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The Institute of Medicine released a report today on how to prevent obesity in children from birth to age 5: Early Childhood Obesity Prevention Policies.

The report is remarkable for its focus on policies for parents and child care providers, and its almost complete lack of attention to policies for improving the food environment in which parents and caregivers operate.

The report’s key recommendations for children from birth to age 5:

• Promote breastfeeding
• Monitor growth
• Increase physical activity
• Provide healthy foods in age-appropriate portions
• Ensure access to affordable healthy foods; educate caregivers and parents
• Limit screen time (all media) to less than 2 hours a day

That’s all? Nothing about keeping sodas and junk foods out of the house?  Only this about food marketing to kids?

The Federal Trade Commission, the U.S. Department of Agriculture, Centers for Disease Control and Prevention, and the Food and Drug Administration should continue their work to establish and monitor the implementation of uniform voluntary national nutrition and marketing standards for food and beverage products marketed to children.

As the IOM well knows from its 2005 report on Food Marketing to Children and Youth, parents and caregivers cannot do this on their own.  They need help, and that means policies to improve the food environment.  The report does say a little about farmers’ markets and green carts as a means to improve access, but that’s it.

It’s time for a follow-up to the 2005 report.  This doesn’t do it, alas.

http://www.iom.edu/Reports/2011/Early-Childhood-Obesity-Prevention-Policies.aspx

In an action highly unusual for the FDA, the agency has released a new “special report” on what it is up against as it tries to get a handle on the safety of imported foods.

Pathway to Global Product Safety and Quality points out that imported foods account for:

• Between 10% and 15% of all food consumed by all U.S. households
• Nearly two-thirds of all fruits and vegetables
• 80% of seafood

And imported foods have increased by at least 10% during each of the last seven years and are expected to increase by 15% per year for the next several years.

The New York Times notes that in 2008 the FDA would have needed “1,900 years to check every foreign food plant at its rate of inspections at the time.”

That’s not all.  According to FDA:

Manufacturers and producers…face intense pressure to lower costs and improve productivity, fueling a cycle in which the quest for efficiency leads to increased production abroad and higher volumes of imported products to regulate.

Goods entering the U.S. will come from new and different markets, flowing through long, multistep processes to convert globally-sourced materials into finished goods.

The shift in global product flows will make it difficult to identify the “source” of a product and to ensure that all players along the supply chain meet their safety and quality responsibilities.

And it is not just legal activity that poses challenges for the FDA. Increasingly, the agency must contend with ever more sophisticated threats of fraud, product adulteration, and even terrorism.

The FDA illustrated its report with terrific graphics.  My favorite is the supply chain for canned tuna:

What will the FDA do about this problem?  It says it will:

1) Assemble global coalitions of regulators dedicated to building and strengthening the product safety net around the world.

2) With these coalitions, develop a global data information system and network.

3) Expand capabilities in intelligence gathering and use.

4) Allocate agency resources based on risk, leveraging the combined efforts of government, industry, and public- and private-sector third parties.

The FDA released its report on practically the same day that the Health and Human Services Inspector General’s office released a report highly critical of the FDA’s ability to monitor the safety of imported foods.

Because FDA’s food recall guidance is nonbinding on the industry, FDA cannot compel firms to follow it and therefore FDA cannot ensure the safety of the Nation’s food supply.

FDA did not always follow its own procedures to ensure that the recall process operated efficiently and effectively.

This kind of criticism is not new.  Just last month, the GAO issued a critical report on the FDA’s problems regulating the safety of imported seafood.  The FDA’s difficulty with recalls is that until Congress passed the food safety act last year, FDA did not have the authority to order recalls.  It had to “pretty please” ask companies to recall unsafe foods.  Now it has the authority, but Congress did not grant new resources to carry out that authority.

The New York TImes explains the reason for the FDA’s lack of oversight:

Audits of the F.D.A.’s oversight of the nation’s food system routinely find the agency’s efforts wanting, in part, the agency says, because its budget for such activities has long been inadequate. And although the new food safety law gave the agency extra supervisory powers, it is not clear how much it will be able to do, given that House Republicans have proposed cutting its budget for protective measures.

The FDA official in charge of food safety, Michael Taylor, has been discussing the vexing resource question in recent speeches.  He points out that the FDA:

Has a a huge workload. And even though public health officials are working hard, the agency will likely not meet all of its deadlines. On top of the backlog, FDA has no idea what its budget will be for fiscal year 2012.

An agriculture appropriations bill that cleared the House last week would cut food safety programs $87 million below fiscal year 2011.

The current budget situation does paint a challenging picture…a patchwork of continuing resolutions to keep the government funded — as we saw in 2011 — makes it nearly impossible to plan ahead.

When Congress gives us our budget over half way through the fiscal year it’s very difficult to use that money in as orderly a way as possible. You can’t use that money to hire the experts you need because the hiring process is such that you won’t get them hired until the end of the fiscal year

When it comes to food safety, we only have one food supply, and it is global.  That was the whole point of my book Pet Food Politics: The Chihuahua in the Coal Mine—a case study of how melamine in China got into American, Canadian, and South African pet foods.  If it could happen to pet food, it could happen to ours.

To monitor the safety of imported foods, the FDA neeeds to be stronger, not weaker.

My post last week about KFC, Pepsi, and cause marketing elicited a lively dicussion along with some further examples.

Ken Leebow of “Feed Your Head” sent this one along with a comment: “Don’t pollute the Earth, but your body: Go for it!”

Cara Wilking of the Public Health Advocacy Institute (PHAI) sent this one: Give blood, eat a Whopper.  Cara, by the way, has done her own piece on why organizations that care about health should avoid partnerships with soft drink companies.

And Lisa Young sent a note about Coca-Cola’s sponsorship of continuing professional education credits for dietitians, for a course about bone health.  On that same site, if you pledge to LivePositively.com, Coke’s Sprite Zero will donate $1 to the American Cancer Society.

For those of you who insist that these kinds of partnerships raise money for Good Causes, please consider whether soft drinks are good for bone health or whether artificial sweeteners are good for cancer prevention.  The answers may not be in, but the questions are worth asking.

Cause marketing, I submit, is much more about the marketing than it is about the cause.

In case you missed it, here’s another contribution to food guides, this one from the Smack! sports section of the Chicago Tribune (June 5):

No comment needed.

Enjoy the weekend!

[Thanks to Yankees fans Sandy and John for sending]

I collect things like this—examples of food company marketing alliances with health and nutrition organizations that by all rights should be advising their members and clients not to eat much of the company’s products.  This one promotes mega-size Pepsi to raise funds for the Juvenile Diabetes Research Foundation.

This particular treasure comes from a blogger, Joe Tower, who runs a business—“Selfish Giving”—that helps companies do cause marketing.  This one crosses a line, even for him:

I’ve said this before: I don’t have a problem with nonprofits and fast-serve chains doing cause marketing. What I do have a problem with is when fast serve chains like KFC encourage consumers to buy products that directly contribute to the health conditions – in this case diabetes – they are supposedly trying to prevent by partnering with the cause in the first place….What was JDRF thinking? I’m not sure, but I’m calling them today to see if I can find out!

Here are excerpts from the response from JDRF:

We appreciate your concerns and your questions about the banner promoting a JDRF fundraising activity at KFC. Please understand that the fundraiser in question is a local initiative in Utah involving a single KFC franchise owner with a personal type 1 diabetes connection.That said, JDRF values its supporters, both individual and corporate, and their efforts to raise funds to support research aimed at improving lives and curing type 1 diabetes. JDRF carefully reviews national partnership opportunities to ensure that they are appropriate prior to joining corporate campaigns to raise funds.

Regarding this particular promotion, we understand that one of the criticisms has been the association with a sugary product, which many have associated with contributing to diabetes. It’s important to note that JDRF supports research for type 1 diabetes, an autoimmune disease that results when the immune system attacks the cells in the pancreas that produce insulin, therefore requiring a child or adult with the disease to depend on insulin treatment for the rest of their lives. It is a common misconception that type 1 diabetes is caused by obesity or eating too much junk food or sweets.

Finally, JDRF does not endorse any particular products, nor any particular diet. People with type 1 diabetes should work with their healthcare team to determine a diet that works best for them. JDRF fully supports people living with type 1 diabetes engaging in healthy eating habits and lifestyles.

–Gary Feit, National Manager, External Communications, Juvenile Diabetes Research Foundation

As I find myself saying again and again, you cannot make this stuff up.   And how does Pepsi, now promoting itself as a wellness company, feel about this?

[Thanks to David Schliefer for sending]

Update June 17: I hear rumors attributed to a Pepsi V.P. that the promotion is “no longer running.”

For an instant tutorial in U.S. food politics, take a look at this Washington Post map of where agricultural subsidies go.

Presidents have been trying to get rid of subsidies for decades, but they also want to be reelected.  Will Obama succeed where others have failed?  We shall soon see.

The Environmental Working Group (EWG) has just published its 2011 guide to the most and least pesticide-laden fruits and vegetables.

The #1 “dirtiest”?  Apples.  The remedy?  Buy from the EWG “clean 15” list or buy organic.

The “dirty dozen” list, in order: Apples, Celery, Strawberries, Peaches, Spinach, Imported nectarines, Imported grapes, Sweet bell peppers, Potatoes, Domestic blueberries, Lettuce, Kale/collard greens.

The “clean 15” list of foods with the least pesticides: Onions, Sweet corn, Pineapples, Avocados, Asparagus, Sweet peas, Mangoes, Eggplant, Domestic cantaloupe, Kiwifruit, Cabbage, Watermelon, Sweet potatoes, Grapefruit, Mushrooms

How much should you worry about pesticides on foods?  As one reader asked,

Is it better to eat conventional fruits (cherries, berries and apples) and other veggies (peppers) that are on the “dirty” vegetable list or forego them altogether?

This is not an easy question to answer.  EWG recognizes that the science linking pesticides to health problems is limited (this is an understatement).  EWG bases its rankings on data published by USDA and FDA.  It considers:

• Percent of samples tested with detectable pesticides
• Percent of samples with two or more pesticides
• Average number of pesticides found on a single sample
• Average amount (level in parts per million) of all pesticides found
• Maximum number of pesticides found on a single sample
• Total number of pesticides found on the commodity

EWG explains that its

Shopper’s Guide is not built on a complex assessment of pesticide risks but instead reflects the overall pesticide loads of common fruits and vegetables. This approach best captures the uncertainties of the risks of pesticide exposure and gives shoppers confidence that when they follow the guide they are buying foods with consistently lower overall levels of pesticide contamination.

Most available research supports the health benefits of eating fruits and vegetables regardless of their pesticide loads.  Ken Cook, the president of EWG says:

We recommend that people eat healthy by eating more fruits and vegetables, whether conventional or organic,” says Ken Cook, president and founder of Environmental Working Group. “But people don’t want to eat pesticides with their produce if they don’t have to. And with EWG’s guide, they don’t.”

By EWG calculations, you can lower your pesticide intake by 92% if you avoid the dirty dozen.  No wonder.  How’s this for an observation: “Hot peppers had been treated with as many as 97 pesticides, followed by cucumbers (68) and greens (66).”  Who knew?

Where is the produce industry in all of this?  EWG reports that produce trade associations are working hand-in-glove with the pesticide industry to attempt to keep information about these chemicals out of the public eye.

I wish more research existed on the dose-response effects of pesticides and on their long-term effects on health, especially in children.  I cannot imagine that pesticides are good for health.  In high doses, they are demonstrably harmful to farm workers.

But what about the low doses on fruits and vegetables?  Here, the evidence for long-term harm is weak, uncertain, and unhelpful.

What to do?

On the personal side: if you want to avoid eating pesticides, you can stick with the EWG 15.  Washing produce before eating it is always a good idea even if it doesn’t get rid of all of the chemicals (USDA studies are done on washed produce).  When in doubt, buy organic.

As for the political, if ever there was a situation where more research was needed, this is it.  And isn’t it time for industrial food producers to find ways to use fewer pesticides?  Let the produce trade associations know that you don’t like their defense of potentially harmful chemicals and that you much prefer organic.

Addition, June 16: For anyone interested, here are the USDA’s pesticide announcements for the new data:

Press release

Consumer factsheet

Report executive summary

For years, as Tom Philpott recounts on his new food and agriculture blog for Mother Jones, public health advocates have fretted about the use of arsenic-containing drugs to kill intestinal parasites and promote growth in chickens.

One such drug is roxarsone, made by Pfizer. Its arsenic is in the organic (carbon-containing) form, which is less toxic than the inorganic form.

But, as the New York Times explained, evidence has been accumulating that the organic form can change into the more toxic, inorganic form, a known carcinogen.

As reported in Food Safety News,  the Center for Food Safety, the Institute for Agriculture and Trade Policy, and several other consumer and agriculture groups petitioned FDA to ban the drug three years ago.

Last week, the FDA announced that the agency had done its own feeding tests.  Chickens fed organic roxarsone had higher levels of inorganic arsenic in their tissues.  The FDA got Pfizer to “voluntarily” withdraw the drug from the market.

The surprise here is not the FDA’s delay in dealing with this drug.  The big surprise is that the FDA did its own testing.  As the Times put it:

The F.D.A. once routinely conducted its own studies of animal and human drugs, but limited budgets led the agency to eliminate much of its scientific and laboratory capacity over the years. The roxarsone study is a triumph for agency scientists but one unlikely to be repeated very often. The agency asked for $183 million in additional funds for food safety efforts next year, but House Republicans have instead proposed cutting $87 million.

Drug companies cannot be expected to do their own testing if there is any chance that the tests will show something not in their best interest.  If independent federal agencies don’t do these kinds of studies, who will?

I can remember when the FDA housed a group of researchers doing outstanding work on food allergies in the 1990s.  The FDA closed down that lab when it was given additional responsibilities by Congress with no additional funding.

The FDA is a public health agency.  Its job is to protect the public against unsafe food contaminated with bacteria or antibiotics such as roxarsone.  The agency gets high marks for taking this on.  And Congress needs to support the FDA’s research mission.