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Just in time for the holidays, we get some good news.   The New York City Health Department reports that rates of childhood obesity are falling.

If the rates were staying constant, I’d consider it a step forward.  But these results show rates going down, even if only by a few percentagel points.

The Bloomberg administration says the numbers are a result of its anti-obesity initiatives, some focused especially on children.  Health Commissioner Dr. Tom Farley told the New York Times that he attributes

the progress partly to the city’s aggressive advertising campaign against sugary sodas, which he said may have altered what parents were providing to their children. The city has also tried to add healthier options to school lunch menus, enacted strict rules on the calorie and sugar content of snacks and drinks in school vending machines, and even put limits on bake sales, a move that caused some grumbling.

As I explained to Bloomberg News,  if this trend continues, it will represent the first truly positive development in years.

It also suggests that the health department’s unusually aggressive efforts to address obesity may be paying off.  If so, they should inspire other communities to do the same kinds of things.  If nothing else, they raise awareness of the problem and help create an environment more conducive to healthy eating.

On the national level, Michelle Obama’s Let’s Move campaign also has raised awareness.  Could it be that we are getting to a tipping point?

It’s pretty clear by now what works.  A Cochane meta-analysis of 55 studies finds strong evidence to support beneficial effects of child obesity prevention programs on BMI, particularly for kids age 6 to 12.

The Office of Inspector General (OIG) of the Department of Health and Human Services, FDA’s parent agency, has just issued a report sharply criticizing FDA’s oversight of State food inspections.

This report is one more piece of evidence for how FDA’s lack of resources makes our food supply less safe.

Because it does not have the personnel to do its own inspections, FDA increasingly delegates them to State agencies.  The Salmonella outbreak from peanuts in 2009 is a prime example of why the State system is too diffuse to work.  As the report explains,

The peanut processing plant responsible for a 2009 salmonella outbreak was inspected multiple times by a State agency working on behalf of FDA. This outbreak resulted in one of the largest food recalls in U.S. history and has led to serious questions about the effectiveness of State food facility inspections.

FDA has long been unable to inspect more than a tiny fraction of food processing facilities and the situation is getting worse, not better: the overall number of facilities inspected decreased from just over 17,000 facilities in 2004 to about 15,900 in 2009 (4%-5% of the total number).

FDA increasingly goes to States to fill the gap.  In 2009, it contracted with 41 States to conduct inspections, and these conducted 59% percent of FDA’s food inspections.  In 2004, State inspections comprised just 42% of inspections.

FDA says it has good reasons for relying on States:

According to FDA officials, one reason FDA relies on States is that these inspections are conducted under State regulatory authority, which often exceeds FDA’s own authority. For example, several FDA officials noted that, under certain conditions, State inspectors can immediately shut down a facility or seize unsafe food products, whereas FDA would have to go through a lengthy legal process to achieve similar results.

But this is not enough.  The current report is only the latest of a series of OIG reports detailing problems with FDA’s food inspections.  Previous reports found that more than half of all food facilities have gone 5 or more years without an FDA inspection.

The report concludes:

Taken together, the findings demonstrate that more needs to be done to protect public health and to ensure that contract inspections are effective and prevent outbreaks of foodborne illness.

Yes, of course they do.  But how is FDA supposed to fix the problem?

Bizarrely, and at great risk to the public, FDA gets its funding from congressional agriculture appropriations committees, not health committees.

In this era of cost cutting, FDA was lucky to get a $50 million increase in funding, or so everyone says.

But this is nowhere near enough to hire and train enough inspectors to do the job right.  It’s not that the States can’t do a good job.  It’s that the dispersion of authority leaves much room for flexibility in interpretation and lack of accountability, as the OIG reports consistently show.

For reasons of politics, this may not be the time to demand a stronger food safety system.  But if not now, when?

I subscribe to The Lancet, and always enjoy reading its editor’s weekly Offline column.  In October, editor Richard Horton wrote about how  government obesity policy needs to be based firmly on scientific evidence.

And what is that evidence?

On this question, the evidence is utterly clear.  Thanks to the work of the best scientific minds in obesity research, the most reliable evidence shows that the government’s plan should include taxes on unhealthy foods and beverages, front-of-pack traffic-light nutrition labeling, reductions of junk food and drink advertising to children, and school-based programmes to reduce television viewing and sugar-sweetened beverage consumption (Lancet, 2011;378:1451).

If you care about public health evidence, that’s what it shows.  But doing these things goes against the business interests of food companies and they are doing everything they can to oppose such science-based measures.

In the U.S., the Sunlight Foundation has just released a report detailing the amounts of money food companies have spent on lobbying to block federal attempts to set nutritional standards for marketing foods to children (see previous posts).

Big companies such as Nestle, Kellogg, Viacom, McDonalds, General Mills, and Time Warner have indicated on official reports that they have lobbied on the controversial proposed guidelines; all together such companies have reported spending more than $37 million on lobbying this year.

The Sunlight report lists reported lobbying expenses (for example, Coca-Cola $4.7 million, General Mills $660,000).  It also points out that

…Over all public relations were handled by Anita Dunn, formerly communications director at the Obama White House, at the firm SKDKnickerbocker Consulting.

Anita Dunn is of special interest because of her previous position at the White House.  Now she’s working for the not-so-loyal opposition.  Marian Burros reported on this switch for Politico:

Dunn, who served as White House communications director, is a senior partner at SKDKnickerbocker Consulting, which is handling public relations for the food industry’s campaign. Switching sides isn’t uncommon in the incestuous world of Washington consulting and lobbying, and the food industry coalition seeking to scuttle the voluntary guidelines argues that they are actually enforceable regulations in disguise that could lead to billions in lost sales.

Dr. Horton’s comments in Lancet imply that the British government isn’t doing much better.

As for the European Union (EU),  Food Chemical News reported on December 8 that major food companies— McDonald’s, Burger King, Coca-Cola, Danone, Kellogg, Mars, Nestlé, PepsiCo, Procter & Gamble and Unilever, as well as the European Snacks Associations—have just pledged to promote only healthful products on their websites aimed at children under age 12.

By “healthful,” they mean products that meet “better-for-you” criteria.  Food Chemical News cites a study suggesting that European children now see 79% less advertising of really bad junk foods on kids’ TV than they did in 2005, and 29% less across all TV programs.

The study did not say whether sales of those products were down too. If not, this could explain the willingness of companies to extend the voluntary restriction to websites aimed at very young children.

All of this would be much simpler for parents if governments paid attention to the research.  If they did, they would:

• Tax unhealthy foods and beverages
• Require traffic-light front-of-pack labels
• Stop junk food and drink advertising to children
• Institute programs to reduce television viewing
• Institute programs to reduce sugar-sweetened beverage consumption

Taken together, these might actually make some progress in reducing childhood obesity.

Food Navigator reports that UK experts are demanding public debate and regulation of nanomaterials in foods.  Without that, they warn, nanotechnology risks “facing the same fate as genetically modified (GM) foods in consumer perceptions.”

Nanotechnology is about manipulating materials on the scale of atoms or molecules, measured in nanometers (nm), one billionth, or 10⁻⁹, of a meter.

Many companies are already using nanomaterials in agriculture, food processing, food packaging, and supplements.  This is not something the public has heard much about.  Food companies often don’t know whether or not they are using these materials.

Nanotechnology science is new, and the industry is unregulated.

The FDA’s nanotechnology web page links to a quite thorough 2007 report from a task force,  but the agency’s only guidance to date tells companies how they can find out whether they are using nanomaterials.

Jumping into that gap, As You Sow has issued a Sourcing Framework for Food and Food Packaging Products Containing Nanomaterials.

As You Sow says:

Not only is this technology unregulated and untested for its implications on public health but companies may not even be aware if they are using products made with nanomaterials….In consultation with food companies such as: Kraft, McDonald’s (which has adopted a “no nano” policy), Whole Foods, Yum! Brands, and Pepsi, the nonprofit organization As You Sow developed this practical tool which clearly outlines what companies should ask their suppliers regarding the safety of products containing nanomaterials.

The report fills an important gap.  Companies using this technology should be telling the public more about it.  Nanotechnology is technical, difficult to grasp intuitively, “foreign,” and not under personal control.  This places it high on the scale of “dread-and-outrage.”

Does it belong there?  Who knows?  But the sooner its risks and benefits are assessed, the better.   Otherwise it risks becoming the next GMO in public perception.

Publicly traded companies cannot simply make a profit.  They must grow profits and report growth to Wall Street every 90 days.  This requirement is tough on all corporations, but especially tough on those selling food.  People can only eat so much.

To expand sales, food companies desperately seek new markets.  Last week, The Guardian and the Wall Street Journal described how food corporations are marketing processed foods to the poorest inhabitants of developing countries.

According to The Guardian,

Nestlé is using a floating supermarket to take its products to remote communities in the Amazon. Unilever has a small army of door-to-door vendors selling to low-income villages in India and west and east Africa. The brewer SABMiller has developed cheap beers in some African countries as part of a “price ladder” to its premium lager brands, and, as a leading Coca-Cola bottler and distributor, is aiming to double fizzy drinks sales in South African townships.

Last year 39% of acquisition deals by consumer goods companies were in emerging markets, compared with just 1% in 2008, according to the Grocer’s OC&C Global 50 league table.

The Wall Street Journal follows a salesman in South Africa who is “digging for his gold” in poor neighborhoods:

While Nestlé’s usual sales staff focus on filling shelves of big supermarkets, Mr. Mugwambane and 80 other salespeople like him hunt for tiny shops across South Africa that will buy such Nestlé products as baby food and nondairy creamers, often in single-serving packages that appeal to Africa’s price-sensitive customers.

…Nestlé says it expects 45% of its sales to come from emerging markets by 2020, up from roughly 30% now.

From the standpoint of food companies, says The Guardian, this is about “finding innovative ways to give isolated people the kind of choices the rich have enjoyed for years and are providing valuable jobs and incomes to some of the most marginalised.”

Baby food and nondairy creamers?

Maybe selling items like these brings jobs to some people, but it also brings nutrient-poor diets, obesity, and the resulting chronic diseases to those populations.

The ultimate costs will be high.

Grist and Food and Tech Connect have excellent reports on last week’s Farm Bill Hackathon.  This event brought together farm bill experts and designers to try to produce materials that make farm bill issues accessible.

The terrific winning entry: A Clean Farm Bill of Health slideshow illustrating the contradiction between USDA dietary advice policy and that for farm supports.

I could not participate in the Hackathon but having just taught a class on the farm bill I know what I’d like to have: a complete text of the farm bill annotated to include all of the relevant information.

The 663-page 2008 farm bill is readily accessible online, but it is unreadable (by me at least).   This is because it refers to previous bills and other Acts of Congress, which in turn refer to previous bills and Acts, in some cases going back to 1933.

You don’t believe me?  Try this entirely typical section, chosen at random:

SEC. 12001. DEFINITION OF ORGANIC CROP.
Section 502(b) of the Federal Crop Insurance Act (7 U.S.C.
1502(b)) is amended—
(1) by redesignating paragraphs (7) and (8) as paragraphs
(8) and (9), respectively; and
(2) by inserting after paragraph (6) the following:
‘‘(7) ORGANIC CROP.—The term ‘organic crop’ means an
agricultural commodity that is organically produced consistent
with section 2103 of the Organic Foods Production Act of 1990
(7 U.S.C. 6502).’’.

It would be so nice to have a text that gives the relevant information in one place: what the Federal Crop Insurance Act says, what paragraphs 7 and 8 are all about, and what’s in section 2103 of the 1990 Act.

Hackers: anyone want to take this on?

The Environmental Working Group (EWG) is getting interested in childhood obesity.  It released a report on sugars in kids’ breakfast cereals.

The report shows—no surprise—that kids’ cereals are really cookies in disguise, typically 40% -50% sugars by weight.   Kellogg’s Honey Smacks topped the list at 55%.

Michele Simon’s analysis of the report notes that these levels don’t even meet Kellogg’s commitment to responsible marketing, a pledge to “apply science-based Kellogg Global Nutrient Criteria to all products currently marketed to children.”

I’ve been reading reports like this since the 1970s when Center for Science in the Public Interest published them at regular intervals.  Not much has changed.

Courtesy of Kellogg, I have a collection of copies of Froot Loop boxes dating back to the year in which this cereal was first introduced.  I thought it would be interesting to check the sugar content.

Froot Loops, Sugar content, grams per ounce

In 2005, Kellogg tried a version with 1/3 the sugar—10 grams—but it didn’t sell and quickly disappeared.

Companies are trying to reduce the sugars by a little, but this seems to be the best they can do.  It’s not enough.

As the EWG press release explains, some cereals are better than others.   It notes that I recommend:

• Cereals with a short ingredient list (of additives other than vitamins and minerals).
• Cereals high in fiber.
• Cereals with little or no added sugars (added sugars are ingredients such as honey, molasses, fruit juice concentrate, brown sugar, corn sweetener, sucrose, lactose, glucose, high-fructose corn syrup and malt syrup).
• Even better, try fresh fruit and homemade oatmeal.

I don’t often write about pesticides, plasticizers, heavy metals or other such potentially toxic substances in food because there usually isn’t enough science available to draw firm conclusions about how much of them is OK to consume.

At high concentrations they are demonstrably toxic.  But in food and water, they appear in amounts measured as parts per billion (ppb) or trillion, and it is difficult to know how harmful they may be at such levels.

The big question: is there a threshold for harm or are they unsafe at any level of intake?  The history of regulation of such substances is one of constant reduction in levels considered safe.

They derive in large part from industrial processes, and attempting to regulate them confronts large and powerful industries eager to argue that low levels are safe.

Now Consumer Reports has tested samples of juice and finds levels of arsenic  higher than allowed in drinking water:

• 10% of the samples contained levels of arsenic that exceed EPA drinking-water standards of 10 ppb.
• 25% contained levels of lead greater than the FDA’s 5 ppb standard for bottled water.
• Most arsenic was inorganic, a form linked to cancer, cardiovascular disease, immune disorders, and type 2 diabetes.
• 35% of children age 5 and younger drink juice in amounts higher than recommended by pediatricians.
• No federal standards exist for amounts of lead and arsenic in juice.

This is a food systems issue.  Inorganic arsenic gets into food from soil contaminated with arsenic-containing herbicides and waste from animals and chickens fed arsenic-containing additives.

Consumer Reports says:

• FDA should set a standard for total arsenic in juice at 3 ppb and 5 ppb for lead.
• EPA should lower the 10 ppb drinking-water limit for arsenic.
• Parents should limit juice servings to small children.

What does the FDA have to say?

The Food and Drug Administration has every confidence in the safety of apple juice…small amounts of arsenic can be found in certain food and beverage products—including fruit juices and juice concentrates….there is no evidence of any public health risk from drinking these juices…FDA has been testing them for years [see the FDA’s Q and A].

As if this were not enough to worry about, Food Quality News reports increasing concern about the amount of arsenic in rice, the dangers of such levels for pregnant women, and the need to establish better standards for safe levels of arsenic in foods.

Consumer Reports is especially concerned about a study published in the Proceedings of the National Academy of Sciences linking rice consumption to levels of arsenic in the urine of pregnant women.   It notes that children in the U.S. typically are fed rice cereal as their first solid food, making them especially vulnerable to the effects of arsenic.

Arsenic gets into rice in the same way that it gets into apples and grapes, but rice is especially efficient in taking up arsenic from soil.

I see all this as further evidence that agricultural practices are key determinants of public health and that we badly need:

• More and better research on the effects of small amounts of arsenic, lead, pesticides, and other such toxins in food
• Research on how to remove such toxins from soil
• Federal safety standards for arsenic in foods and beverages; the Consumer Reports recommendations make sense
• Regulations that restrict use of arsenic drugs in animal agriculture and of pesticides containing arsenic
• Restrictions on the amount of juice and rice given to children

It’s great that Consumer Reports is doing this kind of research but federal agencies should be doing a lot more of it too.