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I was invited to write the editorial to accompany a study published today in JAMA Internal Medicine looking at the highly conflicted process used to decide whether food additives are Generally Recognized as Safe (GRAS).

Here’s the study.

Here’s my editorial.

I know this sounds completely crazy, but here’s what the study found:

• Manufacturers get to decide whether food additives are safe or not.
• Manufacturers get to decide whether to bother to tell the FDA the additives are in the food supply.

And if they do volunteer to inform the FDA (and many do),

• Manufacturers get to decide who sits on the panels that review the evidence for safety.

In reading the study, it seemed to me that:

• As long as not too many people roll over dead after eating foods with new additives, nobody will ever have a clue whether the additive is safe.
• The regulatory gap has spawned an entire enterprise of GRAS consultants and GRAS consulting firms who are in the business—presumably lucrative—of providing the scientific documentation the FDA needs to determine additive safety.

Some of the consultants need to do a better job.  The FDA raises enough questions that about 15% (my estimate) of the requests would be denied.

The good news: If the FDA sees the safety documentation, it does its job.

But what happens to the rejected additives?  Or the ones that don’t get voluntarily sent to FDA?

Nobody really knows (think: caffeine in alcohol drinks–the FDA had no idea).

We need a better food safety system in this country and conflicts of interests in GRAS additive approvals are a good place to start.

Here’s what USA Today has to say about this (I’m quoted).

In what will surely be good news to people with celiac disease and other problems related to gluten intolerance, the FDA has just issued a final rule for defining foods as “gluten-free.”

This, after nine years of work on this issue (see timeline below).

The rule states that companies can label their products gluten-free if they contain less than 20 ppm (parts per million) gluten.  This, says FDA,

is the lowest level that can be consistently detected in foods using valid scientific analytical tools. Also, most people with celiac disease can tolerate foods with very small amounts of gluten. This level is consistent with those set by other countries and international bodies that set food safety standards.

As for gluten intolerance: Roughly 1% of the U.S. population has diagnosable gluten intolerance.  For those who do, eating grains containing gluten (wheat and some others) triggers an abnormal immune response that damages the intestinal tract.  To prevent symptoms—of which there can be many, none of them pleasant—people with this condition must scrupulously avoid eating gluten-containing foods.

The new rule will help establish some uniformity in labeling.  Note: gluten-free does not mean sugar-free.

In reading through the FDA’s notice in the Federal Register, I am struck by the complexity of the agency’s processes for doing something like this.

Policy wonk that I am, I immediately made a timeline.  This indicates that the FDA spent nine years getting to this point. Impressive, no?

Timeline: FDA’s Gluten-Free Rule

FDA’s documents on the gluten-free rule:

• FDA: Gluten-Free Labeling
• FDA: Gluten-Free Labeling Final Rule Q&A
• Consumer Update

I used my August (monthly, first Sunday) column for the San Francisco Chronicle to reflect on the meaning of the Mayor’s Food Forum last month.

Q: I hear that you moderated a food forum for candidates for mayor of New York City and got them to say what they thought about hunger, nutrition and local agriculture. Did any of them say anything worth telling?

A: The forum was indeed amazing. But I’d go further.

I’d call it historic – a turning point in the food movement.

This had to be the first time that food advocacy organizations – an astonishing 88 of them – joined forces to induce candidates for city office to agree to respond to questions about issues of concern to every one of those groups.

Six candidates turned up. What they said hardly mattered (and at this point, the less said about the individual candidates, the better). What does matter is that they thought this audience important enough to come and state their positions on how food production and consumption affect public health, and how political leaders can use their authority to improve the food system.

Food issues have become prominent enough to make politicians and would-be politicians take notice.

The sold-out audience of nearly 1,000 filled the auditorium at the New School as well as two overflow rooms. Others watched the forum streamed live online. (http://new.livestream.com/TheNewSchool/nycfoodforum).

When I was invited to moderate, I could hardly believe what the organizers had accomplished. Twelve groups, each working separately for improvements in food assistance, food access, working conditions, local farming, food systems or health had formed a coalition to plan the forum and make it happen.

These groups met for a more than a year to identify the specific issues they most wanted candidates to think about. Judging from the length of the questions I was given, this cannot have been easy. The organizers must have been exceptionally patient – and persistent – to get 12 advocacy groups to agree on the key issues.

They also did a great deal of community organizing. They not only recruited 76 other food advocacy groups to support the forum, but also encouraged development of an additional forum for young people in low-income communities to get involved in the food issues most relevant to their lives.

Some of these kids were invited to ask questions of the candidates. One, from a Brooklyn teenager: “Where do you shop for food?” This may sound like a naive question, but it elicited a surprisingly thoughtful response that touched on sensitive issues of income and class.

The grown-up questions concerned issues vital to the host groups: How would the new mayor address hunger and food insecurity, inadequate access to healthy food, the low wages and inhumane treatment of restaurant and fast-food workers, the poor quality of school food, and the high rates of diet-related chronic disease among city residents.

Such problems are hardly unique to New York. Even the more city-centered questions – how to use the city’s purchasing power to support regional agriculture and the food economy, and to promote city land for urban farming – have plenty of relevance for other urban areas, including Bay Area cities.

The candidates made it clear that they had thought about the issues, and had come prepared to address them.

Here’s my inescapable conclusion: The food movement is strong enough to make candidates for office stand up, listen and take food issues seriously.

Last fall, writing about California’s Proposition 37 that sought to label genetically modified foods, Michael Pollan issued a challenge to food advocates.

The food movement, he said, needs to do more than work for agricultural reform and an increased market share for healthier food. Advocacy groups need to get together to create a real political movement – an organized force strong enough to propel food concerns onto the national agenda and force politicians to take action to improve food systems.

The forum was a first step in that direction. It proved that food coalitions can have political power.

I can’t think of a better time for food advocacy groups to join forces and work collectively toward common food system goals.

E-mail questions to: food@sfchronicle.com

Tamar Adler.  An Everlasting Meal: Cooking with Economy and Grace.  Scribner 2011.

The book comes with a foreword by Alice Waters and a blurb from Michael Pollan: “Tamar Adler has written the best book on cooking with economy and grace that I have read since MFK Fisher.”  He ought to know (see below).

Ms. Adler cooked at Chez Panisse.  She says:

Cooking is best approached from wherever you find yourself when you are hungry, and should extend long past the end of the page.  There should be serving, and also eating, and storing away what’s left; there should be looking at meals’ remainders with interest and imagining all the good things they will become.

She begins with “how to boil water” and ends with “how to end.”  Very MFK Fisher indeed.

Michael Pollan.  Cooked: A Natural History of Transformation.  Penguin Press, 2013

A review of this book should seem superfluous as a mere look at Pollan’s website makes clear.   But I want to go on record as saying how much I enjoyed reading it.  He writes about the time he spends in the kitchen learning from experienced cooks how to barbecue (fire), make stews (water), breads (air), and cheese (earth).

The writing is so vivid and engaging that I had the strangest reaction to this book: I could smell what was cooking.

Fast food workers striking for higher pay are on the front page of the New York Times today.   And about time too.

The salient quotes:

• Our union’s members think that economic inequality is the No. 1 problem our nation needs to solve. We think it’s important to back low-wage workers…to make the case that the economy is creating jobs that people can’t support their families on.
• In a lot of low-income neighborhoods, probably the largest employer is the fast-food industry, and we’re not going to reduce the level of poverty in those neighborhoods unless we try to get that industry to provide jobs that pay a living wage.
• One Taco Bell worker…has about $900 a month to feed and clothe her three children. They receive food stamps.

Food stamps?  If fast food and restaurant workers need—and qualify for—food stamps to feed their families, this means that American taxpayers are subsidizing the profits of these industries.

And if you want a terrific introduction to what this issue is about, take a look at Saru Jayaraman’s  Behind the Kitchen Door (ILR Press/Cornell, 2013).

The  NY State Supreme Court, Appellate Division, has turned down the Bloomberg administration’s appeal (New York Statewide Coalition of Hispanic Chambers of Commerce v New York City Dept. of Health & Mental Hygiene).

The court’s decision in this case begins on page 22:

Like Supreme Court, we conclude that in promulgating this regulation the Board of Health failed to act within the bounds of its lawfully delegated authority. Accordingly, we declare the regulation to be invalid, as violative of the principle of separation of powers.

…we find particularly probative the regulation’s exemptions, which evince a compromise of social and economic concerns, as well as private interests. As indicated, the regulatory scheme is not an all encompassing regulation. It does not apply to all FSEs [food service establishments]. Nor does it apply to all sugary beverages. The Board of Health’s explanations for these exemptions do not convince us that the limitations are based solely on health-related concerns (pages 17, 18 of the decision).

OK.  So the city should have made the rule apply to all food service places and all sugary beverages.  Live and learn.

Mayor Bloomberg says the city will appeal:

Since New York City’s ground-breaking limit on the portion size of sugary beverages was prevented from going into effect on March 12^th, more than 2,000 New Yorkers have died from the effects of diabetes. Also during that time, the American Medical Association determined that obesity is a disease and the New England Journal of Medicine released a study showing the deadly, and irreversible, health impacts of obesity and Type 2 diabetes – both of which are disproportionately linked to sugary drink consumption. Today’s decision is a temporary setback, and we plan to appeal this decision as we continue the fight against the obesity epidemic.”

The American Beverage Association is pleased.  It’s headline: “Hey New York – Your Beverage Is Still Your Choice!”

We are pleased that the lower court’s decision was upheld.  With this ruling behind us, we look forward to collaborating with city leaders on solutions that will have a meaningful and lasting impact on the people of New York City.

Even if the city loses the final appeal, the 16-ounce soda cap is the writing on the wall for soda companies.

Sales of full-sugar sodas have been falling for years and getting worse for both Coca-Cola and Pepsi.

Cutting down on the portion sizes of sugary drinks is still a really good idea.

Here’s what the news media say about it:

• Reuters
• The New York Times
• The Wall Street Journal

Food Navigator just did a report on cereal “blockbusters,” the top best-selling brands.

Numbers like these are so hard to come by that they inspired me to make a table.

I looked up some figures on advertising expenditures for specific cereals from Advertising Age, 100 leading advertisers (June 24, 2013).

Top selling cereal brands, July 2012-June 2013

*All numbers rounded off.  **All forms of Cheerios: $167 million

My conclusions:

• At least 8 of the top 10 are sugary cereals.
• At least 5 are targeted to children.
• Six of the top 10 are made by Kellogg.
• Advertising expenditures are roughly proportional to sales (Special K is an exception: not sure why).

Think about what that money could do if used to promote public health.

The FDA has finally released safety rules for imported foods, two years after Congress passed the food safety law.  OK.   We now have them.  At last.

Here’s what the FDA is up against:

• 150 different countries ship foods to the U.S.
• These account for about 15% of the food supply, but 50% of fresh fruits and 20% of fresh vegetables.
• The agency has the capacity to inspect about 2% of imported foods.

To deal with this disconnect, the FDA proposes to hold importers accountable for the safety of what they ship to us.

The proposed rules allow two ways to do this: Importers can do their own onsite safety audit, or they can verify that their suppliers did so.

Both methods involve verification by certified verifiers that suppliers used “prevention-oriented food safety practices” (HACCP in other words), and achieved the same level of food safety as domestic growers and processors.

Neither requires inspection by FDA, although importers may use inspection.

The proposed rule and the third-party accreditation proposed rule are available for public comment for the next 120 days.

The previous proposed rules, for produce safety and food production facilities (see below), have been given another 60 days for public comment.  Comments on all proposals will now be due at the same time.  The FDA expect to issue the rules 12 to 18 months after the comments come in and then it will take another 18 months for rules to go into effect.

What does all this mean?

The FDA hardly has the resources to manage U.S. inspections so expecting it to do foreign inspections is unrealistic.  This plan shifts the regulatory burden to producers and shippers (why does this sound like foxes guarding henhouses?).

The FDA also intends to certify third-party auditors.  These invariably involve conflicts of interest, although that system  seems to have worked fairly reasonably well for organic foods.  But we are talking about the safety of imported foods here, and lives are at stake.

This is undoubtedly the best the FDA can do given its limited resources and its problems with Congress.  This Congress is hardly likely to view food safety as a national priority and give the FDA what it needs.

Recall: FDA appropriations go through agricultural appropriations committees, not health appropriations.  And this Congress cannot even pass a decent farm bill.

Congratulations to the FDA for making the best of a bad situation.  And fingers crossed that the proposals survive, get implemented by 2015, and nothing bad happens in the interim.

The document collection:

• FDA Food Safety Modernization Act (FSMA)
• Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food
• Standards for Growing, Harvesting, Packing, and Holding of Produce for Human Consumption
• Fact Sheet: Foreign Supplier Verification Programs for Importers of Food for Humans and Animals
• Fact Sheet: Proposed Rule on Accreditation of Third-Party Auditors 
• Consumer Update

For a detailed discussion of the pros, cons, and questions, see the account in Food Safety News