by Marion Nestle

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Mar 4 2016

Julia Belluz (Vox) on my collection of studies sponsored by food companies

Julia Belluz of Vox has just done a story on my collection of studies funded by food companies.  Here are a few excerpts.  For the entire article and its excellent illustrations, click on the link):

About a year ago, Marion Nestle finally got sick of the rotten state of nutrition science.

Everywhere she looked, she found glaring conflicts of interest. “Without any trouble, I could identify industry-funded nutrition studies by their titles,” says the New York University professor. “It was so obvious”…But Nestle is not the first to notice this problem. Many nutrition researchers have been complaining about conflict-of-interest problems in their field for some time now. Whereas other fields, like medicine, have been putting in place safeguards to protect against undue industry influence, the field of nutrition has lagged behind in this regard.  And other research backs up Nestle’s findings. Take this review of studies on sugary drinks. Independently funded studies tend to find a correlation between soda consumption and poor health outcomes. Studies funded by soda makers, by contrast, are less likely to find such correlations. Or take this investigation of 206 publications on the health effects of milk, soft drinks, and fruit juices. Studies that were funded by beverage companies were four to eight times more likely to come to favorable conclusions about the health effects of those beverages.

The reporter interviewed researchers who work in food and nutrition about all this.

They all acknowledged that she was tapping into a real problem, one that’s been difficult for their community to address.  So why are conflicts of interest allowed to persist in nutrition research?  One root cause is the need for funding. Right now nutrition science is relatively underfunded by government, leaving lots of space for food companies and industry groups to step in and sponsor research…Tradition also plays a role. “Nutrition science has always been close to producers,” Dutch nutrition researcher Martijn Katan told me. “There’s such a direct interest in the outcomes of research for producers”…And food companies have ample incentive to promote this research. Under Food and Drug Administration rules, any health claims that they want to make on their packaging has to be backed up by scientific research. So the food industry has a keen interest in funding research — and favorable research that their profits may depend on.

She quotes Martijn Katan:

In the long term,” Katan said, “the deepest harm being done is that it undermines the credibility of science. In the short term, it means some people will eat more butter or cheese than is good for them, and that it will take longer to get people off soda.”

Her conclusion:

None of the researchers I spoke to suggested we should abolish industry funding of food and nutrition studies. As Katan has written, these collaborations can lead to fruitful discoveries…Instead, they wanted to see more awareness about the problem, more scrutiny of industry-funded research, and organized efforts to control conflicts of interest. “It’s not the quality of the science that’s at issue,” Nestle explains. “The studies are carried out according to strong scientific principles. But the bias seems to come in around the research question that’s asked, the interpretation of the results, putting a positive spin on findings even when the results are neutral.” That’s not good for science or for public health.

Mar 3 2016

More industry-funded studies with industry-favorable results. The score 140/12.

A nutrient profiling system for the (re)formulation of a global food and beverage portfolio.  Antonis Vlassopoulos · Gabriel Masset · Veronique Rheiner Charles ·Cassandra Hoover · Caroline Chesneau‑Guillemont · Fabienne Leroy ·Undine Lehmann · Jörg Spieldenner · E‑Siong Tee · Mike Gibney ·Adam Drewnowski.  Eur J Nutr DOI 0.1007/s00394-016-1161-9.

  • Conclusions:  The NNPS sets feasible and yet challenging targets for public health-oriented reformulation of a varied product portfolio; its application was associated with improved nutrient density in eight major food categories in the USA and France.
  • Funding: The research presented herein was funded by Nestec Ltd, which is a wholly owned affiliate of Nestlé S.A.  The first eight authors are employed by Nestlé.
  • Comment: the paper is the basis of a Nestlé infographic.

Including whey protein and whey permeate in ready-to-use supplementary food improves recovery rates in children with moderate acute malnutrition: a randomized, double-blind clinical trial.  Heather C Stobaugh, Kelsey N Ryan, Julie A Kennedy, Jennifer B Grise, Audrey H Crocker, Chrissie Thakwalakwa, Patricia E Litkowski, Kenneth M Maleta, Mark J Manary, and Indi Trehan.  Am J Clin Nutr  First published February 10, 2016, doi: 10.3945/​ajcn.115.124636.

  • Conclusion: This study highlights the importance of milk protein in the treatment of MAM, because the use of a novel whey RUSF resulted in higher recovery rates and improved growth than did soy RUSF [ready-to-use supplemental food], although the whey RUSF supplement provided less total protein and energy than the soy RUSF.
  • Funding for this project was provided by the Danish Dairy Research Foundation, Arla Foods Ingredients Group P/S, and the US Dairy Export Council. IT was supported by the Children’s Discovery Institute of Washington University in St. Louis and St. Louis Children’s Hospital…The funders had no role in the design or implementation of the study and no role in the analysis or interpretation of the data.

Oral health promotion: the economic benefits to the NHS of increased use of sugarfree gum in the UKL. Claxton, M. Taylor & E. Kay.  British Dental Journal 220, 121 – 127 (2016).  Published online: 12 February 2016 | doi:10.1038/sj.bdj.2016.94

  • Conclusion If all members of the UK 12-year-old population chewed SFG frequently (twice a day), the potential cost savings for the cohort over the course of one year were estimated to range from £1.2 to £3.3 million and if they chewed three times a day, £8.2 million could be saved each year…This study shows that if levels of SFG usage in the teenage population in the UK could be increased, substantial cost savings might be achieved.
  • Declaration: This study and writing support for the manuscript were funded by Wrigley Oral Healthcare Programme.

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base Richard D. Feinman, Wendy K. Pogozelski , Arne Astrup M.D., Richard K. Bernstein M.D., Eugene J. Fine M.S., M.D. , Eric C. Westman M.D., M.H.S.  , Anthony Accurso M.D. , Lynda Frassetto M.D.  , Barbara A. Gower Ph.D.  , Samy I. McFarlane M.D.  , Jörgen Vesti Nielsen M.D.  , Thure Krarup M.D. , Laura Saslow Ph.D. , Karl S. Roth M.D. , Mary C. Vernon M.D. , Jeff S. Volek R.D., Ph.D. , Gilbert B. Wilshire M.D. , Annika Dahlqvist M.D.r , Ralf Sundberg M.D., Ph.D.  , Ann Childers M.D.  , Katharine Morrison M.R.C.G.P.  , Anssi H. Manninen M.H.S.  , Hussain M. Dashti M.D., Ph.D., F.A.C.S.,  F.I.C.S., Richard J. Wood Ph.D., Jay Wortman M.D. , Nicolai Worm Ph.D.  Nutrition. January 2015 Volume 31, Issue 1, Pages 1–13 DOI: http://dx.doi.org/10.1016/j.nut.2014.06.011

  • Conclusion: Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1.
  • Disclosure: AA is consultant/member of advisory boards for the Dutch Beer Knowledge Institute, NL, Global Dairy Platform, USA, Jenny Craig, USA, McCain Foods Limited, USA, McDonald’s, USA, and Gerson Lehrman Group, USA (ad hoc consultant for clients). He is recipient of honoraria and travel grants as speaker for a wide range of Danish and international concerns. He has conducted research funded by a number of organizations with interests in the food production and marketing sector. RDF writes reviews for Fleishman-Hillard, whose client is the Corn Refiners Association and he has received grant support from the Veronica and Robert C. Atkins Foundation. EJF has received grant support from the Veronica and Robert C. Atkins Foundation. TK sits on an advisory board for Eli Lilly and gives lectures for Lilly about the diabetic diet. NW has written popular-audience books on low-carbohydrate diets and is a consultant and promoter for Leberfasten/Hepafast, a specific low-carbohydrate meal replacement program. JW is on the Scientific Advisory Board of Atkins Nutritionals Inc. with paid retainer, honoraria, and travel costs. None of the other authors have anything to declare.
  • Comment: The Atkins Diet is low-carbohydrate.

Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial David G. Marrero, PhD, Kelly N. B. Palmer, MHS, Erin O. Phillips, BA, Karen Miller-Kovach, EBMA, MS, Gary D. Foster, PhD, and Chandan K. Saha, PhD. Am J Public Health. Published online ahead of print February 18, 2016: e1–e8. doi:10.2105/AJPH.2015.303035

  • Conclusions. A large weight-management program is effective for achieving lifestyle changes associated with diabetes prevention. Such programs could significantly increase the availability of diabetes prevention programs worldwide making an immediate and significant public health impact.
  • Funding: This study was funded by Weight Watchers International.

It’s close to a year since I first started collecting these studies.  When the year is up, I will do some analysis.  Until then, the bottom line is that it’s easier to find industry-funded studies with results favorable to the sponsor than it is to find those that are not.

Mar 2 2016

National Restaurant Association gets judge to delay New York City’s salt warning

Grub Street reports that an appeals court has just delayed New York City’s salt warning label.

Oddly, this follows what happened just a few days ago when a state judge denied the National Restaurant Association’s lawsuit to block the warnings.

The NRA is relentless about such things.  Recall how it opposed, successfully, Mayor Bloomberg’s proposal to cap soda sizes at 16 ounces.

The Daily News says nothing will happen on the salt warning until a March 18 hearing before judges at the Appellate Division in Manhattan.

Because most salt in American diets is put into foods by chefs and food processors, the warning label could alert consumers to the huge amounts of salt they add.  Many foods and meals will be affected.  No wonder the NRA doesn’t like it.

That organization ends up on the wrong side of public health all too often.  It needs to back off on this one.

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Mar 1 2016

PAHO issues nutrition standards for ultraprocessed foods. Beverage Associations object.

Cheers to the Pan American Health Organization/World Health Organization for releasing nutritional profile standards for making it easier for governments to distinguish fresh and minimally processed foods from ultraprocessed.  The idea here is to encourage populations to consume traditional diets (see press release).

Ultra-processed foods are defined as industrially formulated food products that contain substances extracted from foods (such as casein, milk whey, and protein isolates) or substances synthesized from food constituents (such as hydrogenated oils, modified starches, and flavors). Drawing on the best scientific evidence available, the model classifies processed and ultra-processed foods and beverages as having “excessive” amounts of sugar, salt and fat according to the following criteria:

  • Excessive sugar if the amount of added sugars is 10% or more of total calories
  • Excessive fat if the calories from all fats are 30% or more of total calories
  • Excessive saturated fat if calories from saturated fats are 10% or more of total calories
  • Excessive trans fat if calories from trans fats are 1% or more of total calories
  • Excessive sodium if the ratio of sodium (in milligrams) to calories (kcal) is 1:1 or higher.

PAHO’s point in setting these standards is to encourage governments to:

  • Restrict the marketing of unhealthy food and beverages to children (see PAHO Plan of Action for the Prevention of Obesity in Children and Adolescents)
  • Regulate school food environments (feeding programs and food and beverages sold in schools)
  • Use front-of-package (FOP) warning labels
  • Define taxation policies to limit consumption of unhealthy food
  • Assess agricultural subsidies
  • Identify foods to be provided by social programs to vulnerable groups.

Yes!

Alas, not everyone is as enthusiastic as I am about the profiles.  The International Council of Beverages Associations released this statement:

We agree that obesity is a global health challenge, and ICBA and its members welcome the opportunity to work with PAHO and other stakeholders to pursue effective and practical solutions. There are some areas, however, where we believe that use of PAHO’s Nutrient Profile Model may not provide helpful guidance to consumers.  There is not current scientific consensus in all areas that the Nutrient Profile Model addresses. It will not be useful if families find that nearly 80% of the foods and beverages in their grocery carts are unacceptable. Such a radical message is not likely to be followed by most individuals…we encourage governments and scientific bodies to offer food and dietary recommendations and national policies that are based on the totality of scientific evidence and provide realistic, positive encouragement to consumers to have a real impact promoting healthful diets and preventing obesity and non-communicable diseases.

 

The PAHO profiles may need tweaking, but they are a great first step.  Now let’s see how they get implemented.

Feb 29 2016

Dairy food politics, Australia. Kangaroo politics too.

Dairy politics

This Melbourne newspaper has a front page story about Australia’s efforts to sell milk to China.Capture

The government allowed a Chinese billionaire to buy the biggest dairy farm in Tasmania for a mere $280 million (an Australian dollar is worth 70 cents U.S.).  The buyer has promised to process the milk into cheese, butter, spreads, and milk powder for infant formula in local Fonterra facilities in order to maintain current prices.

The worry, according to Independent member of Parliament Andrew Wilkie:

The new owner could decide to process the milk elsewhere, or to have it processed at Fonterra but allocated to an overseas market.  There is now uncertainty of supply and price in the market, and understandable fear we’re going to see a repeat of the baby formula episode where so much is going overseas Australians simply can’t buy it here and if they can, it’s at an inflated price.

An editorial in the same issue says:

There is real concern that the new owner of the 17,800-hectare Van Duenen’s Land Company in Tasmania might prefer to supply the Chinese market.  A tin of baby formula sells in China for four times its price in Australia, where supermarket shelves have been stripped bare….Last year, another Chinese billionaire bought two major cattle stations in Australia’s far north…Australians need to know how much of the country has been sold off to foreign investors.

I continue to remain baffled about the massive efforts to get dairy products into China.  Few traditional diets in China contained dairy foods and lactose intolerance, mild to severe, is widespread in Asian populations.

Dairy farming has replaced sheep farming in New Zealand, with devastating effects on the environment.

Kangaroo politics

This newspaper also describes efforts to cull kangaroos for use in pet food.  Kangaroos pose the same traffic-hazard problems that deer do in the U.S.

They are a major hazard [on the roads] and they’re a major concern.  We spend a lot of time picking up dead kangaroos.

Although the article didn’t say so, I’m guessing arguments over the culling are similar to those about deer and similarly splits animal lovers from gardeners and traffic officials.

Feb 27 2016

Three books about eating: 2. The Practice of Eating

This is the second of three books about eating.  The first is here.

Alan Warde.  The Practice of Eating. Polity, 2016.

This is a sociologist’s attempt to establish a theory of food consumption.  Advances in theory, he says, have been limited for three reasons:

First, eating has been looked at as a series of practical problems, as a terrain of crises.  Second, the topic has been dealt with in multidisciplinary contexts where theoretical synthesis has had low priority.  Third, consumption remains subordinated to concern about production.

This book makes up for those deficiencies and will be greatly appreciated by graduate students of sociology, food studies, and other academic disciplines.

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Feb 26 2016

Corrections to the list of industry-funded studies: the count is again 135/12.

Readers have filed corrections to previous postings on industry-funded studies (see here and here).  I am most grateful for their sharp eyes.  No excuses, but I’m having a hard time keeping them straight because there are so many, some are published first online and then again in print, and sometimes I just get them wrong.  Apologies.

The corrections reduce the count to 132/12.  But here are three more to bring it back up to 135/12.

Management of obesity.  George A Bray, Gema Frühbeck, Donna H Ryan, John P H Wilding.  The Lancet.  Published online February 8, 2016 http://dx.doi.org/10.1016/S0140-6736(16)00271-3.

  • Conclusion: For patients who struggle with weight loss and who would receive health benefit from weight loss, management of medications that are contributing to weight gain and use of approved medications for chronic weight management along with lifestyle changes are appropriate. Medications approved in the USA or European Union are orlistat, naltrexone/bupropion, and liraglutide; in the USA, lorcaserin and phentermine/topiramate are also available. Surgical management (gastric banding, sleeve gastrectomy, and Roux-en Y gastric bypass) can produce remarkable health improvement and reduce mortality for patients with severe obesity.
  • Declaration of interests GAB is a consultant to Herbalife International and Medifast; a member of the Speakers Bureau for Novo Nordisk Pharmaceuticals and Takeda Pharmaceuticals; and receives royalties from Up-to-Date and Handbook of Obesity. GF is a consultant to Novo Nordisk Pharmaceuticals. DHR is a consultant to Novo Nordisk Pharmaceuticals, Takeda Pharmaceuticals, Eisai Pharmaceuticals, Vivus Pharmaceuticals, Janssen Pharmaceuticals, Amgen Pharmaceuticals, Real Appeal, Gila Therapeutics, Tulip Medical, and Scientific Intake; is on the speakers’ bureau for Novo Nordisk Pharmaceuticals, Takeda Pharmaceuticals, Eisai Pharmaceuticals, and Vivus Pharmaceuticals; and has equity ownership in Scientifi c Intake. JPHW received grant funding from Novo Nordisk and AstraZeneca, and is a consultant to Novo Nordisk, Janssen Pharmaceuticals, AstraZeneca Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, and Pfi zer Pharmaceuticals.

The effects of potatoes and other carbohydrate side dishes consumed with meat on food intake, glycemia and satiety response in children.  R Akilen, N Deljoomanesh, S Hunschede, CE Smith, MU Arshad, R Kubant and GH Anderson.  Nutrition & Diabetes (2016) 6, e195; doi:10.1038/nutd.2016.1

  • Conclusions: The physiological functions of CHO foods consumed ad libitum at meal time on food intake, appetite, BG, insulin and gut hormone responses in children is not predicted by the GI [glycemic index].
  • Acknowledgements: This study was supported by the Alliance for Potato Research and Education (APRE).
  • Comment: David Ludwig, M.D., PhD says: “Potatoes are at the top of the list for weight gain according to the best epidemiological research studies. A small new study claimed that potatoes actually had beneficial effects on appetite. There’s just one thing: The study was fully funded by the Alliance for Potato Research and Education, whose mission is to ‘recognize the role of all forms of the potato in promoting health for all age groups.’”  Here’s the press release from the Alliance for Potato Research & Education.

Nutrient Intakes and Vegetable and White Potato Consumption by Children Aged 1 to 3 Years.  Maureen L Storey and Patricia A Anderson.  doi: 10.3945/​an.115.008656.  Adv Nutr January 2016 Adv Nutr vol. 7: 241S-246S, 2016.

  • Conclusion: The consumption of all vegetables, particularly those that are excellent sources of potassium and DF, such as potatoes, should be encouraged.
  • Funding: Presented at the Roundtable on Science and Policy: Adopting a Fruitful Vegetable Encounter for Our Children. The roundtable was sponsored by the USDA/Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, and was held in Chicago, IL, 10–11 November 2014. The roundtable and supplement publication were supported by an unrestricted grant from the Alliance for Potato Research and Education. The roundtable speakers received travel funding and an honorarium for participation in the meeting and manuscript preparation. Author disclosures: ML Storey is a paid employee of the Alliance for Potato Research and Education; PA Anderson is a paid consultant for the Alliance for Potato Research and Education.
  • Comment: Potato trade associations must be really worried about views like those of Dr. Ludwig.  Personally, I love potatoes and think they are delicious but should be eaten in moderation of course, and not in the form of French fries.  Speculation: I wonder if frequent consumption of French fries could be a marker of unhealthful diets in general?
Feb 25 2016

Food Navigator-USA’s Special Edition on on Oils and fats

Is fat really good or bad and, one way or the other, is it really back?

Food Navigator-USA has an interest in fats from the perspective of companies that use them in food processing.  Here’s what it says:

Fats are often classed into good, bad and ugly categories. But do consumers know which are which, and how can manufacturers help increase consumption of the healthier variety (MUFAs and PUFAs) and reduce trans- and saturated fats (and that’s assuming that saturated fats really are the bogeyman many dietitians have made them out to be)?

Protein is hot, sugar is public enemy #1, and fat is back (so the trend-watchers say). But when it comes to good, bad and ugly fats, does everyone agree on which are which? Check out our gallery of insights from consumers, industry stakeholders, and the 2015 Dietary Guidelines Advisory Committee…

Cobram Estate will enter US to fill what it says is a void in high quality, extra virgin olive oilsAward winning Australian olive oil manufacturer Cobram Estate in February will extend its reach into the competitive US market, which it says suffers a dearth of high quality, extra virgin olive oils. .. Read

Solazyme to launch algae butter in early 2016: We’re offering a hard fat from a completely new sourceSolazyme is aiming to launch the latest addition to its micro-algae-based ingredients portfolio in early 2016 – an algae butter – which it says could replace hard fats such as palm oil or partially hydrogenated oils in a variety of applications spanning confectionery, bakery and spreads… Read

Do we need new labeling conventions around fully hydrogenated oils?Fully hydrogenated oils (FHOs) do not create harmful trans-fats, and could replace partially hydrogenated oils (PHOs) in many applications. However, manufacturers are reluctant to use them because the word ‘hydrogenated’ has become “demonized”, argues one expert, who says efforts are underway to find an alternative name for FHOs that will satisfy manufacturers, consumers, and regulators.  .. Read

Judge stays Gen Mills trans fat lawsuit, but FDA has left firms exposed to civil litigation, argue attorneysIn a ruling that will be read with interest by food manufacturers worried about being sued for using partially hydrogenated oils (PHOs), a judge in California has stayed a PHO-related class action vs General Mills until the FDA decides whether certain low-level uses should be permitted… Read

JM Smucker to settle lawsuit over ‘all natural’ claims on Crisco oils made with GMOsJM Smucker has agreed to settle a class action lawsuit accusing it of misleading shoppers by labeling selected Crisco cooking oil as ‘all natural’, according to court papers filed in New York… Read

Solazyme unveils Thrive, the first culinary algae oil in the market and its first consumer food brandMicroalgae specialist Solazyme has moved into the consumer packaged goods (CPG) arena with the launch of Thrive, a culinary oil from algae that will make its debut at upmarket grocer Gelson’s Markets in southern California this week… Read

Solazyme expands algae oil JV with Bunge to develop ‘breakthrough” products for food and animal nutritionSan Francisco-based microalgae pioneer Solazyme has expand its joint venture with oils expert Bunge to develop a “range of breakthrough oils for food and products for animal nutrition”… Read

Extra virgin olive oil exec: You wouldn’t buy rotten meat or stale bread, so why are you buying rotten olive oil?Claims that much of the extra virgin olive oil (EVOO) sold in US supermarket is not ‘extra virgin’ at all are hardly new. But the fact that many retail buyers are effectively turning a blind eye to such widespread fraud is immensely frustrating for companies that are playing by the rules, says one industry expert… Read

FDA revokes GRAS status of partially hydrogenated oils; allows food industry to file petition to permit specific usesAs widely expected, the FDA has finalized plans to revoke the GRAS (generally recognized as safe) status of partially hydrogenated oils (PHOs) in a bid to eradicate artificial trans fats from the US food supply. However, it says manufacturers may petition the agency to permit specific uses of PHOs… Read