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A recent commentary in the British Medical Journal (BMJ) is causing a furor among breastfeeding advocates in Great Britain.

Titled Six months of exclusive breast feeding: how good is the evidence?, its authors argue that four months is probably just as good and less likely to cause harm.

The current British recommendation is for six months of exclusive breastfeeding—meaning no added solid foods.  This is based on a systematic analysis of research first published as a Cochrane review in 2002 and updated in 2006.  It compared the health of infants breastfed for six months to those breastfed for three-to-four months, and concluded that the science demonstrated significant advantages to the longer breastfeeding period.

That analysis was the basis of breastfeeding recommendations by United Nations agencies, such as the World Health Organization and UNICEF.  In Great Britain, UNICEF UK has issued its own statement defending the six-months recommendation.

Adding to the furor, the British Guardian titled its article about the new commentary, “Six months of breastmilk alone is too long and could harm babies, scientists now say.”  A second account in the Guardian provided a more cautious interpretation of the science.

I can understand why breastfeeding advocates are so upset about the BMJ paper.  They are worried about promotion of infant formulas as substitutes for breast milk, especially in developing countries.  Infant formulas can be adequate, if not perfect, substitutes for breast milk under conditions where they can be properly diluted and refrigerated.  When those conditions are impossible, as is the case in many low-income areas, formulas can become contaminated with harmful bacteria.  Use of infant formulas has a long history of association with infant illness and death (I wrote about this in Food Politics).

Formula companies did and continue to promote their products as convenient—and preferable—substitutes for breast feeding.

As it turns out, several of the authors of the BMJ commentary consult for formula companies.

Those authors vehemently deny that their ties to formula companies influence their opinions.  That may or may not be so, but such ties strongly correlate with research results and opinions favorable to the corporate ally.

In the United States, pediatricians strongly advocate breastfeeding, but flexibly.  In 1997, the American Academy of Pediatrics (AAP)  policy statement said.

Exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing protection against diarrhea and respiratory tract infection….Complementary foods rich in iron should be introduced gradually beginning around 6 months of age.

But the AAP noted,

Unique needs or feeding behaviors of individual infants may indicate a need for introduction of complementary foods as early as 4 months of age, whereas other infants may not be ready to accept other foods until approximately 8 months of age.

As any parent of more than one child can tell you, babies differ.  Some are happy with exclusive breastfeeding.  Others want solid foods the instant they learn how to swallow.

The new commentary isn’t wrong, exactly, although it says nothing new.

It just isn’t helpful.  And that’s reason enough to be upset about it.

 Bill Marler, the food safety lawyer in Seattle, is asking for responses to the question, “if you had a magic wand, how would you fix the food safety system?” 

I’ve been mulling over his question in light of the recent enactment of the food safety bill, as yet unfunded.  Magic wand in hand, here’s what I’d do:

Create a single food safety agency: the new law is designed to fix the FDA.  It does nothing to fix the USDA’s food safety functions.  These remain divided between the two agencies, with USDA responsible for the safety of meat and poultry, and FDA responsible for everything else.  This division pretends that animal wastes have nothing to do with the safety of fruits and vegetables which, alas, they do. 

Require safety control systems for all foods.  Everyone who produces food should do it safely using proven methods for identifying where hazards can occur, taking steps to prevent those hazards, monitoring to make sure the steps were taken, and—when appropriate— testing to make sure the system is working. 

Apply safety controls from farm to table.  The new law does this for FDA-regulated foods.  But USDA safety regulations begin at the slaughterhouse after animals have already been contaminated in feedlots or in transport.  Everyone involved in food production, even farmers large and small, should be actively engaged in food safety efforts.

Fund food safety through congressional health committees.  For irrational reasons of history, the FDA gets its funding through agricultural committees, not health—even though FDA is an agency of the Public Health Service within the Department of Health and Human Services.   As a consequence, the FDA is at the mercy of appropriations committees whose mandate is to protect agricultural interests.  This anomaly explains why 80% of food safety funding goes to USDA, and only20% to FDA.  The new chair of the House agricultural appropriations committee has made it clear that he does not believe FDA needs any more funding.   Health appropriations committees might view FDA’s role in food safety in a more favorable light.

Fund food safety adequately.  To protect the domestic food supply—and to ensure the safety of imported foods—more money is needed to pay for inspection, testing, and research. 

Give the food agency cabinet-level status.  Everyone eats.  Food safety affects everyone.  Food has critically important economic and food security dimensions, domestically and internationally.   

Require election campaigns to be publicly funded, with no loopholes. This is the only way we will be able to remove corruption from our political system and elect officials who care more about public health than corporate health.

Require Wall Street to rate corporations on long-term sustainability.  Wall Street pressures on corporations to report growth every quarter are at the root of corner-cutting on food safety.  Food corporations should be valued for excellent food safety records and for maintaining high ethical standards in every aspect of their business.

Even a magic wand may not be enough to do this.  It will take more than a magic wand to do this, I fear.  Hey, I can dream.

The USDA announced today that it is starting the interminable rulemaking process for new nutrition standards for school breakfasts and lunches.

The new standards are designed to add more fruits, vegetables, whole grains, fat-free and low-fat milk to school meals.

These are food-based standards.  The lengthy Federal Register notice specifies the number and size of servings of fruits, vegetables, meat, dairy, and grains (table 3, page 2516).  This is a huge step forward and USDA deserves lots of support for doing this.

I am somewhat less enthusiastic about some of the other provisions, but perhaps they are the price to pay for progress:

Nutrient-based standards? The standards also are designed to limit levels of saturated fat, sodium, calories, and trans fats.  They specify a range of calories as well as maximum values for saturated fat and sodium (trans fats have to be zero).

Alas, the devil is in the details.

Nutrient-based standards force some questionable choices on menu planners.  This is evident from the menus comparing the old and new standards.  The old menus included “kids food”—food-like objects such as pizza sticks and breaded beef patties.

Happily, the new menus drop those and call for real foods.  Some of them—jicama, kiwi, and grape tomatoes, for example—are likely to seem exotic to kids accustomed to chicken fingers.  So far, so good.

But the foods are accompanied by strangely tasting miracles of food technology such as reduced-fat mayonnaise, low-fat salad dressings, and soft margarines.  Why?  To meet nutrient standards.

What about sugars? The standards don’t mention sugars except to say that if the others are followed, there isn’t much room allowed for sugary foods.  Canned fruits are to be low in sugar.  Use of highly fortified sugary foods is discouraged.

Chocolate and other flavored milk? The new standards allow skim “flavored” milk (translation: sugar-sweetened).  Otherwise, says USDA, kids might not drink milk and will not get enough calcium.  Sigh.  Milk, as I keep saying, is not an essential nutrient.  Chocolate or strawberry milk is a dessert.  Chalk this one up to dairy lobbying.

The USDA based the new standards on the report released in October 2009 by the Institute of Medicine (IOM): School Meals: Building Blocks for Healthy Children. It looks to me as though the USDA actually followed the IOM recommendations, a miracle in itself.

If you want to comment on the new standards, you can do so until April 13 at  http://www.regulations.gov. Enjoy!

The Worldwatch Institute, a group that conducts research on climate & energy, food & agriculture, and the green economy, has just released its 2011 State of the World Report, subtitled “Innovations that Nourish the Planet.”

By “innovations,” Worldwatch means agriculture-based methods that have been shown to prevent food waste, help resist climate change, and promote urban farming.  The report describes 15 such innovations, all of them environmentally sustainable.

As Olivier De Schutter, the United Nations Special Rapporteur on the Right to Food, writes in the introduction,

Increasing the production of food and eradicating hunger and malnutrition are two very different objectives—complementary perhaps, but not necessarily linked…Some clear conclusions are emerging from all this evidence.

We need to improve the resilience of countries—particularly poor, net food-importing countires—vis-à-vis increasingly high and volatile prices on the international markets.

We need to encourage modes of agricultural production that will be more resistant to climate change, which means that they will have to be more diversified and use more trees….

And we need to develop agriculture in ways that contribute to rural development by creating jobs both on farms and off them in the rural areas and by supporting decent revenues for farmers.

The report describes programs that do just those things.  Examples: breeding rice in Madagascar, trading grain in Zanzibar, using solar cookers in Senegal, and promoting safer wastewater irrigation in West Africa.

It’s always useful to have Worldwatch reports and this one is especially relevant to food, agriculture, and international development.

The USDA seems to be paving the way for approval of genetically modified (GM) alfalfa with pleas for coexistence and cooperation. These will be needed.  Organic alfalfa is the mainstay of organic animal feed.  Organic standards exclude GM.  But pollen from GM alfalfa transmits GM genes to organic alfalfa.

In releasing the Environmental Impact Statement on GM alfalfa, USDA Secretary Tom Vilsack used Cold War rhetoric:

We have seen rapid adoption of biotechnology in agriculture, along with the rise of organic and non-genetically engineered sectors over the last several decades… While the growth in all these areas is great for agriculture, it has also led, at times, to conflict or, at best, an uneasy coexistence between the different ways of growing crops. We need to address these challenges and develop a sensible path forward for strengthening coexistence of all segments of agriculture in our country.

USDA is working hard on this one.  It held a stakeholders meeting to discuss the issues.  Secretary Vilsack also wrote an open letter to stakeholders pressing the need for coexistence:

The rapid adoption of GE crops has clashed with the rapid expansion of demand for organic and other non-GE products. This clash led to litigation and uncertainty. Such litigation will potentially lead to the courts deciding who gets to farm their way and who will be prevented from doing so.

Regrettably, what the criticism we have received on our GE alfalfa approach suggests, is how comfortable we have become with litigation – with one side winning and one side losing – and how difficult it is to pursue compromise. Surely, there is a better way, a solution that acknowledges agriculture’s complexity, while celebrating and promoting its diversity.

By continuing to bring stakeholders together in an attempt to find common ground where the balanced interests of all sides could be advanced, we at USDA are striving to lead an effort to forge a new paradigm based on coexistence and cooperation. If successful, this effort can ensure that all forms of agriculture thrive so that food can remain abundant, affordable, and safe.

The USDA is not going to back down on GM.  But I see real progress here.  At least—and at last—USDA recognizes the threat of GM agriculture to organic production.

We have an obligation to carefully consider…the potential of cross-fertilization to non-GE alfalfa from GE alfalfa – a significant concern for farmers who produce for non-GE markets at home and abroad.

I’m guessing USDA will approve GM alfalfa.  Will approval include mandatory—and enforceable—safeguards to protect organic production?  Let’s hope.

Addition: Guess what.  Farm groups supporting GM alfalfa strongly object to Vilsack’s “coexistence” initiative.   In a  letter, the groups argue that the coexistence policy could “adversely impact all producers of biotech crops, as well as the integrity of the American agriculture system.”

Noting that USDA’s Animal and Plant Health Inspection Service concluded that RR alfalfa does not pose a plant pest risk, the groups accuse the Department of using motives beyond science to impose “unprecedented” conditions on alfalfa growers that they say may include isolation distances and geographic planting restrictions.

By “alfalfa growers,” they do not mean organic. Here’s who signed the letter:

• American Farm Bureau Federation
• American Soybean Association
• National Cotton Council
• National Association of Wheat Growers
• National Council of Farmer Cooperatives
• USA Rice Federation

When San Francisco voted to eliminate toys from McDonald’s Happy Meals, the Forum at the Harvard School of Public Health invited comments on this issue.  Here’s what I had to say about it:

I’m surprised at the mayor’s comment that “parents, not politicians, should decide what their children eat,” because the San Francisco ordinance is not about the food. It’s about the toys.

Nobody is stopping parents from ordering Happy Meals for their kids. But as everyone knows, kids only want Happy Meals because of the toys.

The idea that government has no role in food choice is ludicrous. The government is intimately involved in food choices through policies that make the cost of some foods—those containing subsidized corn or soybeans, for example—cheaper than others.

It is not an accident that five dollars at McDonald’s will buy you five hamburgers or only one salad. It is not an accident that the indexed price of fruits and vegetables has increased by 40% since the early 1980s, whereas the indexed price of sodas has decreased by 30%. Right now, agricultural policies support our present industrialized food system and strongly discourage innovation and consumption of relatively unprocessed foods.

Agricultural policies are the results of political decisions that can be changed by political will. If we want agricultural policies aligned with health policies—and I certainly do—we need to exercise our democratic rights as citizens and push for changes that are healthier for people and the planet.

Yes, individuals are the ultimate arbiters of food choice.

But our present food system makes unhealthful eating the default. We need to be working for government policies that make healthy eating the default. The San Francisco ordinance is a small step in that direction.

Thanks to the New York Times for telling us about the Census Bureau’s release of the 2011 Statistical Abstract of the U.S.  This is lots of fun and the Times’ account picked out a few highlights of what has changed since 2000:

• The meat industry is contracting? Red meat consumption is 108.3 pounds per capita, down 5.4 pounds.
• Nutritionists!  Uh oh: Vegetable consumption is 392.7 pounds per capita, down a shocking 30 pounds.
• The wine industry must be happy: Wine consumption is 2.5 gallons per capita, up by half a gallon.
• The establishment of organic standards in 2002 is working: Organic farmland covers 4.8 million acres, a 170% increase.
• Hold your nose: Five states—Minnesota, Iowa, Nebraska, North Carolina, and South Dakota—have more pigs than people.

You can pick out your own favorite food and nutrition factoids by taking a look at the health and nutrition and the Agriculture statistical tables.  Fisheries has a section of its own.  Enjoy!

This diagram is flying all over the Internet and has been sent to me by so many people (thanks to all) that I’m eager to share it.

I particularly like it because it’s just what I used to say in lectures after What to Eat came out in 2006.  My What to Eat rules say never to eat a food with:

• More than five ingredients (too processed)
• An ingredient you can’t pronounce (ditto)
• Anything artificial (ditto)
• A health claim on the front (these are always about marketing, not health)
• A cartoon on the package (it’s being marketed to kids)

Much praise and many thanks to the designer, Darya Pino (of Summer Tomato):