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The New York City Health Department announces good news and bad news.  The good news is that seven companies have agreed to reduce the salt in their products.  The bad news:

• The average sodium intake in New York is 3.1 grams (2.3 grams is recommended for people who are not at risk of hypertension; for those who are, it’s 1.5 grams )
• 79% of New Yorkers exceed sodium recommendations
• 89% of New Yorkers at high risk of hypertension exceed sodium recommendations

Reminder: salt is 40% sodium.  This means that 3.1 grams of sodium is equivalent to nearly 8 grams of salt (two teaspoons).

The health department is working hard to bring restaurants and packaged food companies on board with salt reduction initiatives.  Packaged foods are easier (they have to label the amount of sodium).  The salt in restaurant foods is up to the chef, and one meal can easily exceed recommended levels for a day.

As for the effect of such efforts on food companies, FoodNavigator.com has compiled its recent pieces on salt restriction, all from the viewpoint of industry:

Salt restriction could increase risk of iodine deficiency: Restricting salt intake could increase risk of iodine deficiency, particularly among women, according to a new study published in the American Journal of Hypertension…

Mandatory sodium reduction 20 times more effective, finds study: Imposing mandatory sodium limits for processed foods could be 20 times as effective as voluntary reduction measures, suggests a new study published in the journal Heart…

Review shows steady US sodium consumption: Rising obesity rates may be a more important factor for hypertension than rising sodium consumption, claim the authors of a new study that suggests US sodium intake has remained relatively constant over the past 50 years…

Food makers look to umami as they cut sodium, says Bell Flavors: Food manufacturers are increasingly looking to boost the taste of their products with mouth-filling umami-type flavors as they reduce sodium in their products, according to Bell Flavors and Fragrances…

Concerted industry effort needed for sodium reduction: In order to cut sodium from American diets food manufacturers must work in unison to reduce sodium in their products – and their efforts have gained momentum, according to major industry players…

Packaged food makers have to label the sodium in their products

I was interested to read Charles Blow’s comment in the New York Times (March 12) on the results of a recent Pew Research Center poll.  The question: Should the government should have a role in obesity prevention?

Nearly 60 percent said yes. Only about 40 percent said no.  Blow comments:

This is a remarkable change in public sentiment from 2005 when the Harvard School of Public Health asked a similar question and got almost the exact opposite result.

So what happened in the intervening years? One major occurrence has been the push by the president and first lady to combat the problem. Their initiatives promote commonsense approaches like increased breast-feeding, better diets and more exercise. Who could argue with that? The right, that’s who.

Blow presents the obesity statistics for states won by John McCain in 2008 (see below).  His conclusion:

This really shouldn’t be a partisan issue. This should be an all-hands-on-deck issue, including the hands of the government.

And red states, many of which are now the biggest losers in the fight against childhood obesity, have the most to gain.

To me, the interesting thing about this table is what we public health people call “tracking.”  Obesity tracks (correlates) with other measures of poor health—diet, activity, prenatal care, health care—all of which also correlate closely with poverty.

The curiosity here is why people who lack access to education, health care, and, for that matter, healthful diets would vote for candidates who don’t want them to have those things, but that’s American politics for you.

I keep telling you.   You can’t make this stuff up.  Try these for food politics–in this case, soda politics–in action.

Beverage Association gives $10 million to Children’s Hospital of Philadelphia (CHOP)

From the Philadelphia Inquirer blog (March 16):

In keeping with a controversial pledge to made last year to City Council as part of an effort to ward off Mayor Nutter’s steep tax on sugar-sweetened beverages, the soft-drink industry will donate $10 million to the Children’s Hospital of Philadelphia to fund research into and prevention of childhood obesity.

The three-year grant is funded by a new organization, the Foundation for a Healthy America, created by the American Beverage Association, the national trade group representing manufacturers and bottlers. The ABA was instrumental in lobbying Philadelphia City Council to reject Nutter’s proposal to tax sugary drinks at 2-cents per ounce as a way to cut consumption and raise money for the general fund.

In a press release Wednesday, CHOP insisted that it will “retain absolute clinical and research independence,” as the source of its funding for the research is likely to come under attack from those wary of the beverage industry’s influence. That includes funding for clinical studies to be submitted to peer-reviewed publications.

Atkins Obesity Center publishes review of effects of soft drinks on obesity

In a delicious irony, the latest review of this topic comes from the Atkins Center at Berkeley.  Yes, the Atkins Diet Atkins, the one that promotes high-fat, low-carbohydrates, and has everything to gain from proving that sugars are bad for you.

With that duly noted, set the irony aside.  The review was funded by independent agencies and organizations.  Let’s take its results at face value.

The reviewers looked at five kinds of evidence: secular trends, mechanisms, observational studies, intervention trials and meta-analyses.  All supported the idea that

The currently available evidence is extensive and consistently supports the hypothesis that sweetened beverage intake is a risk factor for the development of obesity and has made a substantive contribution to the obesity epidemic experienced in the USA in recent decades.

Sweetened beverages are an especially promising focus for efforts to prevent and reduce obesity for two reasons: (i) the evidence supporting the association between sweetened beverage intake and excess weight is stronger than for any other single type of food or beverage; and (ii) sweetened beverages provide no nutritional benefit other than energy and water.

Coca-Cola funds North Carolina School of Public Health campaign against Childhood Obesity

Isn’t that nice of them?  The apparently unironical slogan of the campaign : “Everything in moderation.”

Robert Wood Johnson Foundation report, “F as in Fat”, features piece by PepsiCo’s CEO

Melanie Warner, writing on bNET, explains that the RWJ Foundation is usually scrupulously independent but that putting Pepsi’s PR piece into its document makes no sense.

A third of the way into the report, up pops a bizarre “personal perspective” from PepsiCo’s (PEP) CEO Indra Nooyi in which she details the many ways her company is working to make America healthier. “Helping consumers by building on our portfolio of wholesome and enjoyable foods is not just good business for PepsiCo -– it’s the right thing to do for people everywhere,” Nooyi chirps in a two-page soliloquy that reads like a press release and touts everything from Pepsi’s pledge to reduce the sodium in its products by 25% by 2015 to its reduced sugar drinks like Trop50 and G2. No other food company is mentioned, just Pepsi.

[This inclusion]…also ties into the ongoing debate about what role the food industry should play in helping Americans slim down. Are food companies trusted partners who are committed to fundamental changes, or is getting people to eat healthier versions of processed food really a whole lot of Titanic deck chairs?

As the research linking soft drinks to obesity gets stronger and stronger, it is no wonder that the Beverage Association is buying off city councils, and soft drink companies are eager to position themselves as helping to solve the problem of childhood obesity, not cause it.

Do these actions remind you of any other industry’s behavior?  Cigarette companies, anyone?

I was surprised to read a report in FoodNavigator.com that a private company is about to conduct an enormous—and undoubtedly very expensive—study of the nutritional status of children in Southeast Asia.

The study will collect data from more than 16,000 children aged 12 and under in four countries:

• Dietary profiles and nutrient intake assessment, including food intake, bone density and cognition.
• Iron status, vitamins, lipid profile and blood pressure.
• Body composition and physical activity, including measurements on weight, height and hand grip strength.

The company is doing this in partnership with institutions in Indonesia, Malaysia, Thailand, and Vietnam.

Why would a private company embark on a project like this?  The company is FrieslandCampina, a Dutch firm specializing in dairy products:

We provide people around the world with all the good things milk has to offer, with products that play an important role in people’s nutrition and well-being.

Our product range: baby and infant food, milk-based drinks, cheese, milk, yoghurts, desserts, butter, cream, milk powder, dairy-based ingredients and fruit-based drinks.

As the company explains, “We aspire to help people move forward in life with our dairy nutrition, and are committed to helping our consumers maintain and improve their nutritional well-being with the goodness of milk.”

I’m willing to predict that these studies will show that kids in Southeast Asia would be a lot healthier if they drank more milk.   And will find reasons to dismiss concerns that lactose intolerance is the norm in Asian populations over the age of five or so.

I’ve been mulling over the article in the New York Times (March 13) about the effects of an itinerant lifestyle and the threat of deportation on the children of farmworkers in California.  If ever there was an example of how the political gets personal, this is it.

The article focuses on a third-grade teacher, Oscar Ramos, who is on the front lines trying to give these kids a chance in life, let alone at the American dream.  It describes what he’s up against: nearly all his students are near the poverty line, and nearly 80% have limited English.  They move frequently and live under crowded conditions.

But the often disrupted lives of the children of migrants here is likely to grow still more complicated as the national debate over immigration grows sharper.

Efforts by lawmakers to rescind automatic citizenship for children born in the United States to illegal immigrants are already stoking fears among many agricultural workers, and that has consequences for their children.

Some parents, as they move with the crops, are already keeping their children out of school when they get to Arizona because they are worried about the bureaucracy and tougher restrictions in the state.

The article is long but well worth reading.  If nothing else, take a look at the photographs.

This is how our relatively inexpensive food gets to us.   The costs, as the economists tell us, are externalized.  Here is one of those externalized costs–the potential of those kids to become functioning citizens in our democratic society.

Today’s New York Times has a story about how Mexico is trying to improve school food in an effort to help prevent childhood obesity.

By all measures, Mexico is one of the fattest countries in the world, and the obesity starts early. One in three children is overweight or obese, according to the government. So the nation’s health and education officials stepped in last year to limit what schools could sell at recess. (Schools in Mexico do not provide lunch.)

The officials quickly became snared in a web of special interests led by Mexico’s powerful snack food companies, which found support from regulators in the Ministry of the Economy. The result was a knot of rules that went into effect on Jan. 1.

“What’s left is a regulatory Frankenstein,” said Alejandro Calvillo, Mexico’s most vocal opponent of junk food, particularly soft drinks, in the schools. “They are surrendering a captive market to the companies to generate consumers at a young age.”

By all reports, schools in many Latin American countries sell candy and soft drinks in lieu of real food.  Kids pretty quickly get used to the idea that those foods mean lunch, and eating them is normal.  Never mind the effects of such diets on teeth—dental decay is increasing rapidly—and body weights.

By coincidence, I just received a paper from Brazilian investigators documenting the way soft drink companies are funding physical education activities in that country.  That’s one way to deflect attention from aggressive marketing in schools and other venues.

Last year, Coca-Cola, Pepsi-Cola, and Kraft reported rising profits from overseas sales.  With the U.S. market for their products flat or declining, companies are looking to developing markets for increased sales.  Obesity is sure to follow.

Yet another study confirms the obvious: kids prefer foods with cartoons on the package. Why should this be obvious?  Why else would the cartoons be there if not to sell products to kids?

The latest study comes from the Archives of Pediatrics and Adolescent Medicine.

It says pretty much the same thing as the study published in Pediatrics last year by investigators from the Yale Rudd Center.

The newer study did something cute. It invented a cereal box and tested kids’ responses to it and variations with and without cartoons of the penguins Mumble and Gloria from the movie Happy Feet .

The results:

• Kids preferred the taste of the cereals with cartoons
• They preferred boxes labeled “Healthy Bits” more than “Sugar Bits”
• They most preferred “Healthy Bits” with a cartoon
• They least preferred “Sugar Bits” without a cartoon

This is why is would be a good idea to just say no to cartoons on food packages aimed at kids.

Michael Osterholm writes in the current New England Journal of Medicine that despite claims that foodborne illness is declining in the United States, that is only part of the story. His editorial refers to the now-published study of Salmonella Saintpaul that I talked about in a previous post.  He says:

All these findings, however, must be interpreted with caution, since most of the decreases occurred between 1996 and 2000, and there has been little additional change since then.

When the 2009 incidence of infections with the eight primary bacterial and parasitic pathogens is compared with their incidence in the period from 2006 through 2008, no significant change can be seen for six pathogens; only the infection rates with shigella and STEC O157 show significant decreases (see graph).

In addition, recent studies have demonstrated a significant increase in the incidence of foodborne disease caused by emerging non-O157 STEC, suggesting that surveillance for O157 is no longer sufficient to determine the effect of foodborne STEC infections.

On the basis of FoodNet data for the past 14 years,we must conclude that the improvements made in the late 1990s in the safety of our food supply are still having a positive effect. But we’ve made little additional progress in the past decade.

The graph he refers to comes from Pathogen. It represents the percent change in laboratory-confirmed foodborne infections from 2006–2007 to 2009.  The horizontal line represents no change.