by Marion Nestle

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Sep 13 2021

Industry-sponsored study of the week: Tea!

I learned about this one from a tweet:

This seemed worth a follow up.

Here’s the article from The Standard:

Drinking tea from the age of four helps children to combat obesitystress and heart disease, according to a new study.

I checked the study: Tea and Wellness throughout Life

Overall, this review concludes that tea consumption contributes to health and wellness throughout life and that everyone should be encouraged to enjoy three cups daily as part of a healthy lifestyle pattern.

Who paid for this?

Conflicts of interest: The authors received funding provided by the Tea Advisory Panel (www.teaadvisorypanel.com), which is supported by an unrestricted educational grant from the UK TEA & INFUSIONS ASSOCIATION (UKTIA), the trade association for the UK tea industry. UKTIA plays no role in producing the outputs of the panel. Independent panel members include nutritionists, biochemists, dietitians, dentist and doctors.

I don’t really care who was on the panel.  This was an industry-paid project with a predictable—if eyebrow-raising—result.  Tea is lovely and there is no reason to think it unhealthy, but surely some skepticism is called for here?

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

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Sep 10 2021

Weekend reading: Break up Big Ag

Two articles on similar themes have come out recently.

Is It Time to Break Up Big Ag? — The New Yorker

Nationally, the four largest dairy co-ops now control more than fifty per cent of the market. They’ve been able to grow so big, in part, because of a 1922 law called the Capper-Volstead Act, which provides significant exemptions from antitrust laws for farmer-owned agricultural coöperatives. “The agricultural industry is different than other industries because Capper-Volstead allows them to combine in ways that other individuals would go to jail for,” Allee A. Ramadhan, a former Justice Department antitrust attorney who led an investigation into the dairy industry, told me.

The law’s protections were intended to give small, independent farmers the right to collectively bargain prices for processing and selling their goods, but many large co-ops, such as D.F.A., have increasingly come to resemble corporations.

Break Up Big Chicken — The New York Times

Most chicken that Americans eat is processed by a handful of big companies because, in recent decades, the government gave its blessing to the consolidation of poultry processing, along with a wide range of other industries. The unsurprising result: In recent years, the surviving companies took advantage of their market power to prop up the price of chicken, overcharging Americans by as much as 30 percent.

Evidence of the industry’s misconduct became so blatant — thanks in part to lawsuits filed by wholesale poultry buyers — that regulators were roused from complacency. Beginning in 2019, the government has filed a series of charges against the companies and their executives.

And while we are at it, let’s not forget Philip Howard’s work, which I’ve written about previously.

Sep 9 2021

Thanks Leah Douglas for your work at FERN

The Food and Environment Reporting Network (FERN) announces that its long-time reporter, Leah Douglas, is leaving to take a job with Reuters.

FERN is also giving up its counts of Covid cases and deaths among farm workers and meat-packing workers.

This week we wrapped up the mapping project of Covid-19 outbreaks at food-production facilities and farms around the nation. This nearly 18-month-long project, spearheaded and updated almost daily by staff writer and associate editor Leah Douglas, came to an end largely because of a lack of reliable data.

As Leah explains, companies and states have decided to keep much of their data secret, even with the rise of the Delta variant. But to date she has counted nearly 100,000 cases and 466 deaths among food system workers.

Here is an example of the data she produced.  In the absence of any industry or government tracking, her project was all we had.

And here’s another one.

You can see why these companies don’t want anyone to have these data.  Leah did a great job of working with what she could find.

I will miss her work on this project but look forward to seeing what she does for Reuters.

Congratulations Leah!

Sep 8 2021

Marketing strategy of the week: impulse buys

As I discussed in my book, What to Eat, the entire purpose of a grocery store or supermarket is to encourage sales, particularly impulse buys of profitable items.  Food and beverage companies pay stores to place their most profitable products where customers can most easily see them.

This makes checkout counters prime grocery real estate.

Mars Wrigley tells you how this works.

Mars Wrigley showcases new impulse shopping solutions and products

Mars Wrigley said its multifaceted merchandising solutions will shape impulse throughout the shopper journey and provide an effective retail experience, be it at curbside pick-up, online or in-store.

The company is set to work alongside retail partners to implement solutions that reimagine impulse at checkout and identify new spaces in aisle and digitally to optimise category presence and drive conversion [i.e., sales].

Spearheading this growth is its new Accelerating Impulse Moments (AIM) insights platform. This four-pillar platform consists of conversion strategies for retailers across all channels in stores and online, with Snacks Aisle Optimization, Secondary Display Growth, Transaction Zone Reinvention and Digital Solutions Execution.

These strategies will help retailers shape impulse throughout the shopper journey to create an effective and engaging omni-channel experience.

Comment: You are the subject of this “effective and engaging omni-channel experience.”  This may look as if it is about helping grocers market products, but it is really about getting you to buy candy and chewing gum.

Sep 7 2021

Nutrition research basics: Association does not equal causation

I subscribe to a newsletter, Obesity and Energetics Offerings, that often includes a section on “Headline versus Study.”  This demonstrates how  headline writers jump actual findings and draw attention-getting conclusions that the studies don’t always support.

Here are four examples, all from the UK Biobank study, an enormous epidemiologic investigation of half a million participants who filled out a dietary questionnaire, and then were followed and tested to see what diseases they developed.  These data enable investigators to link specific dietary factors to disease risk.

Such links are associations. 

This kind of study is not designed to determine whether a dietary factor causes (or prevents) a disease.  For that, other kinds of research are required.

These four examples examine associations of coffee intake with disease risk.  That’s all they do.

The headlines, however, assume causation—an epidemiologic fallacy.

I.  Headline: A Daily Dose of Coffee May Protect You from COVID-19.

Study: Self-Reported Dietary Behaviors and Incident COVID-19 in the UK Biobank.

Results: After multivariable adjustment, the odds (95% CI) of COVID-19 positivity was 0.90 (0.83, 0.96) when consuming 2–3 cups of coffee/day (vs. <1 cup/day), 0.88 (0.80, 0.98) when consuming vegetables in the third quartile of servings/day (vs. lowest quartile), 1.14 (1.01, 1.29) when consuming fourth quartile servings of processed meats (vs. lowest quartile), and 0.91 (0.85, 0.98) when having been breastfed (vs. not breastfed). Associations were attenuated when further adjusted for COVID-19 exposure, but patterns of associations remained.

Conclusions: In the UK Biobank, consumption of coffee, vegetables, and being breastfed as a baby were favorably associated with incident COVID-19; intake of processed meat was adversely associated.

Caveats:  This study looked at associations of several dietary factors to Covid risk: breastfed as baby, and consumption of coffee, tea, oily fish, processed meat, red meat, fruit, and vegetables.  Based on the results, the fallacious headlines could just as easily have read:

  • Vegetables may protect you from COVID-19
  • Being breastfed may protect you from COVID-19
  • Processed meats may increase your risk of COVID-19

The operative word is “may.”  This means that “may not” might also be appropriate.

2.  Headline: Too Much Coffee Can Cause Your Brain to Shrink, Raise Risk of Dementia by 53 Percent, Study Finds.

Study: Associations Among High Coffee Consumption, Brain Volume and Risk of Dementia and Stroke in UK Biobank.

Results: There were inverse linear associations between habitual coffee consumption and total brain (fully adjusted β per cup −1.42, 95% CI −1.89, −0.94), grey matter (β −0.91, 95% CI −1.20, −0.62), white matter (β −0.51, 95% CI −0.83, −0.19) and hippocampal volumes (β −0.01, 95% CI −0.02, −0.003), but no evidence to support an association with white matter hyperintensity (WMH) volume (β −0.01, 95% CI −0.07, 0.05). The association between coffee consumption and dementia was non-linear (Pnon-linearity= 0.0001), with evidence for higher odds for non-coffee and decaffeinated coffee drinkers and those drinking >6 cups/day, compared to light coffee drinkers. After full covariate adjustment, consumption of >6 cups/day was associated with 53% higher odds of dementia compared to consumption of 1–2 cups/day (fully adjusted OR 1.53, 95% CI 1.28, 1.83), with less evidence for an association with stroke (OR 1.17, 95% CI 1.00, 1.37, p = 0.055).

Conclusion: High coffee consumption was associated with smaller total brain volumes and increased odds of dementia.

Caveat: But why non-linear?  If coffee had these effects, shouldn’t more of it should have more of an effect?  Association, alas, does not equal causation.

3.  Headline: Your Morning Cup of Coffee May Lower Your Risk of Liver Disease.

Study: All Coffee Types are Associated with Lower Risk of Adverse Clinical Outcomes in Chronic Liver Disease: A UK Biobank Study.

Results: Compared to non-coffee drinkers, coffee drinkers had lower adjusted HRs of CLD (HR 0.79, 95% CI 0.72–0.86), CLD or steatosis (HR 0.80, 95% CI 0.75–0.86), death from CLD (HR 0.51, 95% CI 0.39–0.67) and HCC (HR 0.80, 95% CI 0.54–1.19). The associations for decaffeinated, instant and ground coffee individually were similar to all types combined.

Conclusion: The finding that all types of coffee are protective against CLD is significant given the increasing incidence of CLD worldwide and the potential of coffee as an intervention to prevent CLD onset or progression.

4.  Headline: Coffee Drinking Won’t Harm Your Health, New Study Reveals Caffeine Lowers Arrhythmia Risk.

Study: Coffee Consumption and Incident Tachyarrhythmias with Mendelian Randomization for Caffeine Metabolism in the UK Biobank.

Findings  In this large, prospective, population-based community cohort study of more than 300 000 participants, each additional daily cup of coffee was associated with a 3% reduced risk of developing an arrhythmia; these associations were not significantly modified by genetic variants that affect caffeine metabolism.

Meaning  Neither habitual coffee consumption nor genetically mediated differences in caffeine metabolism was associated with a heightened risk of cardiac arrhythmias.

Comment: Whether coffee drinking is good, bad, or indifferent to health has long been hotly debated.  For a long time, studies seemed aimed at proving coffee bad for health.  Now, studies seem aimed at showing the opposite.  The UK Biobank is expensive; its funders are largely private foundations and government agencies.  As far as I can tell, the coffee industry is not involved.  My take on all of this?  Take these epidemiological associations with a pinch of caffeine, and enjoy coffee if you like it.

Sep 6 2021

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

The study: Impact of low-fat and full-fat dairy foods on fasting lipid profile and blood pressure: exploratory endpoints of a randomized controlled trial.  Kelsey A Schmidt, et al. The American Journal of Clinical Nutrition, nqab131, https://doi.org/10.1093/ajcn/nqab131.  Published: 13 July 2021

Background: “Dietary guidelines traditionally recommend low-fat dairy because dairy’s high saturated fat content is thought to promote cardiovascular disease (CVD). However, emerging evidence indicates that dairy fat may not negatively impact CVD risk factors when consumed in foods with a complex matrix.”

Method: “Participants were then randomly assigned to 1 of 3 diets, either continuing the limited-dairy diet or switching to a diet containing 3.3 servings/d of either low-fat or full-fat milk, yogurt, and cheese for 12 wk.”

Conclusions: “In men and women with metabolic syndrome, a diet rich in full-fat dairy had no effects on fasting lipid profile or blood pressure compared with diets limited in dairy or rich in low-fat dairy. Therefore, dairy fat, when consumed as part of complex whole foods, does not adversely impact these classic CVD risk factors.”

Funding: “National Dairy Council, Dairy Farmers of Canada, Dutch Dairy Association (Nederlandse Zuivel Organisatie), Dairy Australia, and the French Dairy Interbranch Organization (CNIEL),” and NIH and others.

Conflict of interest: “This study was initiated by the principal investigator (MK). The dairy-related funding organizations suggested changes to details of the study design prior to the conduct of the study, some of which were implemented. Otherwise, the funding organizations had no impact on the design or conduct of the trial or the analysis and interpretation of study data.”

Comment: Let’s give these investigators high marks for disclosing that the dairy funders influenced the design of the study, which, as we know from the data of Lisa Bero and her colleagues, is the place where biases caused by industry funding most typically show up.  Food companies that fund research are looking for benefits; they won’t risk study designs that might yield inconvenient results.

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

Sep 3 2021

Weekend reading: food and climate change

I recently ran across this useful website: Climate Change Resources, with live links to each of these sections.

But it also has a general section on the impact of food production and consumption, with ideas about what to think about:

It also links to the World Resources Institute’s How to sustainably feed 10 billion people by 2050, in 21 charts.

This, in turn comes from a WRI report, Creating a Sustainable Food Future: A Menu of Solutions to Feed Nearly 10 Billion People by 2050.

We have plenty of work to do.  And here are plenty of ideas about where to start.

Sep 2 2021

Will almonds prevent skin wrinkles? The Almond Board wants you to think so.

I know I’ve already posted one of these this week, but this one is too good not to share.

Let’s start with the press coverage: Snack yourself young: Study investigates the effects of daily almond consumption on wrinkles

A study by American research found that eating almonds daily reduces wrinkle severity – along with improving skin pigmentation – in postmenopausal women.

The 2021 study – published in Nutrients and funded by the Almond Board of California – expands upon findings of a 2019 study​ that found there may be more than one reason to add almonds to a daily skin care routine.

And here’s the study in question: Prospective Randomized Controlled Trial on the Effects of Almonds on Facial Wrinkles and PigmentationAuthors: Sivamani RK, Rybak I, Carrington AE, Dhaliwal S, et al.  Nutrients. 2021; 13(3):785

This is not their first on this topic.  See: Prospective randomized controlled pilot study on the effects of almond consumption on skin lipids and wrinklesAuthor: Sivamani RK, Foolad N, Vaughn AR, Rybak I, et al   Phytother Res. 2019 Dec;33(12):3212-3217

Nor are these the first studies to link specific foods to wrinkle prevention.  I’ve written previously about a study on mangos and wrinkle prevention, sponsored—of course—by a mango trade association.

I wish companies and trade associations would stop doing studies of one food and some health outcome. Diets that contain reasonable proportions of fruits, vegetables, and whole grains are demonstrably healthy.  Can any one food really make all that much difference?

The sellers of these foods would like you to think they are “superfoods.”  Alas, no such thing exists.  But it’s a great marketing strategy.

As for sponsored research in general?

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.