by Marion Nestle

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Apr 3 2024

The FTC’s wishy-washy report on infant formula disruptions

The Federal Trade Commission (FTC) has issued a report on Market Factors Relevant to Infant Formula Supply Disruptions 2022. 

As the report explains:

Widespread supply disruptions for infant formula began shortly after Abbott Nutrition voluntarily recalled several powdered infant formulas manufactured at its facility in Sturgis, Michigan in response to reports of bacterial contamination on February 17, 2022. The FDA advised consumers that same day not to use the recalled formula. In turn, the USDA provided guidance to WIC State agencies and offered program flexibilities to support WIC participants’ access to infant formula.

The infant formula market in the United States is, to say the least, distorted.

  • It is highly concentrated; the top 2  manufacturers control 66% of the market; the top 4 control 97%: Mead Johnson/Reckitt (39%), Abbott (27%), Nestle/Gerber (18%), Perrigo/store brands (13%).
  • More than half (56%) of infant formula is sold through the WIC program through state-determined single-supplier contracts awarded to companies who offer the largest rebates (sometimes selling formula to the government below cost).
  • Why would they do this?  Suppliers who hold state contracts dominate non-WIC sales in that state (the WIC halo or spillover effect).

Obviously, this system is highly vulnerable to disruptions and price inflation.

So what does the FTC conclude?

This Report was written from the perspective of the FTC, which is an agency tasked with promoting fair, competitive markets that deliver high quality, affordable, reliable supplies of products. Pursuant to this mandate, the FTC analyzes high levels of concentration in the infant formula market and explores whether certain policy changes could promote greater competition and resiliency, thereby rendering the market less susceptible to serious supply disruptions. We recognize that concerns about competition and resiliency must be balanced against other policy priorities, and that any attendant tradeoffs will require thoughtful and careful analysis.

Members of Congress asked for the report.  Did they get what they wanted?

The USDA’s recent annual report on WIC, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Background, Trends, and Economic Issues, 2024 Edition, points out that this system doubles the cost of formula for non-WIC families.  Highly consolidated markets pretty much always lead to higher prices.

WIC is an important program for low-income women and children, demonstrably effective in reducing food insecurity.  Nobody wants to criticize it out of fear that Republicans will cut its budget.

But there has to be a better way to do this.

Apr 2 2024

ProPublica: the U.S. government interferes with international regulation of formula marketing

ProPublica has issued a major and highly importantt investigative report: The U.S. Government Defended the Overseas Business Interests of Baby Formula Makers. Kids Paid the Price.

The report documents how the U.S. has opposed marketing restrictions on infant formula throughout the world.

It refers specifically to what happened in Thailand over attempts to restrict the marketing of toddler formula (an unneccesary product).

In 2017, Thai health experts tried to stop aggressive advertising for all formula — including that made for toddlers. Officials feared company promotions could mislead parents and even persuade mothers to forgo breastfeeding, depriving their children of the vital health benefits that come with it. At the time, Thailand’s breastfeeding rate was already among the lowest in the world.

But the $47 billion formula industry fought back, enlisting the help of a rich and powerful ally: the United States government…U.S. officials delivered a letter to Bangkok asking pointed questions, including whether the legislation was “more trade restrictive than necessary.” They also lodged criticisms in a bilateral trade meeting with Thai authorities and on the floor of the World Trade Organization, where such complaints can lead to costly legal battles…In the end, though, the Thai government backed down. It banned advertising for infant formula but allowed companies to market formula for toddlers like Gustun — one of the industry’s most profitable and dubious products. The final law also slashed penalties for violators.

ProPublica also obtained documents detailing the arguments between trade and health officials over these policies.  See: Documents Show Internal Clash Before U.S. Officials Pushed to Weaken Toddler Formula Rules.

In this case, trade won over health.

The US government role in infant formula marketing goes way back to its opposition to the international code of marketing of breastmilk substitutes.  It is not a nice history and distressing that it continues.

More on infant formula tomorrow…

Apr 1 2024

Beef industry request for research proposals: act quickly (not an April 1 joke)

Jim Krieger, of Healthy Food America forwarded this request for research proposals (RFP) from the National Cattlemen’s Beef Association’s Senior Director of Human Nutrition Research.,

On behalf of The Beef Checkoff, the National Cattlemen’s Beef Association (NCBA) is conducting a request for proposals (RFP) in Human Nutrition, to further understand beef’s nutritional qualities and define beef’s role in a healthy diet to nourish and optimize health at every life stage including research topics related to growth and development, healthy aging, and reduced risk of chronic disease… As part of their long-standing commitment to further scientific discovery, beef farmers and ranchers are invested in funding high quality, rigorous research — from observational epidemiological and clinical intervention trials to modeling and substitution analyses. As nutrition science continues to evolve, broadening and deepening the beef nutrition evidence base is essential to ensure that consumers have the most up-to-date information to make informed choices about the foods they eat

The Human Nutrition Research Program follows a two-part application process, beginning with the submission of a preproposal. Pre-proposals are intended to be a brief overview of the proposed project. Pre-proposals must meet the submission deadline and follow the guidelines in the RFP to be considered. Principal Investigators may submit more than one pre-proposal. Please share this RFP with interested colleagues

PRE-PROPOSALS MUST BE SUBMITTED BY Wednesday April 3, 2024 at 11:59pm MT.

Submit a Pre-Proposal here to join our RFP email list and get information about new research funding opportunities.

Comment: This is how industry funded research begins.  The RFP is not open-ended; it is not asking you to find out whether beef has benefits.  If you want this funding, you had best come up with a research plan highly likely to demonstrate the benefits of beef in nourishing and optimizing health—otherwise, it won’t be funded. This is the USDA-sponsored Beef Checkoff at work.

Here’s your chance!

 

Mar 29 2024

Weekend reading: Practicing Food Studies!

The exclamation point is because this is my department’s long-awaited book ,for which I wrote the Foreword and part of one of the last chapters.

Practicing Food Studies: Bentley, Amy, Parasecoli, Fabio, Ray, Krishnendu, Nestle, Marion: 9781479828098: Amazon.com: Books

If you are in the New York area, come to its celebration on April 1 at 5:3 p.m. at New York University’s Institute for Public Knowledge, 20 Cooper Square (South of 3rd Ave and North of The Bowery between 4th and 8th Streets), 5th Floor.  For information and registration for the event, click here.

There will also be an online presentation of the book on April 29 through the NYU Library’s Critical Topics series.  For details, watch for the announcement.

To buy the book from NYU Press, click here.

My department at NYU, now known as the Department of Nutrition and Food Studies, invented the field of Food Studies in 1996.  Now, more than 25 years later, practically every college in America, and plenty outside the U.S., offers courses or programs about the role of food in society, commerce, and the environment.

Food studies is highly interdisciplinary (my doctoral degree is in molecular biology, for example).  As NYU Press puts it, scholars from an enormous range of fields

felt limited by the conventions of their traditional discipline. Many gravitated to food studies to be able to describe and critically examine their specific areas of interest beyond the borders of academic disciplines.

Faculty and doctoral graduates from our department wrote extraordinarily personal essays for this book to explain their connection to Food Studies and how this new filed made their work possible.

We do not necessarily agree with each other about what Food Studies is, exactly, and whether and how it fostered our work.  We argue throughout, respectfully, of course.

I think the book is enormous fun and I could not be more proud of what it accomplishes.

Here are two of the blurbs:

“NYU’s Food Studies department has a lot to teach: about pedagogy, art, library sciences, the limits of traditional disciplinary fields, and the world beyond the academy. With essays that blend biography with analysis, this anthology finds the universal in the particular. Anyone interested in how to address the urgent  and practical questions, while confronting the systemic ones, will find inspiration in this fine anthology.” ― Raj Patel, University of Texas at Austin

“Food studies provides a home for deeply interdisciplinary scholars; Practicing Food Studies packages that intellectual belonging into a single book that you’ll want to not just read but keep close. The editors, each a leading voice in the field, use NYU’s program as a case study that delivers a must-read history of food studies itself. Critical reflections, warmth, and candor leap from each page, fascinating and endearing at every turn.” ― Emily J.H. Contois, The University of Tulsa

Mar 28 2024

Mexico vs. US: trade dispute over genetically modified corn

I am deluged with emails urging me to say something about the trade dispute between Mexico and the United States over genetically modified (GMO) corn.

Let me confess immediately to a particular difficulty understanding international food trade.  I find the abbreviations (NAFTA, USMCA) and odd terminology (Sanitary, Phytosanitary) off-putting and confusing.

With that confessed, here is my understanding of what this trade dispute is about.

Under the terms of USMCA (the U.S. Mexico Canada Free Trade Agreement), passed in 2020, the three countries must accept each others’ products without tariffs or other unnecessary barriers.

Unnecessary is subject to interpretation.

In February 2023, Mexico published a presidential decree prohibiting the use of GMO corn in Mexico’s dough and tortilla production.  It also announced its intention to phase out the glyphosate herbicide.

These decrees affect imports of corn from the US, which is mostly GMO.

The US says the USMCA does not allow Mexico to ban GMO corn because doing so has no scientific justification.

In response, Mexico issued a 189-page report reviewing and detailing the scientific basis for the ban.

A trade tribunal has been set up to adjudicate this dispute., with the decision expected later this year.

Almost everyone I’ve heard from views Mexico’s analysis as highly convincing.

The biotechnology industry, unsurprisingly, supports the US position:

This dispute raises serious issues of national food sovereignty—who gets to decide how a country’s food system works.

  • Mexico wants to protect the genetic integrity of its native corn landraces.
  • Mexico also wants to protect its population against what it sees as hazards of GMO corn and the glyphosate herbicide used with it.
  • The US wants to use this trade agreement to force Mexico to accept its GMO corn.

It will be interesting to see how this plays out.  Stay tuned.

Mar 27 2024

The federal vision for chronic disease prevention: individual behavior, not the environment

At the insistence of Jerry Mande, I watched the meeting of the President’s Council of Advisors on Science and Technology (PCAST) to learn about the Federal Vision for Advancing Nutrition Science in the United States.

This Vision derives from last year’s White House Conference on Hunger, Nutrition, and Health and its pillar on enhancing nutrition research.

Cathie Woteki, who introduced the report, made a forceful case for the importance of chronic disease prevention.  Her committee was shocked  that the majority of Americans are overweight or obese, and at a cost of $500 billion annually.  She pointed out the lack of focus and coordination of 200 existing programs that ought to be addressing this issue.

The conclusion: not enough research on chronic disease and more funding needed.

No question about that.  Yes, we need more nutrition research and more funding for it.  A lot more.

But the White House request for the Office of Nutrition Research is only $1.3 million (see p. 26).  Surely this  is some kind of joke?  It’s hardly even a rounding error in federal terms.

As for the PCAST report’s efforts needed:  That’s all?

Yes we can use more data and research on personal eating habits and individual behavior, but what about the food environment?

Maybe PCAST is under political constrainsts but this sure does feel like a lost opportunity.

The report —as yet unpublished—appears to say nothing about:

  • The effects of ultra-processed foods on individual food choices and weight. (the word “ultra-processed” was not mentioned)
  • The need to change the food environment to make it easier and less expensive for individuals to make healthier food choices.
  • Policies to requirie food companies to produce healthier foods and reduce serving sizes.
  • Policies to stop the food industry from marketing ultra-processed foods to kids.
  • Programs to achieve the existing 2030 health objectives to prevent obesity and chronic disease (these were not mentioned).

The committee said it consulted widely to produce this report.  Not widely enough, I’d say.

Compare this to what the UK House of Lords is doing in its hearings on  Food, Diet and Obesity.  Take a look at who they are listening to.

If the PCAST committee talked to any of these people, their comments are not showing up.

PCAST has a real opportunity here to push for a strong research and policy agenda to address obesity and its related chronic diseases.

What kind? Here are my suggestions.

Mar 26 2024

The Weight of Ozempic: Today’s panel discussion

Today I’m participating on a panel discussion on Ozempic at 12:30 EDT.  See announcement to the right; register for it here. 

I watched the Oprah special on the obesity drugs.

Its messages:

  • Obesity is a disease, requiring treatment.
  • These drugs offer treatment.
  • The drugs are effective; side effects are minimal.
  • Yes they are expensive and therefore, promote inequality; therefore, the government should pay for them.

The program was a one-hour, prime-time commercial for the drugs.

The physicians who testified on their behalf consult for the drug companies.

The program has already had an effect.  cause the FDA says semaglutide helps prevent heart attacks, strokes, and deaths in overweigth people, the government will now authorize payment through Medicare Part D.

Here’s what was not discussed.

  • The fortunes the drug companies spent on getting doctors, health professionals, and influencers to promote the drugs and minimize their side effects.  See Reuters for US doctors and The Guardian for European influencers.
  • The sharp rise in obesity prevalence between 1980 and 2000 and the environmental and commercial reasons for it.
  • Anything about prevention. and changing that food environment.
  • Anything serious about the down side of taking the drugs (lifetime treatment, cost, side effects, loss of joy in eating).

An editorial in The Lancet says:

A simple pill or injection will undoubtedly help some patients, but it cannot be the sole basis for addressing the complexities of obesity. Obesity is a product of not only an individual’s circumstances and behaviour, but also society at large, shaped by global food markets and trade agreements. Multidimensional approaches are needed to curb the effects of the obesogenic environment, particularly against an international industry that promotes overproduction of cheap food and drinks. Physical activity needs to increase; walking and cycling for journeys to work or school should be normalised and made easier and safer. Sugar taxes and curbs on marketing of high-energy, high-fat, ultra-processed foods need to be implemented. Prevention must be the foundation upon which everything else follows.

Other comments

Much to be said about all this.  Stay tuned.

Mar 25 2024

A rare gem: an industry-funded study with a negative result, and for blueberries yet!

I’ve posted several studies sponsored by the blueberry industry , most recently on their effects on menopausal symptoms.  Blueberry trade associations, as I discuss in my book Unsavory Truth: How the Food Industry Skews the Science of What We Eat, led the way in promoting research suggesting this fruit is a “superfood.”

If only.

They are still at it, apparently, but sponsorship does not always guarantee the desired outcome.  Here is a rare exception to the rule that industry-sponsored studies almost invariably give results favorable to the sponsor’s marketing interest.  Let’s give credit where it is due.

  • The study:  Chronic and postprandial effect of blueberries on cognitive function, alertness, and mood in participants with metabolic syndrome – results from a six-month, double-blind, randomized controlled trial.  The American Journal of Clinical Nutrition.  Available online 6 February 2024, https://doi.org/10.1016/j.ajcnut.2023.12.006
  • Methods: “A double-blind, randomized controlled trial was conducted, assessing the primary effect of consuming freeze-dried blueberry powder, compared against an isocaloric placebo, on cardiometabolic health >6 mo and a 24 h postprandial period (at baseline).”
  • Results: “Postprandial self-rated calmness significantly improved after 1 cup of blueberries (P = 0.01; q = 0.04; with an 11.6% improvement compared with baseline between 0 and 24 h for the 1 cup group), but all other mood, sleep, and cognitive function parameters were unaffected after postprandial and 6-mo blueberries.”
  • Conclusion: “Although self-rated calmness improved postprandially, and significant cognition-metabolite associations were identified, our data did not support strong cognitive, mood, alertness, or sleep quality improvements in MetS participants after blueberry intervention.”
  • Conflict of interest: “AC reports financial support provided by the US Highbush Blueberry Council (USHBC) and Biotechnology and Biological Sciences Research Council (BBSRC, UK). AC and EBR both act as advisors and consultants to the United States Highbush Blueberry Council grant committee. All other authors report no conflicts of interest.”
  • Funding: “This work was supported by the United States Highbush Blueberry Council with oversight from the USDA and the Biotechnology and Biological Sciences Research Council (United Kingdom). The funders of this research had no involvement in this publication and have placed no restrictions on the publication of these data.”

Comment: In this instance, the last statement could well be correct (it isn’t always, alas).  I like blueberries but they are not a superfood.  There is no such thing as a superfood.  If you want to eat healthfully, by all means eat fruit—and enjoy the ones you like best.