a report.

From the sound of it, this committee is doing some tough thinking about how to deal with “overarching issues” that affect dietary advice:

• The high prevalence of overweight and obesity among all Americans
• The need to focus recommendations on added sugar, fats, refined carbohydrates, and sodium (rather than the obscure concept of “discretionary calories” used in the 2005 guidelines)
• The benefits of shifting to plant-based, rather than meat-based, diets
• The need to help individuals achieve physical activity guidelines
• The need to change the food environment to help individuals meet the Dietary Guidelines

Applause, please, for this last one.  It recognizes that individuals can’t do it alone.

The committee’s key findings and recommendations:

• Vegetable protein and soy protein: little evidence for unique health benefits, but there are benefits, such as added dietary fiber intake, from diets high in vegetable and soy proteins.
• Carbohydrates: a consistent relationship between soft drink intake and weight gain. Overweight and obese children should reduce overall energy intake, especially from added sugars (and especially in the form of soft drinks and sugar-sweetened beverages).
• Fats: mono and polyunsaturated fats, when replacing saturated fats, decrease the risks of heart disease and Type 2 diabetes in healthy adults. No benefit from increased intakes of omega-3 fatty acids above 250-300 mg a day.  Adults should eat two servings of fish per week to obtain omega 3 fatty acids.
• Sodium: decrease sodium intake to 2,300 mg sodium per 2,000 calorie diet to lower blood pressure in adults and children. Since 70 percent of the population is hypertensive, the goal for most individuals should be 1,500 mg per 2,000 calorie diet.
• Potassium: because higher intakes of potassium are associated with lower blood pressure, adults should increase intake to 4,700 mg daily.

Translation: more fruits and vegetables, fewer processed foods, and changes in the food environment to make it easier for everyone to follow this advice.

Next steps: the committee is supposed to complete its report by May 12 and send it to USDA and DHHS. The agencies post the report in June for public comment. Then, agency staff write the guidelines and publish them by the end of the year.

Historical note: prior to 2005, the committee wrote the guidelines.  I was on the 1995 committee and we drafted guidelines that the agencies hardly touched (except to tinker with the alcohol guideline, as I discussed in Food Politics and What to Eat).  The guidelines have always been subject to political pressures, but with the agencies writing them, expect even more.

Let’s hope the committee’s sensible ideas will survive the process.  I will be paying close attention to how the 2010 guidelines progress.  Stay tuned.

Food politics makes strange bedfellows.

The Associated Press reports that an organization of retired military personnel, Mission Readiness, is upset about obesity.  American youth, it says, are  Too Fat to Fight. Obesity may be a threat to personal health, but this group sees the problem as a threat to national security (see note below).

Here’s the irony.  The exact opposite was true in World War II.  Then, the army had trouble finding recruits who were not undernourished.

How did we go from lean to fat?  TV food commercials, for one thing, says Jane Brody in a review of recent studies.   Kids eat what they see.  The Rudd Center at Yale has even more recent data on the number of commercials watched by young children.

The Federal Trade Commission (FTC) is responsible for regulating advertising.  It has been making noises lately about taking on food marketing to kids.  I’ve heard rumors that the FTC is ready to release a report on the topic but food marketer’ complaints are holding it up.  Many marketers (not just of food) are worried that the FTC might move to restrict Internet marketing.

This might be a good time to ask the FTC what it is doing about food marketing to kids.

Note: Thanks to Bob Bannister for reminding me of George Saunders’ Shouts & Murmurs piece on this topic in the New Yorker.

Addition, April 22: The rumors about food industry pressures on the FTC turn out to be true.  Margo Wootan of CSPI reports on a meeting today with representatives of the FTC:

A number of members of the Food Marketing Workgroup met with FTC Chairman Jon Leibowitz today and delivered the letter [urging the FTC to publish standards for marketing to children]. It was a good meeting.They said that the standards are not in jeopardy and should be out in the near future. All the industry opposition has caused the agencies to go through a more thorough (i.e., slow) clearance process.

If you can’t block action, you can always delay it as long as possible.

The Washington Post reported yesterday that the FDA is about to launch an initiative to get food companies to reduce the amount of sodium in their foods.

If true, this would be a major big deal.  But by late afternoon, the FDA had issued a press release denying the Washington Post’s report (and see note below):

A story in today’s Washington Post leaves a mistaken impression that the FDA has begun the process of regulating the amount of sodium in foods. The FDA is not currently working on regulations nor has it made a decision to regulate sodium content in foods at this time.

Over the coming weeks, the FDA will more thoroughly review the recommendations of the IOM report and build plans for how the FDA can continue to work with other federal agencies, public health and consumer groups, and the food industry to support the reduction of sodium levels in the food supply.

The FDA is referring to a report also issued yesterday by the Institute of Medicine: Strategies to Reduce Sodium Intake in the United States. According to the IOM Summary, voluntary efforts by the food industry to reduce sodium intake have failed.  The report’s first recommendation is for the government to set standards for the sodium content of packaged foods.  And that sounds like what the Washington Post thought the FDA was about to do.

The idea is to get all companies to start reducing sodium.  USA Today quotes Jane Henney, the previous FDA Commissioner who chaired the IOM committee: “The best way to accomplish this is to provide companies the level playing field they need so they are able to work across the board to reduce salt in the food supply.”

The IOM is doing a public briefing on the report at 10:00 a.m. today, at the National Press Club in Washington DC.  You can listen to it via audio webcast at www.nas.edu.

The Center for Science in the Public Interest (CSPI) first asked the FDA to start regulating salt in processed foods in 1978.  Its press release and report, Shaving Salt, Saving Lives, explain why the FDA’s action would be such good news for public health.

Salt is as controversial as any nutrition issue can get.  I expect plenty of pushback from the Salt Institute and other industry trade groups if there is any hint that FDA might be about to regulate salt content.  Could the FDA’s denial be the result of industry pressure?  It would be interesting to find out.

Some basic facts: Recall that sodium is 40% of table salt (sodium chloride).  Too much raises the risk of high blood pressure and stroke.  Nearly 80% of salt is in processed and pre-prepared foods that are salted before they get to you.

The recommended maximum for adults is 2300 mg or about a teaspoon a day.  If you are at risk for high blood pressure, the maximum is just 1500 mg, or two-thirds of a teaspoon.  Americans consume more than twice that much on average.

Note added April 20: the FDA has produced a Q and A on its salt regulatory policy.

Additions April 21: Here’s the New York Times story on the IOM report.  The LA Times reports on the amounts of sodium in fast food restaurant meals.  Impressive.

On April 16, the CDC published its annual report on foodborne illnesses in a ten-state sample.  CDC writes in passive voice and it’s a struggle to get to the good news:

In comparison with the first 3 years of surveillance (1996–1998), sustained declines in the reported incidence of infections caused by Campylobacter, Listeria, Salmonella, Shiga toxin-producing Escherichia coli (STEC) O157, Shigella, and Yersinia were observed…Compared with the preceding 3 years (2006–2008), significant decreases in the reported incidence of Shigella and STEC O157 infections were observed.

Some consumer groups urge caution in interpreting the drop in toxic E. coli cases, as previous drops have rebounded.

And then there’s the not-so-good news: “The incidence of Vibrio infection continued to increase.”

Vibrio infections reflect the oyster problem I talked about last fall.  The gulf oyster industry is still fighting the FDA over methods to decrease these preventable infections.  Perhaps this bad news will encourage the FDA to get busy and regulate oyster safety.

The Inspector General of the Department of Health and Human Services is worried about FDA’s inspection ability:

• On average, FDA inspects less than a quarter of food facilities each year, and the number of facilities inspected has declined over time.
• Fifty-six percent of food facilities have gone 5 or more years without an FDA inspection.
• The number of facilities that received OAI [Official Action Indicated] classifications has declined over time.  In addition, nearly three-quarters of the facilities that received OAI classifications in FY 2008 had a history of violations. Two percent of facilities that received OAI classifications refused to grant FDA officials access to their records.
• FDA took regulatory action against 46 percent of the facilities with initial OAI classifications; for the remainder, FDA either lowered the classification or took no regulatory action.
• For 36 percent of the facilities with OAI classifications in FY 2007, FDA took no additional steps to ensure that the violations were corrected.

This is also bad news.  Worse, is congressional inaction over food safety.  The House passed its food safety bill–one designed to fix the FDA–last August.  The Senate has yet to deal with its version.  Can food safety wait?  No, it must not.

Statistician Nate Silver uses KFC’s nutritional analysis (which nobody seems to believe, for good reason, as you can see from the added note below) to create a Double Down Index for evaluating the nutritional quality of fast food based on fat, cholesterol, and sodium.

I’ve created an index based on the amount of fat, sodium and cholesterol that the Double Down and a variety of comparable sandwiches contain as a portion of the USDA daily allowance. (In the fat category, saturated fats are counted double and trans-fats are counted triple.) The index is scaled such that the Original Recipe version of the sandwich receives a score of 1.00, a measure of gluttony that will hereafter be known as The Double Down (DD).**

** To calculate Double Downs for your own favorite sandwich, apply the following formula: divide the number of mg of cholesterol by 469, the number of mg of sodium by 3,754, the number of grams of total fat by 133, the number of grams of saturated fat also by 133, and the number of grams of trans-fat by 66. Then sum the result.

He also calibrates Double Downs per Calorie (DDPC): “Take the above result, divide by the number of calories, and multiply by 540.”

His charts are great. Take a look.

Thanks to Richard Einhorn for sending.

Additional note: My NYU colleague Lisa Young, author of The Portion Teller, wrote the company to correct the calorie calculations.  She says:

I’ve done my own calculations for calories obtained from USDAs website….Even the grilled chicken version has nearly 600 calories, and that is without any sauce. Also the actual product looks bigger than the serving size info provided to me which would suggest that the breadless sandwich may even contain more calories than I have listed below.

2 3-oz pieces fried chicken = 441 kcal
2 slices Monterey Jack cheese (1 oz each)=211 kcal
2 slices bacon, medium, cooked= 87 kcal
TOTAL= 739 kcal

2 3-oz pieces grilled chicken = 282 kcal
2 slices Monterey Jack cheese (1 oz each)=211 kcal
2 slices bacon, medium, cooked= 87 kcal
TOTAL=580 kcal

Really, you can’t make this stuff up.  KFC has a new promotion with Susan G. Komen for the Cure, the group that raises funds to fight breast cancer.  The campaign is called “Buckets for the Cure.”

Participating KFC franchise locations will be selling specially designed pink buckets of grilled and Original Recipe chicken. KFC has pledged 50 cents to Komen for every pink bucket ordered by its restaurant operators during the promotion period, with a minimum donation of $1 million and a goal to raise more than $8 million. Twenty-five percent of the funds raised will be earmarked to Komen’s 120-plus domestic Affiliates for breast cancer programs in their communities. The remainder of the funds will support Komen’s national research and community programs.

OK, scientists are still arguing about the dietary determinants of breast cancer and aren’t too worried about fat, but they do worry about body weight.  Maintaining a healthy body weight is still the first recommendation of the American Cancer Society, for example.  Isn’t this campaign an incentive to buy as many buckets of KFC as you can?

On the topic of KFC’s pink buckets: the Dogwood Alliance is collecting signatures on a petition to stop KFC from destroying forests to make them in any color.

KFC buys from International Paper, a company notorious for “business as usual” destructive forest management practices like large-scale clearcutting, conversion of natural forests to plantations and reliance on toxic chemicals in forest management.

Dogwood wants KFC to use more environmentally friendly packaging for its buckets.  It has collected more than 9,000 signatures so far.  Here’s where you can add yours.

Addition, May 1: Thanks to Michelle Simon for forwarding this clip from Colbert.  A must-see.  It starts after the worm story at 1:15.

In the latest issue of the American Journal of Public Health, Derek Yach and his colleagues at PepsiCo in Purchase, NY, say yes, it can, in answer to the question they pose in their article, “Can the food industry help tackle the growing global burden of undernutrition?”

If we are to successfully combat global undernutrition, efforts must be sustained by multiple stakeholders from various sectors. We believe that trust is built through industry’s demonstration of practical actions that improve health, and recognition of these actions by governments and nongovernmental organizations. Only through new and innovative public–private sector partnerships can we truly make a difference.

Three international public health leaders counter with no, it can’t, in an article entitled “The snack attack.”  They point to irreconcilable differences between the the goals of private industry and public health:

The problem lies with food, drink, and associated companies whose profits depend on products that damage public health and that also have damaging social, economic, and environmental impacts. These most of all include transnational companies, of which PepsiCo is one. To succeed, big business must sustain and increase annual turnover, profit, and share price…We suggest that public health professionals see papers such as those of Yach et al. as part of the marketing strategies of transnational food and drink companies…The privatization of public health does not work.

This argument reminds me of the editorial that David Ludwig and I wrote for JAMA late in 2008: “Can the food industry play a constructive role in the obesity epidemic?”  We concluded:

With respect to obesity, the food industry has acted at times constructively, at times outrageously. But inferences from any one action miss a fundamental point: in a market-driven economy, industry tends to act opportunistically in the interests of maximizing profit. Problems arise when society fails to perceive this situation accurately.

While visionary CEOs and enlightened food company cultures may exist, society cannot depend on them to address obesity voluntarily, any more than it can base national strategies to reduce highway fatalities and global warming solely on the goodwill of the automobile industry. Rather, appropriate checks and balances are needed to align the financial interests of the food industry with the goals of public health.

PepsiCo owns Pepsi Cola, of course, but also Gatorade, Frito-Lay snacks, and Aquafina water, among many other brands.  According to Advertising Age (June 22, 2009), PepsiCo earned $43 billion in worldwide sales in 2008. Its product-specific advertising expenditures in 2008, just for “measured media” (meaning run through advertising agencies) were, for example:

• $162 million for Gatorade
• $145 million for Pepsi Cola
• $27 million for Tostitos
• $14 million for Doritos
• $11 million for Fritos.

These figures, staggering as they may be, do not include the amounts Pepsi spends on lobbying, supporting the American Beverage Association’s efforts to fight soda taxes, funding medical research at Yale, or marketing to children and adults in India and other developing countries, as previously discussed on this site.

Is corporate “social responsibility” really responsible?  Or is it just marketing?  And what should be the checks and balances?  You decide.

Added April 17: This comes from a former employee of PepsiCo who asks that I post this anonymously:

I think you probably know that the “marketing dollars,” the share (ads/direct marketing), of companies like Pepsico are only a fraction of what are their actually marketing/promotions budgets.  Many years ago, PepsiCo made a conscious effort to redefine/shift budgets to what is called promotional spending from traditional marketing spending.  In doing so though, they keep the control and allocation of the funds in the hands of the marketing teams.

For Pepsi I know that the $145 million you mention is probably only 25% of what Pepsi “internally” considers consumer marketing spending.  For example, direct to retails “incentive” bonus funds are given for moving volume — those funds are almost entirely funneled into the retails increasing consumer marketing to their direct customers.  There are even examples where they can hide 10’s of millions of dollars at a time by linking event sponsorships (stadiums, etc.) to retailer agreements, thus moving those dollars to long-term “capital expenditures.”  I would guess that for Pepsi alone that that $145 million could be as much as a billion a year for direct and indirect consumer marketing spending.

It is not just obscene how much gets spent to increase volume… since, for companies like PepsiCo, Coke, etc.  Volume is the only way they generate higher profit to their shareholders.  As you say, to expect a corporation to do things for the good of the consumer just shows a misunderstanding of their primary function when they are a for-profit entity.

The National Research Council has a new study out evaluating the benefits of GM (Genetically Modified) foods: Impact of Genetically Engineered Crops on Farm Sustainability in the United States.  The blurb about the book gives the good and bad news (which is which depends on how you interpret it):

Since genetically engineered (GE) crops were introduced in 1996, their use in the United States has grown rapidly, accounting for 80-90 percent of soybean, corn, and cotton acreage in 2009. To date, crops with traits that provide resistance to some herbicides and to specific insect pests have benefited adopting farmers by reducing crop losses to insect damage, by increasing flexibility in time management, and by facilitating the use of more environmentally friendly pesticides and tillage practices.

But then it continues:

However, excessive reliance on a single technology combined with a lack of diverse farming practices could undermine the economic and environmental gains from these GE crops.

I haven’t had a chance to read the book yet but I most certainly will.  I am curious to know how the report defines “sustainability” in relation to GM food crops.  In the meantime, the New York Times has weighed in on some clearly unsustainable aspects of this technology:

Use of Roundup, or its generic equivalent, glyphosate, has skyrocketed to the point that weeds are rapidly becoming resistant to the chemical. That is rendering the technology less useful, requiring farmers to start using additional herbicides, some of them more toxic than glyphosate…Shares of Monsanto [the manufacturer of Roundup], which have been falling since January, slipped nearly 2 percent Tuesday to $67.75.

When the FDA first approved GM food crops for planting in 1994, critics warned that overuse of Roundup would eventually promote the growth and proliferation of plants resistant to this chemical.    Well, yes.

As for the scope of planting, we have Louis Umerlik to thank for creating these nifty maps of use of GM crops in the U.S.  Start with this one (it gives references to sources of the information).  Then look at his maps of soybean, corn, and cotton plantings.  Enjoy (or not).