by Marion Nestle

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Dec 13 2021

Industry-funded study of the week: whole-fat dairy

I’m kind of a dairy agnostic.  If you like dairy foods, fine; if not, don’t eat them.

But the arguments about them are fierce, and the current Dietary Guidelines for Americans advise choosing low-fat alternatives.

So when I saw the title of this study, I wondered whether it had been funded by the dairy industry.  It was not, although some of the investigators have dairy industry ties.

The study: Whole-fat dairy products do not adversely affect adiposity or cardiometabolic risk factors in children in the Milky Way Study: a double-blind randomized controlled pilot study.  Analise Nicholl, Kane E Deering, Kate Evelegh, Philippa Lyons-Wall, David Lawrence, Trevor A Mori, Mario Kratz, Therese A O’Sullivan.  The American Journal of Clinical Nutrition, Volume 114, Issue 6, December 2021, Pages 2025–2042, https://doi.org/10.1093/ajcn/nqab288

Conclusions: Our results suggest that although changing from whole-fat to reduced-fat dairy products does reduce dairy fat intake, it does not result in changes to markers of adiposity or cardiometabolic disease risk in healthy children.

Acknowledgments: …The Principal Investigator, TAOS, was awarded funding in 2011 for a previous study from the Dairy Health and Nutrition Consortium. MK has received honoraria and reimbursements for travel as well as a research grant from several dairy-related organizations, including National Dairy Council/Dairy Management Inc., Dairy Farmers of Canada, the Dutch Dairy Association (Nederlandse Zuivel Organisatie), Dairy Australia, and the French Interbranch Organization (CNIEL). All other authors report no conflicts of interest.

Notes: …No funding body played any role in the Milky Way Study design, implementation, analysis or interpretation of the data, or publication. The Milky Way Study received no funding from any dairy or food industry organization or affiliation toward study research, dairy product purchase or provision, child assessments, project personnel, or publication.

Comment: No funding body needed to be involved in this study to raise questions of conflicted interests; two of the authors report financial ties to dairy companies.  At the very least, these ties give the appearance of conflict of interest.  Are dairy foods good, bad, or indifferent for health?  My guess is that like pretty much everything else in the diet, it depends on everything else you are eating (unless you are lactose or dairy protein intolerant, in which case you know to avoid dairy foods).  The underlying purpose of this study is to encourage sales of full-fat dairy products to children.   Is that a good idea?  You decide.

Reference: For a summary of research on the “funding effect”—the observation that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests, but that recipients of industry funding typically do not recognize its influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Dec 10 2021

Weekend reading: The Farmer’s Lawyer

Sarah Vogel.  The Farmer’s Lawyer: The North Dakota Nine and the Fight to Save the Family Farm.  Bloomsbury, 2021.

This book comes with an impressive collection of blurbs from the likes of Willie Nelson, Dan Barber, Ricardo Salvador, and Fred Kirschenmann, and, fittingly, with one from John Grisham on the cover because much of the book reads like something out of one of his thrillers.

The book tells two stories, both amazing.

The first is how Vogel, as a young lawyer, filed a class-action suit representing small farmers who had been treated terribly by a USDA agency, the Farmers Home Administration.  This agency started during the Great Depression as a way to help small farmers survive from year to year through loans and other measures.

But early in the Reagan years, the agency switched to treating farmers harshly, quickly foreclosing on unrepaid loans, garnishing bank funds, and forcing the farmers off their land—in violation of the agency’s own rules.  Most of the book is about how Vogel took on these cases, pursued them carefully, and, incredibly, won.

The second story is about the personal cost of this case to Vogel, who worked without pay during the years this litigation was in the works.  Without a salary, she couldn’t keep up her own mortgages, lost two houses, and lived hand to mouth.

It’s hard to believe anyone would take on a case like this at such risk, but the book is also about her dedication to a cause she deemed too important to abandon.

The book is packed with legal details but so well written and is so compelling that I could hardly put it down.

And the good guys won!

For that alone, the book is inspirational.  And I love the way she ends it.

The North Dakota Nine had small to midde-sized farms.  In the 1980s, their lives were very difficult.  In today’s economy, they wouldn’t have a prayer.  But farmers like them are exactly the kind of farmers we need today: farmers who will love their land, grow crops as well as communities, plant trees, care for their animals, and leave the earth better than when they found it.  In the big picture, farmers like them can help solve global warming, revitalize the countryside, and provide abundant, healthy food…We can save farmers, protect the environment, solve the hunge crisis, and rebuild rural and urban economies from the ground up…if we act soon.

Yes!

Jerry Hagstrom did a review of this book a couple of weeks ago on his Hagstrom Report.  Here’s his list of resources:

Dec 9 2021

Some recent articles on food product reformulation

What with all the pressure to make foods healthier, food manufacturers have been tweaking their products to reduce less healthful ingredients, especially salt and sugar.

Reformulated ultra-processed foods are still ultra-processed.

They raise the question: is a slightly healthier ultra-processed food a good choice?

These articles come from FoodNavigator-Asia.com, which tracks the food industry in that part of the world.

Dec 8 2021

The FDA plans to define “healthy”

Healthy food? What’s that?

The FDA is working on a definition of “healthy” on food labels.

Blame KIND bars for all this.

The chronology of this saga.

2015: KIND puts the word “Healthy” on the labels of its whole-food bars.  FDA issues warning letter to KIND because its labels do not meet the requirements to make health claims.

2016: FDA reconsiders, says KIND can use “healthy.”   FDA issues request for information and comments on Guidance for Industry: Use of the Term “Healthy” in the Labeling of Human Food Products.

2017: FDA says it will reevaluate use of the term; holds public meeting on how to redefine the term “healthy” as a nutrient content claim.

2018: FDA’s Nutrition Innovation Strategy includes defining the term.

Healthy” is one claim that the FDA believes is ready for change, and we have already signaled our intention to update the criteria for this claim. The Agency is considering how to depict “healthy” on the package so that consumers can easily find it. Similarly, the FDA has also received requests for clarity on the use of “natural” in labeling. Just like other claims made on products regulated by FDA, we believe the “natural” claim must be true and based in science.

2019: The FDA proposes, and OMB approves, focus group review of a “healthy” icon on food packages.

As one of the methods for achieving this step of the Action Plan, the FDA is exploring the development of a graphic symbol to help consumers identify packaged food products that would meet an FDA definition for “healthy.” The symbol would be voluntary, allowing packaged food companies to place it on their products if the products meet the FDA definition of “healthy.”

2021: FDA again sends proposal to redefine “healthy to OMB, and announces further research on developing a ‘healthy” icon.

Nutrient Content Claims, Definition of Term: Healthy: The proposed rule would update the definition for the implied nutrient content claim “healthy,” and would revise the requirements for when the claim “healthy” can be voluntarily used in the labeling of human food products. In a separate but related action, on 7 May 2021 the FDA issued a notice in the Federal Register announcing that it is conducting preliminary quantitative consumer research on symbols that could be used in the future to convey the “healthy” claim on packaged foods.

The FDA has not said what definition it is considering.  I can think of three possible options:

  • Nutrient-based: Below some level of sugar, salt, calories, or whatever
  • Food-based: Must contain a fruit, vegetable, or whole grain
  • Process-based: Must be unprocessed, processed, or minimally processed; cannot be ultra-processed

Anything other than process-based is too easy for food companies to game.

Center for Science in the Public Interest has plenty of concerns.

Allowing some products to carry a ‘healthy’ claim because they contain a minimal amount of a fruit, vegetable, or other recommended food would just make it easier for veggie chips and ‘fruit’ snacks to compete with fresh fruits and vegetables…No matter how FDA defines the term, consumers should realize that manufacturers will mostly be interested in using ‘healthy’ for marketing purposes—to sell you more processed food that you may not need.

The voluntary nature of the “healthy” symbol also raises questions.  If a food label does not use the symbol, how will anyone know if it’s not there because the product does not meet the definition of “healthy” or if its maker just chose not to use the symbol?

On “healthy,” whether word or symbol: stay tuned.

Dec 7 2021

FDA at work: another try at produce safety

Leafy greens pose a seemingly intractable food safety problem.

  • They are responsible for many harmful and deadly outbreaks of toxic E. coli (lawyer Bill Marler has a handy table listing outbreaks from 1995 to 2019).
  • They are mostly eaten raw.
  • They are often grown on land adjacent to dairy farms or cattle grazing or irrigated with water containing waste from animal agriculture.

The FDA is now taking on this last point.  It is is proposing standards for water use on produce for human consumption:  FDA.  Standards for the Growing, Harvesting, Packing, and Holding of Produce for Human Consumption Relating to Agricultural Water: Notice of proposed rulemaking.  The key provisions:

This proposal would replace the microbial criteria and testing requirements for pre-harvest agricultural water for covered produce (other than sprouts) with provisions for systems-based agricultural water assessments that are designed to be more feasible to implement across the wide variety of agricultural water systems, uses, and practices, while also being adaptable to future advancements in agricultural water quality science and achieving improved public health protections. Additionally, we are proposing to require
expedited mitigation for hazards related to certain activities associated with adjacent and nearby lands, in light of findings from several recent produce outbreak investigations.

Translation: Farms would have to assess where contamination of irrigation water might occur and take steps to prevent it, but will not have to test the water.

In its press release, the FDA says:

Today, the U.S. Food and Drug Administration issued a proposed rule that aims to enhance the safety of produce. It proposes to require farms to conduct comprehensive assessments that would help them identify and mitigate hazards in water used to grow produce. This is the latest step in the agency’s implementation of the FDA Food Safety Modernization Act (FSMA), and it proposes to replace some of the existing requirements for agricultural water in the Produce Safety Rule (PSR).

This updates the FDA’s previous attempts:

Food safety lawyer Bill Marler asks: Is FDA creating a HACCP for Produce? Are assessment and mitigation going to create safer produce?

He notes that the FDA is focusing on “pre-harvest risk assessment of water risk as opposed to water testing for pathogens generally.”  This requires produce growers to evaluate local pathogen risks such as cattle operations and/or wild animal populations and then take measures to prevent them from contaminating water supplies.

But without having to test the water, it’s going to be hard to confirm that the assessment of risk actually reduces it.  Marler says:

So, in my view the jury is still out on 1) will eliminating water testing and increasing assessments make for a safer product? and, 2) should there not be a recognition that produce is essentially a “ready-to-eat” product grown outside with the risks inherent by what is directly around it or what may blow or flow to it, and therefore a broader environmental approach will be required to assure produce safety?

Is the FDA backing off of safety requirements?  The link explains how to file comments.  Now is the time to weigh in.

Dec 6 2021

Industry-funded review of the week: dairy foods and inflammation

My thanks go to New Zealand reader Kirsten for sending this one.

The study: Exploring the Links between Diet and Inflammation: Dairy Foods as Case Studies. Julie M Hess, Charles B Stephensen, Mario Kratz, Bradley W Bolling.  Advances in Nutrition, Volume 12, Issue Supplement_1, October 2021, Pages 1S–13S,

Note: This article was intended as a review article based on presentations made by CBS, MK, and BWB at the American Society for Nutrition 2020 LIVE ONLINE Conference 7–10 June 2020.

Background: Systemic chronic inflammation may be a contributing factor to many noncommunicable diseases, including diabetes, cardiovascular disease, and obesity. An emerging body of evidence indicates that consuming certain foods, including dairy foods like milk, cheese, and yogurt, may be linked to a decreased risk for inflammation.

Method: Review of research on dairy foods and inflammation.

Conclusion: While there is currently insufficient evidence to prove an “anti-inflammatory” effect of dairy foods, the substantial body of clinical research discussed in this review indicates that dairy foods do not increase concentrations of biomarkers of chronic systemic inflammation.

Funding: The ASN Nutrition 2020 session that this article is based on was supported by the National Dairy Council. This support included honoraria for MK and BWB. The authors reported no funding received for this study.

Author disclosures: JMH was an employee of the National Dairy Council at the time this article was written. MK has received honoraria and reimbursements of travel costs as well as research funding from dairy-related organizations, including the National Dairy Council, Dairy Management, Inc., Dairy Farmers of Canada, the Dutch Dairy Organization (Nederlandse Zuivel Organisatie), Dairy Australia, and the French Dairy Interbranch Organization (CNIEL). BWB has received research funding for dairy-related projects from University of Wisconsin Dairy Innovation Hub, the National Dairy Council, and USDA National Institute of Food and Agriculture (NIFA) HATCH WIS02094. The other author reports no conflicts of interest.

Comment: This is a study by dairy-funded authors with an interesting spin.  The research review found no anti-inflammatory effect of dairy foods but concludes that they have a benefit: they don’t make inflammation worse.  I realize that dairy foods have a bad reputation among some eaters, but I wish the dairy industry didn’t sponsor research so blatantly in its self-interest.  I also wish we could get away from one-food research.  One food cannot possibly make a substantial difference in the diets of reasonably healthy people who eat a variety of foods.  I am all for eating dairy foods if you like them, especially from well-treated animals.  They have a place in healthful diets—or not ,if you don’t like or want to eat them.

Reference: For a summary of research on the “funding effect”—the observation that research sponsored by food companies almost invariably produces results favorable to the sponsor’s interests but that recipients of industry funding typically do not recognize its influence—see my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Dec 3 2021

Weekend reading: Caribeños’ Comida

Melissa Fuster.  Caribeños at the Table: How Migration, Health, and Race Intersect in New York City.  University of North Carolina Press, 2021.

My former NYU colleague, Melissa Fuster, now at Tulane, has written a book length report on her research investigating the eating preferences of immigrants to New York from Puerto Rico, the Domincan Republic, and Cuba.

She used qualitative methods—interviews—to come to some reality-based conclusions about immigrant foodways.  She did not find deep longings for traditional Caribbean diets.  Instead, she also identified class, race, and gender as major influences on dietary preferences.

 Hence, with this work I aim to change ongoing scholarly conversations on the immigrant food experience and health outcomes in the United States, which tend to overemphasize the importance of culture when addressing immigrant communities.  This overemphasis on culture dimishes the role of the structural factors (class, race, gender) that intersect to shape the experiences of these communities, overstates the uniqueness of specific cultural groups, and risks blaming culture for the health inequities observed in these communities. (p. 5)

She has interesting things to say about how dietitians view the traditional diets of the Caribbean—as unhealthy and unsophisticated.

These racialized descriptions of comidas, including those made in nutri-speak [talking about foods strictly in terms of nutrient content]…are laden with meanings that reflect the cuisines roots in slavery and colonization—institutions that are built on oppression through racialization.  Despite the stigma attached to foods that emerged out of slave and colonial foodways, these foods traveled with their communities from the Caribbean to the United States.  (p. 96)

And she urges us to think about migrant eating patterns in the broader context of everyone’s eating patterns:

The prevalent focus on culture in the food and migration scholarship minimizes the struggles immigrants face in the home-making process and the political forces surrounding such processes…Moreover, this emphasis often carries an implicit assumption that traditional foods are  important for immigrant or ethnic communities, and that these foods are always healthier than the “new’ American foods.  We must also rethink this dichotomy.  All diets have a range of healthfulness, and in migration contexts, this depends on the interpretation of what traditional comidas are, and how frequently they are consumed.  As found in other studies, migrant communities engage in both healthful and unhealthful dietary practices upon moving.  (p. 128)

Dec 2 2021

Keeping up with the plant-based food product industry

New items come out every day about the plant-based market for alternatives to meat and dairy foods.  Think of this as big business and hyper-marketing.