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The World Health Organization (WHO) has a new, tough report out: “Set of recommendations on the marketing of foods and non-alcoholic beverages to children.”

It’s policy aim: to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.

Here are some of its recommendations (edited):

• Given that the effectiveness of marketing is a function of exposure and power, the overall policy objective should be to reduce both the exposure of children to, and power of, marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• To achieve the policy aim and objective, Member States should consider different approaches, i.e. stepwise or comprehensive, to  reduce marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt, to children.
• Settings where children gather should be free from all forms of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• Governments should be the key stakeholders in the development of policy and provide leadership, through a multistakeholder platform, for implementation, monitoring and evaluation. In setting the national policy framework, governments may choose to allocate defined roles to other stakeholders, while protecting the public interest and avoiding conflict of interest.
• Considering resources, benefits and burdens of all stakeholders involved, Member States should consider the most effective approach to reduce marketing to children of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• Member States should cooperate to put in place the means necessary to reduce the impact of crossborder marketing (in-flowing and out-flowing) of foods high in saturated fats, trans-fatty acids, free sugars, or salt to children.

The Rudd Center at Yale has just released Fast Food F.A.C.T.S., a thoroughly comprehensive report on the marketing of fast food to children and adolescents.

The report lavishly illustrates and extensively documents the ways in which fast food companies market to kids, the strategies they use, and the effects of these efforts on kids’ diets.

Readers: add it to your library!  FDA and FTC: get busy!

Addition: Advertising Age reports on the fast food industry’s response to the Rudd Center report.  All the industry can come up with, says Advertising Age, is a “canned response.”  Looks like the Rudd Center got it right.

My monthly (first Sunday) San Francisco Chronicle column deals with the quite astonishingly complex and consumer unfriendly rules for labeling alcohol beverages, in answer to this question:

Q: I like to read nutritional information on the foods and beverages I consume. Why is there no such information on alcoholic beverages?

A: You want to know the alcohol, calories and ingredients in your wine, beer and liquor? Good luck.

Some alcohol drinks label some of this, but so inconsistently that it’s hard to make sense of it. The alcohol beverage industry prefers that you not think about what’s in their products. And Congress does not want alcohol marketed as nutritious.

Remember Prohibition? This was the era from 1920 to 1933 when alcohol could not be made, transported or sold in America. When it ended, Congress passed the Alcohol Administration Act of 1935, still in force. Recognizing the tax potential of alcohol beverages, Congress assigned their regulation to the Treasury Department. Treasury’s Alcohol and Tobacco Tax and Trade Bureau (TTB) sets rules for alcohol labels.

Absurd as it may seem, the labeling rules differ for wine, beer and distilled spirits. Substances to which people might be sensitive, such as sulfites and yellow No. 5, must be labeled, but TTB considers “ingredients” only to mean carbohydrate, protein and fat. If a label states calories, it must also state those ingredients, even though wine and hard liquor hardly have any (beer has some carbohydrate).

Listing other ingredients is voluntary and some winemakers are placing ingredient lists on labels – mostly grapes, but sometimes oak products.

Concentrate hard on what comes next. Labels of distilled spirits must state percent alcohol. They may list calories (but usually don’t). Wine label rules depend on percent alcohol. Wines containing 14 percent alcohol or more must display alcohol content; they may list calories (but don’t).

Wines from 7 to 14 percent must list alcohol and may list calories, unless they are labeled “light” or “table,” in which case they do not have to list either.

And get this: Wines with less than 7 percent alcohol are regulated by the Food and Drug Administration, not TTB. They must display Nutrition Facts labels with calories, nutrients and actual ingredients. They may disclose percent alcohol, and some do.

The 1935 act prohibited beer labels from disclosing alcohol content, lest manufacturers compete to sell “stronger” products, but the ban was successfully challenged in court.

Now beer labels may state percent alcohol, and when it helps sales, they do. The “energy-booster” beers associated with college drinking freely display alcohol content. Their labels also boast of caffeine, ginseng and taurine, ingredients regulated by the FDA as food additives.

Calories on beer labels are equally inconsistent. Regular beer may state calories. Light beer must do so.

I’m not done yet. If a beer is made from a grain other than malted barley, it is FDA-regulated. It must display Nutrition Facts; it may display alcohol.

Strangest of all, regulations differ from one state to another and state rules sometimes can supersede those of TTB, but not those of FDA.

Let’s credit the advocacy group Center for Science in the Public Interest with trying to fix this absurd, consumer-unfriendly situation. For decades, CSPI has petitioned Treasury to require disclosure of alcohol, calories and contents on alcohol labels.

In the early 2000s, CSPI and a coalition of 70 consumer and health groups petitioned TTB to require Alcohol Facts labels listing those and other relevant details. The alcohol industry countered with a proposal for voluntary labeling. At the height of the low-carbohydrate diet craze, makers of distilled spirits were eager to market them as “no-carb.”

In 2004, TTB issued guidance to industry on how to voluntarily label products with a Serving Facts panel. In 2007, in response to public comment, TTB finally proposed mandatory labeling rules for alcohol beverages. These called for a Serving Facts panel listing alcohol, calories, carbohydrate, protein and fat in all beverages under TTB jurisdiction.

But lest these requirements appear too onerous, TTB agreed to allow companies to leave percent alcohol off the Serving Facts panel, as long as it appeared someplace else on the label. In response, CSPI insisted that TTB delete the unnecessary fat and protein listings, include alcohol on the panel and list all actual ingredients, along with a warning statement about excess alcohol consumption.

To date, TTB has neither responded to CSPI nor issued final rules. Its proposals apparently got caught in election cycles and remain in limbo. CSPI, in cutting budgets, closed its alcohol policy center last year.

What to do? If you want to know calories, you mostly have to guess. Standard servings of wine (5 ounces), regular beer (12 ounces) and spirits (1.5 ounces) each provide about 100 alcohol calories. Carbohydrates add 20 or more to wine, and 50 or so to beer. Yes, those calories count, and more and larger drinks have more calories.

For unlabeled alcohol, sweeteners and other food additives, you just have to hope for the best. Or you can write your congressional representatives to get TTB moving on alcohol labeling.

This article appeared on page K – 4 of the San Francisco Chronicle

I am indebted to FoodSafetyNews for a curious item about President Obama’s food tasting problem in India.  I can understand why the White House would be concerned.  It is easy for Americans unused to the local bacteria to get food poisoning while traveling anywhere, and such things happen in India (I have some personal experience with this problem, alas).

The Indian government has recruited twelve somewhat reluctant doctors at a hospital in Mumbai to join the tasting staff that usually travels with the President.  [Aside: I wonder how one gets a job like this.  It could be a lot of fun].  The Indian doctors’ view, however:

This job is often annoying because we are not professionals and are used as guinea pigs. However, it is exciting to work for Obama,” one anonymous doctor told the Mirror. “We have already started doing our homework on what he will be eating. We will be meeting the hotel chefs tomorrow.”

“We taste samples and also store some for the cops,” explained one doctor on the assignment. “If anything goes wrong, we can use these samples for investigation.”

These physicians live in India and must have built up some immunity to the local flora.

And I can’t figure out how the tasting would work.  It often takes some hours after eating before the effects of food poisoning to show up.  Just because a food is safe early in the day does not necessarily mean it would still be safe after sitting around for some hours.

I’m guessing the President has to follow the same food safety rules as the rest of us when traveling in tropical countries with questionable water supplies:

• Do not drink tap water and do not use it to brush your teeth.
• Do not drink bottled water if the seal on the bottle has been broken.
• Do not use ice unless you’re sure it’s made from purified water.
• Do not drink milk or eat dairy products that have not been pasteurized (heated to a temperature that kills all germs).
• Do not eat raw fruits or vegetables unless they can be peeled and you are the one who peels them.
• Do not eat cut-up fruit salad.
• Do not eat lettuce or other leafy raw vegetables (such as spinach).
• Do not eat raw or rare (slightly cooked) meat or fish.
• Do not eat food from people who sell it on the street.

I hope he enjoys his trip.  The food is likely to be supremely delicious—as soon as it cools down enough to enjoy.

In a friend of the court brief, the justice department said human and other genes should not be eligible for patents because they are part of nature.

Although the brief focuses on genes for breast and ovarian cancer, and specifically excludes man-made genetic modifications like those in corn and soybeans, it could be interpreted as having some implications for food biotechnology—excluding “biopiracy,” for example.

As I explain in my book, Safe Food: The Politics of Food Safety, patents on genetically modified foods raise at least six difficult issues, biopiracy among them:

• Ownership: the patents are often broad and owned by just a few companies. Biopiracy: this is the pejorative term for the private appropriation of public biological resources, the precise issue that elicited the justice department’s brief.
• Enforcement: biotechnology companies use aggressive techniques to enforce their patent rights.Injustice: court decisions have consistently favored the patent rights of food biotechnology companies.
• Biopiracy: the pejorative term for the private appropriation of public biological resources.
• Animal rights: patenting of animal genes raises religious and ethical questions.
• Terminator technology: the patenting of genes that prevent seed germination (meaning that farmers cannot save seeds and have to buy new ones every year)

Even with its limited scope, patent lawyers and biotechnology industry representatives hate the brief.

One patent lawyer characterized the new position as dumb. The Biotechnology Industry Organization warned that such a policy, if carried out, would “undermine U.S. global leadership and investment in the life sciences.”

No wonder they hate it.  Stocks promptly fell.

Patenting is patently unfair.

The justice department’s brief helps some, but needs to address more of the issues noted above.

I’ve been doing some writing about alcohol labeling lately and was surprised to see a Joose flavored malt beverage (translation: beer) in a local Duane-Reade drug store.  Its label said it contained caffeine, taurine, and ginseng, ingredients not usually found  in beer.

But what really surprised me was the alcohol content–9.9%–displayed in three places on the label.

This is twice the alcohol content of many beers.  Alcohol beverages are regulated by the Treasury Department which does not require alcohol contents to be listed on beer labels.  So this was a voluntary disclosure that could have only one purpose: marketing the higher alcohol content.

So I have been following the current furor about the effects of the Four Loko brand on the health and welfare of college drinkers.  Four Loko, in case you missed it, has sent students at several colleges to emergency rooms with extreme alcohol toxicity.

The New York Times quoted Peter Mercer, President of Ramapo College in New Jersey, one of the places where six students drank themselves into a stupor.  One of the students had a blood alcohol level of .40, which is twice the concentration needed to stupify.  Ramapo has now banned the beverage from campus.

I do not see any socially redeeming purpose being served by these beverages….At the end of the day, they’re aimed at a young, inexperienced market for the purpose of enabling them to become rapidly intoxicated.

The Times’ Frank Bruni did a tasting experiment:

And what I quickly came to see was that if you set out to engineer a booze delivery system that is as cloying, deceptive and divorced from the usual smells, tastes and presentation of alcohol as possible, you’d be hard pressed to come up with something more impressive than Four Loko.  It’s a malt liquor in confectionary drag.

Bruni’s conclusion:

Four Loko is all stealth: spoonfuls of sugar to help the medicines go down. Until I felt a slight flush in my cheeks and subtle tingling on my scalp, I could have convinced myself that I was drinking candy. It wasn’t to my liking, but then neither are jelly beans. Spike a satchel of those with both an intoxicant and a stimulant, and Four Loko might have some fierce new competition.

None of this is news, really.  The Marin Institute, which calls itself the “Alcohol Industry Watchdog,” has been writing about the dangers of caffeinated alcohol beverages to young drinkers since the products were first released.

In its report, “Alcohol, energy drinks, and youth: a dangerous mix,” the Institute summarizes the hazards:

• The products are designed to look like non-alcoholic versions.
• Sometimes the alcoholic and non-alcoholic versions are indistinguishable except for the Nutrition Facts label on the non-alcoholic varieties.
• The effects of alcohol are masked by the sugar and caffeine.
• They are marketed to make kids drunk.

And now comes an investigative report that Four Loko did a major spin on its social media to remove all traces of evidence that the company, Phusion Products, was promoting it as a party drink.  My favorite part of this report is a conversation between the reporter and Chris Hunter, a lawyer for Four Loko.

When Hunter objected to me calling Four Loko an energy drink, I pointed out that I had read the language directly from Phusion Projects’ website. Silence followed. I read him parts of the phrasing from the now-changed company profile (“three college friends from The Ohio State University noticed the growing popularity of mixing alcoholic and energy drinks, like Red Bull and vodka, and decided to create a beverage company of their own”).

“Okay, no worries,” he answered.

I then pointed out that the language is now different on the page.

“No worries,” he said again.

So it’s not an energy drink?

“No, this is a caffeinated alcoholic beverage.”

As for caffeine, its effects when combined with alcohol are considered serious enough to merit creation of a new journal, the Journal of Caffeine Research: The International Multidisciplinary Journal of Caffeine Science. The journal will be devoting much attention to the role of caffeine in alcohol energy drinks.

Thanks to Michele Simon of the Marin Institute for alerting me to much of this.

Addition: Michele points to Phusion’s defensive posting explaining why its products are safe and acceptable.  Its comment of FDA vs TTB Treasury Department) regulation is an indication of the messy way in which alcohol beverages are regulated.  TTB regulates the labels in an exceptionally complex way, with many inconsistencies and exceptions.  FDA regulates one category of wines (less than 7% alcohol) and beers that are made from something other than malted barley.  But FDA is also responsible for food additives, no matter where they go.  So the caffeine, tauring, and ginseng in Four Loko fall under FDA authority–not that it has done anything about them yet.

In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes “The big issue is ultra-processing.”  Because his Commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.

The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.

Monteiro makes it clear that all foods and drinks are processed to some extent.  Fresh apples are washed and, sometimes, waxed.  Drinking water is filtered.  Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:

• Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
• Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt.  These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
• Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).

The purpose of Type 3 ultra-processing is to create:

durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration (‘long shelf life’), to be transportable for long distances, to be extremely palatable (‘high organoleptic quality’) and often to be habit-forming. Typically they are designed to be consumed anywhere – in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.

Monteiro argues: “the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world.”

As evidence, he notes that ultra-processed products as a group are:

• Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
• [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
• Relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy.
• Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
• Available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
• The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.
• Promoted by lightly regulated or practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being of children.

Overall, he says:

Their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.

His groups the main points of his argument in three theses:

• Diets mainly made up from combinations of processed ingredients and unprocessed and minimally processed foods, are superior to diets including substantial amounts of ultra-processed products.
• Almost all types of ultra-processed product, including those advertised as ‘light’, ‘premium’, supplemented, ‘fortified’, or healthy in other ways, are intrinsically unhealthy.
• Significant improvement and maintenance of public health always requires the use of law. The swamping of food systems by ultra-processed products can be controlled and prevented only by statutory regulation.

Lest there be any confusion about the significance of this proposal for public health nutrition, an accompanying editorial (unsigned but assumed to be by Geoffrey Cannon) poses a serious challenge: “Nutrition science: time to start again.”

This editorial is about the significance of food processing, and in particular of ‘ultra-processed’ food and drink products. It is also about the nature, purpose, scope and value of nutrition science, which as conventionally taught and practiced, is now widely perceived to have run into the buffers or, to change metaphor, to have painted itself into a corner.

The editorial argues that nutritionists’ focus on nutrients, rather than foods, has led to the assumption that if foods contain the same nutrients, they are the same—even though it is never possible to replicate the nutritional content of foods because too much about their chemical composition is still unknown.

This notion is an exquisite combination of stupidity and arrogance, or else of intelligence and cunning. For a start, similar results can only be of those chemical constituents that are at the time known, and actually measured.

These are important ideas, well worth consideration and debate.  I am struck by their relevance to the latest survey of soft drink availability in American elementary schools.  Despite the efforts of the Clinton Foundation and the voluntary actions of Coca-Cola and Pepsi-Cola, the availability of soft drinks to young school children increased from 49.% to 61% just in the year from 2006-07 to 2008-09.  Soft drinks, in Monteiro’s terms, are ultra-processed.  Doing something about them requires statutory regulation.

Consideration of the effects of ultra-processing might help us look at what we feed our kids in a more constructive way.  This is important work.

Addition: I should have mentioned that Monteiro’s approach is consistent with that of the people (including me) who worked with the Strategic Alliance in Oakland, CA to write Setting the Record Straight: Nutritionists and Health Professionals ” Define Healthful Food.

The Alliance is California’s network of food and activity advocates, we’ve developed a definition of healthy food that asserts that truly healthful food comes from a food system where food is produced, processed, transported, and marketed in ways that are environmentally sound, sustainable, and just.

If you agree with Setting the Record Straight, you can endorse it on the Strategic Alliance’s website.