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New York City is serious about trying to reduce rates of obesity and the expensive and debilitating conditions for which obesity raises risks.  Its latest move?  It is asking the USDA for a Food Stamp waiver for two years during which recipients would not be allowed to use their benefit cards to buy sodas.

I hardly know where to begin on this one.  I learned about this from the front page of this morning’s New York Times and from reading the accompanying op-ed by city Health Commissioner Tom Farley and New York State Health Commissioner Richard Daines.

This is an old, old idea that has been consistently rejected by USDA and by public health advocates for the poor.  It is based on the commonly held notion—never conclusively demonstrated by independent data—that recipients of Food Stamps (now called SNAP, the Supplemental Nutrition Assistance Program)–make worse food choices than everyone else.

New York City, according to the Times account, has 1.7 million people who receive SNAP benefits.  The rationale for banning soda purchases?

City statistics released last month showed that nearly 40 percent of public-school children in kindergarten through eighth grade were overweight or obese, and that obesity rates were substantially higher in poor neighborhoods. City studies show that consumption of sugared beverages is consistently higher in those neighborhoods….Anticipating such criticism, Dr. Farley and Dr. Daines said that the food-stamp program already prohibited the use of benefits to buy cigarettes, beer, wine, liquor or prepared foods.

The op-ed points out:

Every year, tens of millions of federal dollars are spent on sweetened beverages in New York City through the food stamp program — far more than is spent on obesity prevention. This amounts to an enormous subsidy to the sweetened beverage industry.

I asked for data on soda purchases by New York City SNAP recipients, and was sent the city’s waiver request to USDA:

An estimated $75 to $135 million dollars of SNAP funds were spent on sweetened beverages in New York City (NYC) alone in 2009 [Based on Nielsen beverage market data for 2009, the prevalence of SNAP participants in NYC, and prior studies of SNAP purchasing behavior].   This use of federal funds to purchase a group of products that are leading contributors to the diabetes and obesity epidemics (and whose extensive consumption contradicts the USDA’s own recommended dietary guidelines) far outstrips current federal funding for prevention of these health problems.

I am, as readers of this blog well know, no fan of sodas.   If people want to do something about controlling body weight, the best place to begin is by cutting out sodas.  Soft drinks contain sugars and, therefore, calories, but nothing else.  As the Center for Science in the Public Interest has long maintained, sodas are liquid candy.   And I am on record as favoring soda taxes (see previous posts) as a strategy to discourage use, especially among young people.

But if I were in charge of Food Stamps, I would much prefer incentives: make the benefit worth twice as much when spent for fresh (or single-ingredient frozen) fruits and vegetables.

How far will the city get with this request?  I can’t wait to find out.  If you want to watch lobbying in action, keep an eye on this one, as I certainly will.

As for this proposal?

I can’t quite get my head around this one.  According to USA Today (October 5), some makers of alcohol drinks have joined the “pink” campaigns to raise awareness of breast cancer and more research.

Chambord’s website notes that its Pink Your Drink campaign has raised more than $50,000 in donations for the Breast Cancer Network of Strength and other patient groups.

Mike’s Hard Lemonade has given $500,000 over the past two years to the Breast Cancer Research Foundation, company President Phil O’Neil says. The company was inspired by the loss of an employee named Jacqueline who died after a long battle with breast cancer.

But alcohol is clearly implicated as a cause of breast cancer.  USA Today discusses that connection—to imbibe or not—in another article in the same issue.

Alcohol raises complicated public health issues for women.  On the one hand, moderate drinking reduces the risk of heart disease.  On the other, it raises the risk of breast cancer.

That is why dietary guidelines suggest no more than one drink a day for women, with a drink defined as 5 ounces of wine, 12 ounces of beer, and 1.5 ounces of hard liquor.

But alcohol companies using donations to pink causes as marketing?  Could we expect breast cancer research sponsored by alcohol companies to focus on the relationship of alcohol to breast cancer?  Is this any different than cigarette companies paying for lung cancer research?

Ethics, anyone?

Nick Freudenberg, Amy Kwan of the City University of New York School of Public Health at Hunter College and Kristen Mancinelli of City Harvest have produced a report on the state of school food in New York City: Recipes for Health: Improving School Food in New York City.

The report is about the “vibrant and fast-growing school food movement in NYC.” It:

• Describes the various programs and activities that are transforming the food environment in city schools.
• Explains how the school food system works in New York City.
• Highlights recent improvements made by the Department of Education and other agencies to address food quality and nutrition concerns.
• Describes the continuing challenges the city faces in providing ideal school meals.
• Explains how to take action to support systemic improvements to the school food environment.

If this can be done in New York City, it can be done anywhere.  Get to work!

My first-Sunday-of-the-month San Francisco Chronicle Q and A column, Food Matters, is out.  This month it’s about figuring out what “whole wheat” labels mean on food packages.

Q: I pay $4 for multigrain or whole wheat breads because I’ve heard white bread isn’t as healthy. But when I compare nutrition labels, $2 white breads look much the same. Are they?

A: My Talmudic answer: yes and no. You are asking about commercial sliced breads. Bread may be the staff of life, but you would never know it from reading the ingredient lists of most commercial products.

Commercial breads are indeed much the same, with only a few differences that matter.

To decide whether these have anything in them worth eating beyond their calories, you must inspect labels to make sure the first ingredient is whole grain, the total number of ingredients is small and devoid of unpronounceable chemicals, the fiber content is at least 2 grams per 1-ounce serving and the label says 100 percent whole wheat. Anything less is reconstituted white bread with occasional pieces of the original grain added back.

And then there is taste. Artisanal breads begin with just four ingredients – flour, water, salt and yeast – and turn them into loaves so crusty, chewy and fragrant that you cannot stop eating them. If they have some whole grain in them, even better.

But handmade breads take forever to make and quickly go stale. Commercial bakeries deal with these problems by rushing the bread-making process and compensate for the loss of flavor by adding stabilizers, dough softeners and preservatives, and covering up the chemical tastes with sweeteners. Breads with 30 or more ingredients are not unusual and violate my rule: Never buy processed foods with more than five ingredients.

To compare breads, you must read labels. Bread companies do not make this easy. Some list the serving size as one slice, some two, and their weights can vary by twofold. When you convert everything to ounces, the nutrient content of supermarket breads looks much alike.

An ounce provides 70 to 80 calories, a trivial difference. The grain is what counts.

Wheat grains have three components – the nutrient-rich bran and germ (“chaff”), and the endosperm, which is mostly starch and protein. One hundred percent whole wheat flour contains all three in the same proportion as in the original grains.

White flour contains about 80 percent of the original components. It is mostly endosperm.

Nutrients in the chaff are lost, so bakers are required to replace the five nutrients least likely to be available from other foods: niacin, riboflavin, thiamin, folic acid and iron. The others are not replaced.

Neither is fiber. White flour contains only trace amounts of fiber.

Because high-fiber diets promote healthy bowel function and appear to reduce risks of heart disease and bowel cancers, dietary advice is to eat at least three daily servings of whole grains – 3 ounces of 100 percent whole wheat bread, for example.

Food labeling rules do not make it easy to figure out fiber content. Some white breads list 1 gram of fiber, but watch out for serving size. It takes two slices to reach half a gram, which can be rounded up to 1.

Whole wheat bread with 2 grams of fiber per 1-ounce slice may have four times as much fiber as white breads. But watch out for breads listing 3 grams fiber; their slices may weigh nearly 2 ounces.

In response to dietary advice, commercial bakeries have introduced whole grain breads acceptable to white bread eaters. These grind the wheat bran super fine, add extra dough conditioners to keep the bread soft, and toss in some bran or cracked wheat to make the bread look like whole wheat. Check for fiber grams and the position of chaff ingredients on the list. The further down the list, the smaller their contribution.

And where is the Food and Drug Administration to help with whole grains? Alas, the FDA has not set rules for grain content. It permits manufacturers to make statements such as “100 percent whole grain” as long as the statement is true and does not imply that the food is an “excellent source.”

The FDA’s nonbinding guidance says anything labeled “100 percent whole grain” must contain all three components of the original wheat seed, in proportion.

This regulatory gap permitted creation of the industry-sponsored Whole Grain Council. The council issues a certifying stamp in two forms: 100 percent and Basic. One hundred percent means all grains are whole. But the more prevalent Basic stamp allows refined grains and disproportionate additions of bran or germ.

This article appeared on page K – 3 of the San Francisco Chronicle.

Note: E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.  Read previous columns at sfgate.com/food.

The Center for Food Safety reports that a Federal Appeals Court has overturned an Ohio state ban on label statements such as “rbGH Free,” “rbST Free” and “artificial hormone free” on milk from cows that have not been treated with genetically modified bovine growth hormone (a.k.a. bovine somatotropin, or rbST).

In ruling on the case, IDFA et al v. Boggs, the court said:

The district court held that the composition claims were inherently misleading because “they imply a compositional difference between those products that are produced with rb[ST] and those that are not,” in contravention of the FDA’s finding that there is no measurable compositional difference between the two.

This conclusion is belied by the record, however, which shows that, contrary to the district court’s assertion, a compositional difference does exist between milk from untreated cows and conventional milk (“conventional milk,” as used throughout this opinion, refers to milk from cows treated with rbST). As detailed by the amici parties seeking to strike down the Rule, the use of rbST in milk production has been shown to elevate the levels of insulin-like growth factor 1 (IGF-1), a naturally-occurring hormone that in high levels is linked to several types of cancers, among other things. The amici also point to certain studies indicating that rbST use induces an unnatural period of milk production during a cow’s “negative energy phase.” According to these studies, milk produced during this stage is considered to be low quality due to its increased fat content and its decreased level of proteins.

The amici further note that milk from treated cows contains higher somatic cell counts, which makes the milk turn sour more quickly and is another indicator of poor milk quality. This evidence precludes us from agreeing with the district court’s conclusion that there is no compositional difference between the two types of milk.

The court also said:

Like composition claims, production claims such as “this milk is from cows not supplemented with rbST” are potentially misleading because they imply that conventional milk is inferior or unsafe in some way. But neither the FDA nor any study has conclusively shown that to be the case.

Want to bet that this one goes to the Supreme Court?

At current exposure levels, is BPA toxic or not?  The question turns out to be difficult to answer for two reasons: science and politics.  Science does not have an easy way to determine the health effects of exposures to very low doses of chemicals, and the plastics industry does everything it can to minimize risks.

A recent study says that human exposure to BPA is much higher than previously estimated, not least because many of the sources of this estrogen disrupting chemical have not yet been identified.   The authors of the study, according to FoodQualityNews, want the chemical registered so that exposures can be assessed.  They also call for immediate action to reduce exposures.

In contrast, FoodProductionDaily reports that the European Food Safety Authority (EFSA) has just ruled that current exposure levels are safe.  Its expert panel reviewed  hundreds of studies of BPA’s effects over a six-month period.  The committee could find no new evidence for setting a lower level for the Tolerable Daily Intake, now established at 0.05 mg/kg/body weight.  But at least one member of the committee disagreed and viewed the evidence as less certain.  As FoodProductionDaily explains:

Bisphenol A is a chemical used as a monomer in polycarbonate plastic and epoxy resins – two food contact materials used in the manufacture of baby bottles and food and drink can linings respectively. Its continued use is a matter of fierce debate, with scientific evidence divided on the issue. In January 2010, the US Food and Drug Administration (FDA) said the substance was safe at current exposure levels. It also recommended that children and pregnant women reduce their exposure to the substance and that industry should seek to develop BPA-free materials for use in food contact materials.

As might be expected, the plastics industry is delighted with the EFSA decision.  FoodProductionDaily quotes a representative of the chemical industry:

Consumers around the world can be reassured that EFSA’s intense scientific scrutiny continues to reaffirm the safety of BPA in food contact applications, and again concludes that established safe intake levels for BPA provide a sufficient margin of safety for protection of consumers, including for infants and young children.

Aren’t you reassured by this?

Glass baby bottles, anyone?

Update, October 4:  France and Denmark say that unless EFSA requires lifting their bans on BPA, they intend to keep the bans.

I would have loved to be in the room when Stephen Colbert testified before Congress a few days ago.

I’ve been to congressional hearings.  They are a peculiarly American form of Kabuki theater, full of posturing, entirely predictable script-following, and institutionalized rudeness.  Colbert, in character, took perfect advantage of the opportunity.

I thought his testimony was brilliantly funny.  But I can well understand why the members of Congress stuck with Kabuki rituals—stony silence and hiding behind their equivalents of fluttering fans–BlackBerries.

Mr. Colbert gave devastating testimony, well worth 5 minutes to watch.  One of the Times’ bloggers (Sept 24) made a point of what he said at the end when he went out of character:  “I like talking about people who don’t have any power, and it seems like one of the least powerful people in the United States are migrant workers who come and do our work but don’t have any rights themselves.”

In character, his testimony offered some ideas about how to stop undocumented farm labor: “The obvious answer is for all of us to stop eating fruits and vegetables–and if you look at the recent obesity statistics, you’ll see that many Americans have already started.”

He’s right on about that one.  Kim Severson of the New York Times reports:

Despite two decades of public health initiatives, stricter government guidelines, record growth of farmers’ markets and the east of products like salad in a bag, Americans still aren’t eating enough vegetables.

Quoting CDC statistics, she reports that “only 26 percent of the nation’s adults eat vegetables three or more times a day…and no, that does not include French fries.”  We do better with fruit: 33% of Americans eat 2 servings of fruit a day.

All of this is why concern about our food system and where our food comes from also must include concern about who works in the fields, raises the animals, and works in the slaughterhousese.  Immigration is a food issue, big time.

Thanks Colbert–in character and not–for taking this issue to our government.  May it do some good.

The newly alive Federal Trade Commission (FTC) says POM Wonderful must stop making unscientific claims for the health benefits of pomegranate juice.  POM juice, the FTC says, has not been shown to prevent or treat heart disease, prostate cancer, or erectile dysfunction, as the company claims:

“SUPER HEALTH POWERS! … 100% PURE POMEGRANATE JUICE. … Backed by $25 million in medical research.  Proven to fight for cardiovascular, prostate and erectile health.”

“NEW RESEARCH OFFERS FURTHER PROOF OF THE HEART-HEALTHY BENEFITS OF POM WONDERFUL JUICE.  30% DECREASE IN ARTERIAL PLAQUE … 17% IMPROVED BLOOD FLOW … PROMOTES HEALTHY BLOOD VESSELS … ”

“Prostate health…You have to be on pomegranate juice.  You have a 50 percent chance of getting [prostate cancer].  Listen to me.  It is the one thing that will keep your PSA normal.  You have to drink pomegranate juice.  There is nothing else we know of that will keep your PSA in check. … It’s also 40 percent as effective as Viagra.”

Clinical studies prove that POM Juice prevents, reduces the risk of, and treats, erectile dysfunction.

The complaint cites advertisements in the Washington Post and Fitness magazine, as well as this ad:

According to the New York Times account, the POM Wonderful folks are not taking this lightly.  They have spent a reported $34 million on research to “prove” that POM has antioxidant activity.

But I could have told them that before they spent a dime!  All fruits and vegetables have antioxidant activity.

I love using POM research as an example of how easy it is to design studies to give you the answer you want.  POM research demonstrates that pomegranate juice has antioxidant activity and acts as an antioxidant in the body.  Of course it does.

But so does every other fruit and vegetable and what this research does not do is compare the effects of pomegranate juice to those of orange juice, for example.     That’s the issue I talked about in my November 19, 2007 post titled “The (silly) battle of the antioxidants.”

Which fruit has the most antioxidants? The latest report says blueberries, followed by cranberries, apples, red grapes, and finally green grapes. What? Pomegranates don’t even make the top five? In this case, who knows? The investigators were testing a new assay method and those were the only fruits they examined.

And then there is the troubling matter of whether antioxidants make a demonstrable difference to health.  The European Food Standards Agency has been turning down health claims for antioxidants like mad.  As I discussed on April 16, 2009:

Here’s another example from the pomegranate folks.  They do brilliant advertising, but this time the British are complaining that these marketers went too far when they posted billboards stating that pomegranate (“antioxidant powerhouse”) juice will help you cheat death.  The British advertising standards agency balked.  Here too, pesky science gets in the way.  Studies not only fail to support a benefit of antioxidants but sometimes show harm.

If only that pesky science weren’t so inconvenient, marketers could do as they please.  The New York Times reports that the POM folks are not taking this lightly.  They are suing the FTC—not because they are claiming they have science on their side, but because they think their health claims, believable or not, are protected by the First Amendment.

Did our founding fathers really introduce the First Amendment to protect the right of marketers to make unsubstantiated health claims?  Do our judges really believe this?  Is this a good case for taking on this question.  Lawyers: get to work!