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Food Chemical News reports that the Senate Appropriations bill comes with report language instructing the FDA to:

• Conduct a risk assessment to see how harmful it really is to eat Listeria-tainted frozen vegetables [these, presumably, would be cooked before eating].  CRF Frozen Foods had to recall of 358 organic products after 7 people became ill.
• Release no sodium guidelines before the National Academies of Science has a chance to update the Daily Reference Intake (DRI) for sodium [which will take years].  The report says “it is “imperative that any guidance be issued using the latest sound science…based upon an updated DRI report.”  House directives said the same thing.  [The FDA has just released voluntary sodium guidelines for public comment].
• Release its overdue report on food traceability systems: “The Committee directs the FDA to collaborate with science-based international and industry-led food traceability initiatives of the type recommended by the pilot projects…[and] to make publicly available information on FDA’s efforts to encourage…traceability initiatives.”
• Reconsider its E. coli standard.  The Senate views this standard as too stringent and disruptive of raw milk cheese businesses.
• Actively engage stakeholders in best practice standards for medical foods. “They should work together on “forming a framework for a distinct regulatory pathway for medical foods that does not encumber its progress towards approval for patient use.”
• Better enforce standards for antibiotics in shrimp imports.
• Sample olive oil bottles at retail to determine if they are adulterated, and report findings to Congress.
• Report on efforts to implement regulations for the growing commercial human milk industry.

Some of these directives would improve food safety, but some would not.

All make more work for the FDA.

Does the Senate also plan to appropriate sufficient funds for the FDA to do all this in addition to what it is already doing?  Want to take bets?

I’ve just started getting a new Science and Research newsletter from William Reed: Informing Business Growth.

Some of the listings focus on dietary patterns or emerging microbiome research:

But most of them focus on single nutrients, ingredients, or foods—suggesting that they are about marketing those ingredients, not necessary health (people don’t eat single foods exclusively; we eat meals and mixtures).

These are a lot of fun.  They raise the possibility of magic bullets (if only).

But watch out for the weasel words “may,” “could,” “might”.  These mean “may or may not,” “could or could not,” “might or might not.”

• Long-term multivitamin use linked to fewer heart problems: Harvard study: A daily multivitamin may protect men from cardiovascular events such as heart attack and stroke in the long-term, says a new study… Read
• Eating black raspberries may decrease heart disease risk: Study: An extract found in black raspberries can significantly lower arterial stiffness, a key measure of cardiovascular disease, according to data from a Korean study… Read
• New forum showcases the benefits of pulses: A networking forum to help manufacturers understand the nutritional value of pulses has been created by McGill University in Montreal, Canada… Read
• Fish oil, cocoa & plant sterols: The winning combination against heart disease?: Combining fish oil, cocoa extract and plant sterols food supplements could offer an effective defence against heart disease, a new study suggests.  .. Read
• Plant-derived bacteria shows anti-obesity effects: RCT: Heat-killed Pediococcus pentosaceus LP28 derived from the longan fruit may help trim waist lines and reduce body fat, say results from a double-blind, randomized, placebo-controlled study… Read
• Olive-sourced hydroxytyrosol effective in biscuits: Study: Olive oil phenol hydroxytyrosol has been shown to be highly bioavailable and to lower oxidised LDL (low density lipoprotein) levels when incorporated into biscuits, suggesting functional food applications could be on the horizon for this EFSA-backed polyphenol. .. Read
• Study shows Calanus oil may benefit blood pressure and heart health: Supplements containing Calanus oil may support cardiovascular health via anti-inflammatory effects in blood vessel walls, says a new study… Read
• Review supports immune health potential of larch arabinogalactan: Supplements of Larch arabinogalactan may support immune health and help reduce the incidence of common cold infections, says a new review… Read
• Insights into banana carotenoids could hold key to fighting blindness: Insights into how bananas make and store carotenoids could help in the future development of banana varieties to combat vitamin A deficiency and blindness, say researchers… Read
• Niagen to be researched for neuroprotective effect among football players: Thorne Research and ChromaDex Corp. are partnering with the Mayo Clinic and the University of Minnesota on a study to assess the effect of nicotinamide riboside (NR) on the brains of football players… Read
• Dark chocolate rivals beetroot juice in boosting athletic performance, study shows: Dark chocolate provides similar benefits to beetroot juice consumed already by elite athletes to improve exercise endurance, a study revealing similar levels of flavanol content has suggested… Read

Wouldn’t you rather eat chocolate than beets?  That’s what such studies are about.  And I wonder how many of them are funded by the makers of the products.  Want to take a look?

Yesterday, the FDA opened for public comment its long-awaited guidance for industry about reducing salt in processed food products.  The guidance affects about 150 products.  It gives baseline data for those products and sets targets for salt reduction.

Please note that I am using the word salt, not sodium.  The targets are for sodium reduction.  Most dietary sodium comes from salt added to processed foods and pre-prepared foods.  Salt is 40% sodium.  The target dietary intake of 2300 mg sodium comes to just under 6 grams of salt a day, which is not particularly low.  It is, however, lower than current intake levels.

In a blog post, FDA official Susan Mayne said the link between sodium intake and blood pressure is “strong and well documented,” but

In fact, it’s very difficult in the current marketplace NOT to consume too much sodium. The average intake today is over 3,400 milligrams—significantly more than the 2,300 milligram limit recommended by federal guidelines. And it’s not just adults who are eating too much sodium: Children and teens consume more than is recommended.

Vox, for example, provides a terrific chart on the amounts of sodium in foods.  It starts with this:

Susan Mayne goes on to explain that

the FDA assessed the sodium content of thousands of products in the marketplace and engaged with experts in industry, academia, and government to get the best available scientific and technical input. We know that sodium has important functions in many foods, such as taste, texture, and microbial safety… Our approach encourages gradually reducing sodium in the majority of foods that contain it…Moreover, our draft targets apply to processed and prepared foods that are eaten both at home and outside the home.

Despite the voluntary nature of the guidance and the lengthy timeline (up to ten years) for implementation, the makers of processed foods are sure to object.  At their urging, the House committee on appropriations, in draft report language, urged the FDA to postpone guidance on salt until the CDC and Institute of Medicine update the Dietary Reference Intake standards for sodium intake.

The Salt Institute, the trade association for the salt industry, issued a press release charging malpractice:

The issuance today of new “voluntary” sodium reduction mandates by the FDA is tantamount to malpractice and inexcusable in the face of years of scientific evidence showing that population-wide sodium reduction strategies are unnecessary and could be harmful. This effort will limit the food choices of Americans, not increase them as the FDA claims. It will make our food less safe and endanger public health.

In JAMA, CDC Director Thomas Frieden rebuts the scientific arguments point by point and, in my view, demolishes them.  He explains how important this initiative is to public health:

Thirty-nine countries have established sodium targets for foods and meals, with 36 of those adopting voluntary approaches. Setting targets helps create a level playing field for the food industry, supporting reductions already begun by companies such as Walmart, Darden, Unilever, PespsiCo, General Mills, Mars, Nestlé, and others. The United Kingdom set voluntary sodium reduction targets in 2003; from 2003 to 2011 sodium intake decreased 15%. During this same period, average blood pressure decreased, and, following no change in prior years, deaths from ischemic heart disease and stroke decreased by approximately 40% [the reference for this last statement is BMJ Open. 2014;4(4):e004549].

Most people would be healthier cutting down on salt intake.  Food company executives know this.  Politico Morning Agriculture points out that some Big Food companies have joined the public health community in supporting the FDA’s proposal.

The band of strange bedfellows – the American Heart Association, Mars, Academy of Nutrition and Dietetics, Nestlé, PepsiCo, American Public Health Association, Unilever and the Center for Science in the Public Interest – all signed on to a letter last month to Senate Appropriations ag subcommittee Chairman Jerry Moran and ranking member Jeff Merkley to support the FDA on sodium. Find that here.

From a public health perspective, the FDA initiative is a step in the right direction but could go further.  It should have required mandatory salt reduction.  Judging from the Salt Institute’s reaction, this is still a big step.  The New York Times quotes Michael Jacobson:

“The F.D.A. found a sweet spot between doing nothing and regulating…This will at least give the public benchmarks against which we can gauge sodium content of foods.”

FDA resources:  

• Federal Register Notice.  The home page explains how to submit comments by October 31 to Docket No. FDA-2014-D-0055
• Draft Guidance Document in PDF (132KB)
• Draft Food Categories and Draft Voluntary Targets for Sodium Reduction (Appendix Table 1) (XLSX: 43KB)
• Summary Explanation of the Draft Food Categories and Draft Voluntary Targets for Sodium Reduction (Appendix Table 1) (PDF: 277KB)
• Sodium Reduction At A Glance
• Presentation: FDA’s Voluntary Sodium Reduction Initiative (PPTX 3MB) 
• Constituent Update: FDA Issues Draft Guidance to Industry for Voluntarily Reducing Sodium
• Blog: Reducing Sodium in the Food Supply
• At a Glance: Lowering Sodium in the Food Supply
• Frequently Asked Questions on FDA’s Sodium Reduction Strategy
• Additional Information and History of Actions on Sodium Reduction

The FDA issued its final rules for the Nutrition Facts panels, but now I want to know: What ever happened to its front-of-package (FOP) initiatives?

The New York Times editorial on the new food label raised this very question.

But the labels, which most food companies will have to use by July 2018, still have serious limitations. They require busy shoppers to absorb a lot of facts, not all of which are equally important, and then do the math themselves while standing in the grocery aisle. And the labels are on the back of the package, where only the most motivated shoppers will look.

The editorial refers to the FDA’s front-of-package initiatives early in the Obama administration.  These involved two reports from the Institute of Medicine.  The first, released in 2010, examined about 20 existing front-of-package schemes cluttering up the labels of processed foods and evaluated their strengths and weaknesses.  It recommended that FOP labels deal only with calories, saturated fat, trans fat, and sodium.  My question at the time: why not sugars?  The committee’s answer: calories took care of it.

But the IOM’s second report in 2011 included sugars and recommended a point system for evaluating the amounts of it and those nutrients in processed foods.  Packages would get zero stars if their saturated and trans fat, sodium, or sugars exceeded certain cut points.

The Times editorial explained what happened next:

the Grocery Manufacturers Association [GMA] called the Institute of Medicine’s recommendation “untested” and “interpretive.” Along with the Food Marketing Institute, it developed its own front-of-package labeling system, which includes some useful information, but is more complex and less helpful than the institute’s version.

As I stated at the time, the FDA let the GMA get away with this and has said not one more word about front-of-package labels.

According to the Times, the FDA is still studying the matter.

it’s not clear when or if the agency will require front-of-package labels. The food industry, of course, wants to make its products appear as healthy as possible. The F.D.A. would serve consumers best by taking the Institute of Medicine’s good advice and putting clear and concise nutrition labels right where most shoppers will see them.

It certainly would.  It’s time to take those IOM reports out of the drawer and get busy writing rules for them.

Every now and then I like to try to catch up with the arcane topic of trade agreements (see last week’s post).  Today, I’ll deal with the other one still in play, the Trans Pacific Partnership (TPP).  The U.S. Trade Representative’s Office states the administration’s position on the TPP.  Ballotpedia.org has a helpful summary of where we are on it.

For this one, should you be at all interested, the full text of the TPP is available online.  Like all trade agreements in which the U.S. participates, the TPP is about reducing and eliminating tariffs.  In principle, this is supposed to foster competition and create business opportunities and, as the Trade Representative’s Office says, “leveling the playing field for American workers & American businesses.”

The TPP was signed by the U.S. and the 11 other participating countries in February.  But for us to participate in it, Congress has to ratify the agreement.  It has not yet done so, not least because the TPP is caught up in election-year politics.

Contributing to slow approval is the weak endorsement of the International Trade Commission, which was required to report on the agreement’s economic effects.  Its conclusion: TPP would improve the economy by 2032 (the target year, apparently)—but by less than 1%.  The report gives examples of the increased percentage over baseline in 2032:

• Annual real income: $57.3 billion (0.23 %)
• Real GDP: $42.7 billion (0.15 %)
• Employment would be 0.07 %
• Exports: $27.2 billion (1.0 %)
• Imports: $48.9 billion (1.1 %)
• Agriculture and food output: $10.0 billion (0.5 %)

So TPP has an upside, but a small one.

What about the downside?

For starters, see the letter filed in January by 1500 groups opposing the agreement, and this BMJ paper, just out, about the TPP’s potential to block public health policies such as front-of-package food labels.

Public Citizen also has concerns.  These include, among others, that the TPP would:

• Make it easier for corporations to offshore American jobs.
• Push down domestic wages.
• Flood the U.S. with unsafe imported food.
• Permit big pharmaceutical corporations to keep lower cost generic drugs off the market.
• Tacitly permit human rights violations in partner countries (the agreement does not mention “human rights”).

The Institute for Agriculture and Trade Policy (IATP) has problems with the “fast-track” rules passed by Congress earlier this year.  Under these rules, Congress is only allowed to vote yes or no on the agreement.  It cannot amend it. The IATP says:

Provisions in the chapter on Sanitary and Phytosanitary Standards, for example, would reduce the food safety inspection capacity of food imports, and relegate controversies over GMOs to questions of market access rather than public or environmental health. The inclusion of investor state rules would give foreign corporations new ways to challenge a wide range of environmental and consumer laws around the world for alleged loss of anticipated profits. New rules on patent protections would limit farmers’ ability to save seeds. The agreement fails to acknowledge climate change while expanding an extractive mode of globalization. Like previous failed trade agreements, there are a lot of promises to help farmers that will likely result in the accelerated loss of family farms.

Should you want to do some advocacy on this issue, the IATP has produced a timeline for urging Congress to say no to the TPP, and a handy form for doing so.

Garrett M. Broad.  More Than Just Food: Food Justice and Community Change. University of California Press, 2016.

I particularly wanted to read this book for two reasons, one personal and one professional.

First the personal.  The book’s University of California Press publication was supported by the Anne G. Lipow Endowment Fund for Social Justice and Human Rights, established by Stephen M. Silberstein.   Anne and I were friends from the time our children were babies. Sadly, she died in 2004.  Steve, her husband, set up this endowment in her honor.

On the professional side, More Than Just Food is based on Garrett Broad’s dissertation research.  As he explains,

More Than Just Food offers an ethnographic exploration of community-based food justice activism in urban America, using the network of Community Services Unlimited, Inc. (CSU) as a centering artifact of study.  CSU was initially created as the nonprofit arm of the Southern California chapter of the Black Panther Party and today stands as a leading food justice nonprofit organization in its own community of South Los Angeles, with connections to other food justice groups from across the United States and around the world.

To study this group and food justice organizations in general, Broad joined the CSU and participated in its activities in a process he calls “engaged scholarship.”  He has especially interesting things to say about the differences he observed between community-based groups like CSU and outside groups coming into communities that are part of the “nonprofit industrial complex.”

His research was based on theory, the communication ecology perspective, and is academically rigorous.

I argue that food justice activism can be understood as a hybrid praxis, an ever-evolving mix of philosophy and action that takes shape through an ongoing process of co-construction, collaboration, and conflict in food justice work.

With that out of the way, his research led to especially useful insights into food as a tool for community organizing.

The analysis in this book has emphasized how, even as community-based activists make food a centerpiece of their organizing work, they also insist than an isolated focus on food and food alone will not lead them to their ultimate goals.  Instead, guided by a broader social justice vision, food justice organizations offer up food as a uniquely engaging tool that helps build critical consciousness, develop alternative institutions, promote economic development, and cultivate skills for health and well-being among those who have long been subject to injustice in the food system and beyond.

This book is an entirely fitting tribute to Anne Lipow’s memory and I look forward to seeing more in this series.

A couple of years ago, I wrote a long post attempting to explain the Transatlantic Trade and Investment Partnership (TTIP), a trade agreement under negotiation since then with the European Union.  Like all trade agreements, this one is done secretly, making it difficult for interested parties to weigh in.

But Greenpeace Netherlands has now leaked what it says are the texts of 13 chapters of the TTIP.  These include 248 pages of internal documents dating from TTIP talks at some uncertain date.  These include chapters about food and agriculture, as well as many other issues.

The documents include a 25-page “Tactical State of Play” on the negotiations similar to a 20-page public EU report, but with more detail on points of disagreement and consensus.

Greenpeace claims that the documents demonstrate major risks for the climate, environment and consumer safety.  The Office of the U.S. Trade Representative strongly disagrees, and European Trade Commissioner Cecilia Malström says the leaked documents only reflect negotiating positions.

I took a look at the leaked Chapter X Agriculture [US: Market Access].  The European Union proposes, for example:

• [On public health and safety] The Parties recognize that their respective societal choices may differ with respect to public policy decisions affecting agriculture. In this regard, nothing in this Agreement will restrain the Parties from taking measures necessary to achieve legitimate policy objectives such as the protection of public health, safety, environment or public morals, social or consumer protection, or the promotion and protection of cultural diversity that each side deems appropriate.
• [On sustainability] The Parties recall the prominent role of sustainability in its economic, social and environmental dimensions in agriculture and aim at developing a fruitful cooperation and dialogue on agricultural sustainability issues. To this end, the Parties shall work together to…exchange ideas and share experience in developing sustainable farming practices, particularly with regards to organic farming, and environmentally friendly rural development programs.
• [On geographical indicators] The Parties shall cooperate in matters related to geographical indications…The Parties reaffirm the importance of origin-linked products and geographical indications for sustainable agriculture and rural development, and in particular for small and medium-sized enterprises.

On international agricultural development, the United States proposes

The Parties shall work to promote international agricultural development and enhanced global food security by: (a) promoting robust global markets for food products and agricultural inputs; (b) seeking to avoid unwarranted trade measures that increase global food prices or exacerbate price volatility, in particular through avoiding the use of export taxes, export prohibitions or export restrictions on agricultural goods; and (c) encouraging and supporting research and education to develop innovative new agricultural products and strategies that address global challenges related to the production of abundant, safe and affordable food, feed, fiber, and energy.

You have to read between the lines to figure out what they are really talking about (GMOs in the case of this last one).

Politico Pro’s analysis suggests that several issues remain unresolved:

• The link between agriculture and car parts: we take European car parts and they take our agricultural exports.
• Protection of wine names. The EU does not want us to use European names for our wines; Washington does.
• The EU’s October proposal to cut back on antibiotic use in livestock is not in these documents.
• The sanitary and phytosanitary chapter (the one that deals with food safety) finds little agreement on use of animal growth hormones or GMOs.
• GMOs: The US wants the EU to accept them. The US language says “Each Party shall endeavor to meet applicable timelines for all steps in its approval or authorization processes for products of modern agricultural technology.”

Perhaps in response, the EU has now released its own version of the agriculture chapter, and  the European Commission has released all of its working documents related to the TTIP, including draft proposals on agriculture and other matters.

The European Commission also released a report on the state of the negotiations.  Several points are unsettled.  The EU, for example:

• Indicated it does not support a US proposal on modern agricultural technologies.
• Insisted on the importance of animal welfare provisions in trade agreements and the relevance of the matter for SPS [Sanitary and Phytosanitary issues, such as food safety].
• Stressed the importance of joint efforts to fight AMR [antimicrobial resistance] at all levels in all fora and argued for the inclusion of AMR in the SPS Chapter.

On our part, the U.S. goals for agricultural trade are

• Eliminate tariffs and quotas
• Address SPS measures and technical barriers to trade (TBT).

More than two dozen Senators urged U.S. Trade Representative Michael Froman to ensure there is “a strong framework” for agriculture in the TTIP, warning that its absence could have a negative impact on Congressional support for any deal.

As long as the negotiations continue in secret, all of this will remain mysterious and out of the reach of the public.  This makes trade negotiations inherently undemocratic, something Greenpeace attempted to reverse in releasing the leaked documents.

Guest Blog

The FDA’s new rules for food labeling are finally here

The changes are a step toward better health and less obesity, especially in children

By Marion Nestle on May 24, 2016

The FDA’s announcement of final rules for its overhaul of labels on food packages is a signature accomplishment of Michelle Obama’s Let’s Move! campaign to end childhood obesity within a generation.

In 2010, in setting the agenda for Let’s Move!, the White House Task Force on Childhood Obesity called for improving the clarity, accuracy, and consistency of food package labels to enable parents and children to make healthier food choices.  The Task Force noted that more than half the adult public used food labels to decide what to buy, but that the current labels had hardly changed since the FDA’s regulations of 1993.

The FDA actually began work on revising the food label in 2005 with a request for public input on updating serving sizes, and it began formal rulemaking in 2008.  The FDA proposed rules and issued its last call for comments in 2014.

I attribute this nine-year process to details and politics.

First, the details. The Federal Register notice on the food label takes up 943 pages, and it takes another 170 pages to explain the changes in serving sizes.

FDA’s fact sheet on the changes explains the politics.  Most changes are relatively uncontroversial: the greater emphasis on calories, the removal of calories from fat, the requirement for “dual column” labels for “per serving” and “per package,” the updating of serving sizes to more closely reflect actual intake, and the rewording of the Daily Value footnote.  As Michelle Obama put it, ”you will no longer need a microscope, a calculator, or a degree in nutrition to figure out whether the food you’re buying is actually good for our kids.  So that’s a phenomenal achievement.”

Indeed it is, especially in light of a political climate in which the food industry and Congress do all they can to undermine public health measures in school food and child nutrition programs.

Mrs. Obama alluded to the ongoing political controversy: “most important of all, this label will tell you how much sugar in your snack was added during processing, and how much of it comes from ingredients like fruit.”

The new food label distinguishes between intrinsic sugars in food and those added in manufacturing; it also sets a Daily Value for the maximum amount of sugars recommended for diets of 2,000 calories a day.  I credit the Center for Science in the Public Interest for this accomplishment; it petitioned FDA for these changes in 2013 (its first added sugar petition was in 1999).

The Washington Post got right to the core of the controversy: “Why the sugar industry hates the FDA’s new Nutrition Facts label.” Americans consume roughly twice the amount of sugar recommended for good health, and sugars are rampant in processed foods.  All it takes is one 16-ounce soft drink to reach the 50-gram daily maximum.

The Sugar Association, the trade group for producers of sugar cane and sugar beets invokes science as the reason for its intense opposition: “We are concerned that the ruling sets a dangerous precedent that is not grounded in science, and could actually deter us from our shared goal of a healthier America.”

The Association argues, correctly, that the sugars that occur naturally in fruits are biochemically identical to those added in manufacturing.  But this argument misses how added sugars dilute the nutritional value of food products.  Much research supports the health benefits of eating fruit, whereas added sugars raise risks for obesity and other chronic conditions.

The Sugar Association does not really care about science.  It cares about what will happen to sales if people read labels and reject products with added sugars.  This, of course, is one of the purposes of Added Sugars on food labels.

The Association has reason to worry.  Since 1999, per capita consumption of sugars has fallen in the United States, although it still exceeds the 10 percent of calories recommended by the World Health Organization last year.  The new label should accelerate that downward trend.

An even greater worry is that labeling added sugars might encourage manufacturers to reduce the amounts in their products.  The FDA’s listing of trans-fatty acids on food labels in 2006 led to an immediate reductionin the use of hydrogenated oils as ingredients in food products.  I expect to see grams of sugars decline by the time these rules take effect in May 2018 (small food producers get until May 2019).

I see the new label as a political win for public health and Let’s Move!  But let’s keep this in perspective.  Healthful diets are based on foods, not food products.  We would all be healthier eating foods that do not come with Nutrition Facts panels, and saving most of those that do for once-in-a-while occasions.

The views expressed are those of the author(s) and are not necessarily those of Scientific American.

Recent Scientific American Articles by Marion Nestle

• What Science Says about Eating Right
• Eating Made Simple