Food Politics

by Marion Nestle
Aug 23 2021

Industry-funded studies of the week: One Potato, Two Potato

One Potato

Thanks to David Ludwig for alerting me to an e-mail from the Alliance for Potato Research & Education (APRE), a trade association “dedicated to advancing the scientific understanding of the role potatoes play in promoting the health of all people.”

A new APRE-funded study published in Nutrients investigated the effect of increased dietary potassium from a whole food source – baked/boiled potatoes and baked French fries – or a potassium supplement on blood pressure and other cardiovascular disease risk factors compared to a ‘typical American’ control diet (lower potassium intake) among 30 pre-hypertensive-to-hypertensive men and women.

Results showed that baked/boiled potato consumption had the greatest benefit on reducing sodium retention, even more than the supplement, and resulted in a greater reduction in systolic blood pressure (SBP) compared to the control diet.

Further, despite commonly held misbeliefs about French fries and their role in heart-healthy lifestyles, the authors observed that a 330-calorie serving of baked French fries, when eaten as part of a ‘typical American’ diet, had no adverse effect on blood pressure or blood vessel function.

The study concludes:

This was the first controlled feeding study of potassium from food and supplements on BP and CVD outcomes in an unhealthy population…Of public health relevance is our observation that French fries in amounts typical of a large serving in a fast food restaurant has no adverse effect on blood pressure or endothelial function.

It discloses the funding source: “This research was funded by Alliance for Potato Research and Education.”

Comment: Because some (but not all) observational studies have linked potatoes, and especially French fries, to poor health outcomes, the potato industry wants research to give these foods a healthier image.  This study says that potatoes are high in potassium and a high potassium-to-sodium ratio is good for blood pressure and heart disease.  I could have told them that on the basis of food composition data alone: 100 grams of French fries contains 435 mg potassium versus 295 of sodium.  Does that make French fries a health food?  No, alas, it does not.

Once more for the record: industry-funded research is about marketing, not public health.

Two Potato

Last week, I received an emailed notification from APRE, the Alliance for Potato Research & Education announcing a new study.

For decades, people have often associated higher intakes of carbohydrate-containing foods with less healthy lifestyles. Yet, evidence suggests this view is overly simplistic, and it is instead the type and quality of carbohydrate foods that matter most for supporting health…In a newly published perspective in Nutrients, a group of nutrition researchers, who collectively make up the Quality Carbohydrate Coalition-Scientific Advisory Council (QCC-SAC), outline the opportunity for a stronger, more evidence-based approach to defining quality carbohydrate foods to support overall health and provide clearer dietary guidance.

The study: Toward an Evidence-Based Definition and Classification of Carbohydrate Food Quality: An Expert Panel Report.  Kevin B. Comerford, Yanni Papanikolaou,  Julie Miller Jones, Judith Rodriguez. Joanne Slavin,  Siddhartha Angadi.  and Adam Drewnowski.  Nutrients2021, 13(8), 2667.

Conclusion: The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming—such as the 2025–2030 Dietary Guidelines for Americans. 

Funding:  This work was supported by the Quality Carbohydrate Coalition (QCC), which is funded by Potatoes USA. The QCC was not involved in the expert panel discussions, manuscript preparation, or the decision to submit the manuscript for publication.Conflicts of Interest: All authors are invited members of the Quality Carbohydrate Coalition’s Scientific Advisory Council (QCC-SAC). A.D. is the developer of the Nutrient Rich Food (NRF) index, a nutrient profiling model, and has received grants, contracts, and honoraria from entities, both public and private, with an interest in nutrient density of foods, complex meals, and the total diet. Y.P. is the president of Nutritional Strategies, collaborates on NHANES analyses and provides food, nutrition, and regulatory affairs consulting services for food/beverage companies and food-related associations. S.A. and J.M.J. advise the Grain Foods Foundation. J.S. has current grants from Taiyo and Barilla in the area of dietary fiber, and also serves on the Scientific Advisory Boards for Tate and Lyle and Atkins Nutritionals. J.R. has no conflicts of interest. K.B.C. is employed by FoodMinds, which provides science communications consulting services to various food and nutrition entities, including Potatoes USA and the Alliance for Potato Research and Education (APRE).
Comment: This is a successful effort by the potato industry to engage academics in support of the value of potatoes in healthful diets.  The role of potatoes in health is a contentious issue in the nutrition research community (see, for example, this FrontLine interview with Walter Willett).  The potato industry is fighting back by funding research (see above and also a previous post) and now engaging sympathetic academics.  I think potatoes are fine, in moderation.  But I wish academics would stay out of conflicted situations like this one.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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Aug 20 2021

Weekend reading: the food politics of Afghanistan, 2001 version

Reading about Afghanistan sent me back to what I wrote about food aid to that country in my book, Safe Food: The Politics of Food Safety (University of California Press, 2003, revised edition 2010: pages 260-265).  The World Food Programme has declared a hunger emergency  in Afghanistan that affects a third of the population, 14 million people.  This excerpt from my book illustrates a small part of the history of the current Afghanistan tragedies.

A New Emphasis for Food Security: Safety from Bioterrorism 

On October 13, 2001, New York Times photographer James Hill took this photograph of U.S. “Humanitarian Daily Rations” dropped over Afghanistan.  The photograph appeared in the Week in Review section on October 21.  Mr. Hill said the food packets were available in local markets for the equivalent of 60 cents each (Photographer’s Journal: War is a Way of Life, November 19, 2001)…©2001 New York Times Photo Archive.  Used with permission.)

 

Prior to the terrorist attacks [of September 2001], food security in the United States had a relatively narrow meaning that derived from the need to establish criteria for welfare and food assistance.  In the 1980s, the U.S. government expanded its definition of “hunger” (as a problem requiring food subsidies or donations) to include involuntary lack of access to food—the risk of hunger as well as the physical experience.   By this definition, food security came to mean reliable access to adequate food.[1]

The international definition is broader, however.  In 1948, the United Nations adopted the Universal Declaration on Human Rights, which said, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and the necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”[2]  Many interpret this provision to mean that people have a right to food security, in this case encompassing five elements: (1) reliable access to food that is not only (2) adequate in quantity and quality but also (3) readily available, (4) culturally acceptable, and (5) safe.  With respect to safety, the Geneva Convention of August 1949, an international agreement on the protection of civilians during armed conflict, expressly prohibited deliberate destruction or pollution of agriculture or of supplies of food and water.  These broader meanings derived from work in international development, where it was necessary to distinguish the physical sensation of hunger (which can be temporary or voluntary), from the chronic, involuntary lack of food that results from economic inequities, resource constraints, or political disruption.[3]

The significance of the lack-of-access meaning of food security is evident from a health survey conducted in a remote region of Afghanistan just a few months prior to the September 2001 attacks.  Not least because of decades of civil strife, Afghanistan is one of the poorest countries in the world, and its health indices are dismal: a life expectancy of 46 years (as compared to 77 years in the United States) and an infant mortality rate of 165 per 1,000 live births (as compared to 7).[4]   At the time of the survey, the United Nations World Food Programme estimated that 3.8 million people in Afghanistan lacked food security and therefore required food aid.   Investigators examined the health consequences of this lack and found poor nutritional status to be rampant in the population and a contributing factor in nearly all of the deaths that occurred during the survey period.  Half of the children showed signs of stunted growth as a result of chronic malnutrition.  Scurvy (the disease resulting from severe vitamin C deficiency) alone accounted for 7% of deaths among children and adults.  Because visible nutrient deficiency diseases like scurvy are late indicators of malnutrition, the investigators viewed the level of food insecurity as a humanitarian crisis—less serious than in parts of Africa, but worse than in Kosovo during its 1999 upheavals.[5]  After October 2001, when bombing raids led to further displacement of the population, the United Nations increased its estimate of the size of the food insecure population to 6 million and predicted that the number would grow even larger as humanitarian aid became more difficult to deliver.

In part to alleviate shortages caused by the bombings, resulting dislocations, and the collapse of civic order, the United States began a program of food relief through airdrops.  The packages, labeled “Food gifts from the people of the United States of America,” contained freeze-dried lentil soup, beef stew, peanut butter, jelly, crackers, some spices, and a set of plastic utensils, and provided one day’s food ration for an adult–about 2,200 calories.  Beginning in October 2001, airplanes dropped about 35,000 food packages a day.  The quantities alone suggested that their purpose had more to do with politics than food security.[6]  A British commentator did the calorie counts:

If you believe, as some commentators do, that this is an impressive or even meaningful operation, I urge you to conduct a simple calculation.  The United Nations estimates that there are 7.5 [million] hungry people in Afghanistan.  If every ration pack reached a starving person, then one two hundredth of the vulnerable were fed by the humanitarian effort on Sunday.…But the purpose of the food drops is not to feed the starving but to tell them they are being fed.  President Bush explained on Sunday that by means of these packages, “the oppressed people of Afghanistan will know the generosity of America and our allies.”[7]

Even with a possible exaggeration of the extent of food insecurity, this comment suggests that food aid is a complicated business, and at best a temporary expedient.   One problem is getting dropped food to the people who need it most. The Figure illustrates the fate of some of the food aid packages.  As often happens, enterprising people collect the packages and sell them on the open market; this gets the food into public circulation, but at a price.   In this instance, the packages also encountered unexpected safety hazards.  The Pentagon warned that the Taliban might try to poison the packages or spread rumors of poisoning as a means of propaganda against the United States, but Taliban leaders denied this accusation: “No one can be that brutal and ignorant as to poison his own people.”[8]  The packages themselves presented hazards.  They were packed in specially designed plywood containers that could be dropped from 30,000 feet without breaking, but several landed in the wrong place and destroyed people’s homes.  Children sent to collect the food packages died or lost limbs when they ran across fields planted with land mines.  While the food drop was in progress, the political situation made it impossible for food aid to get into the country through conventional routes.  Later, warlords stole shipments, and riots broke out when supplies ran out.[9]  Political stability depends on food security, and food security is inextricably linked to political stability.  Without such stability, food aid alleviates a small part of the humanitarian crisis—better than nothing, but never a long-term solution.[10]

Would increasing the amount of food aid alleviate the crisis?   Former Senator George McGovern, U.S. ambassador to the World Food Programme said, “If these people have nourishment for healthy lives, this is less fertile territory for cultivation by terrorist leaders.”  Bringing in another issue germane to this book, he said that the war on hunger in Afghanistan and elsewhere cannot be waged without biotechnology: “It is probably true that affluent countries can afford to reject scientific agriculture and pay more for food produced by so-called natural methods.  But the 800 million poor, chronically hungry people of Asia, Africa and Latin America cannot afford such foods.”[11]  As we have seen, biotechnology is still a remote solution to food security problems, and it is difficult to imagine how it might alleviate immediate food shortages in Afghanistan.

References

[1]   Andrews MS, Prell MA, eds.  Second Food Security Measurement and Research Conference, Volume II: Papers.  USDA/ERS, July 2001.

[2]   United Nations.  Universal Declaration of Human Rights (Adopted by the U.N. General Assembly, December 10, 1948).  Reprinted in JAMA 1998;280:469–470.

[3]   Oshaug A, Eide WB, Eide A.  Human rights: a normative basis for food and nutrition-relevant policies.  Food Policy 1994;19:491–516.  Drèze J, Sen A.  Hunger and Public Action.  Oxford: Clarendon Press, 1989.

[4]   The World Factbook–United States, 2001. Central Intelligence Agency. Online: www.cia.gov/cia/publications/factbook/index.html.

[5]   Assefa F, Jabarkhil MZ, Salama P, et al.  Malnutrition and mortality in Kohistan district, Afghanistan, April 2001.  JAMA 2001;286:2723–2728.  Ahmad K.  Scurvy outbreak in Afghanistan prompts food aid concerns.  Lancet 2002;359:1044.

[6]   Perlez J.  Individual meals from the sky.  NYT, October 8, 2001:B3.

[7]   Monbiot G.  Folly of aid and bombs. Guardian (London), October 9, 2001.  Online: www.guardian.co.uk.

[8]   Hungry for peace: with winter near, starving Afghans need more than air-dropped relief.  San Francisco Chronicle, October 26, 2001:A1,A18.  Shanker T, Schmitt E.  U.S. warns Afghans that Taliban may poison relief food.  NYT, October 25, 2001:B2

[9]  Dao J.  Sergeant designs a better box for dropping food to Afghans.  NYT, October 10, 2001:B3.  Waldman A.  Food drops go awry, damaging several homes.  NYT, November 21, 2001:B2.  Becker E.  Even with roads still open, security fears are choking the flow of food aid.  NYT, November 30, 2001:B4.  Chivers CJ, Becker E.  Aid groups say warlords steal as needy wait.  NYT, January 4, 2002:A1,A15.

[10]  Nestle M, Dalton S.  Food aid and international hunger crises: the United States in Somalia.  Agriculture and Human Values 1994;11(4):19–27.  Lewis P.  Downside of doing good: disaster relief can harm.  NYT, February 27, 1999:B9.  McKinlay D.  Refugees left in the cold at “slaughterhouse” camp. Guardian (London), January 3, 2002.  Gall C.  Pleas for food, help and a way out.  NYT, January 20, 2002:A15.

[11]   Truelsen S.  Food aid and the war on terrorism.  The Voice of Agriculture.  American Farm Bureau Federation, November 5, 2001. Online: Online:  www.fb.com. 

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Aug 19 2021

Lab-based meat: the latest

Eating less meat is good advice for the health of people and the planet.  How to do that?  The makers of cell-based meat substitutes say they are the solution to this problem.  But are they?  They aren’t on the market yet, except in Singapore, so the jury is still out.

Public interest

  • A taste for lab-grown meat: In an online poll, 19 percent of American adults responded “Yes, I am eager to try” cell-cultured meat when it becomes available, while 78 percent of meat eaters said they would prefer “real meat” in the long run. (Piplsay)

The rationale

  • The film: Meat Me Halfway is a just-released documentary from the Reducitarian perspective, which argues that any reduction in meat intake is a help, any way it happens.  One way is to substitute cell-based meat.  Take a look.  I found the film interesting and compelling, and not just because I’m one of the talking heads in it.

The forthcoming products

  • Bacon:  Sales of Vegan Bacon Are On the Rise as More Brands Hit the Market.  Plant-based producers are attracting notable funding for a market not yet taken over by Impossible Foods and Beyond Meat.
  • Milk: Tech fantasy or a liquid goldmine? BioMilk goes public:  Visitors to BioMilk’s website are asked a simple question: ‘What is milk?’ a question that – until relatively recently – had a pretty obvious answer: the white stuff lactating mammals produce. Today, however, there’s plant-based milk; there are products containing selected components of mammalian milk produced via microbes in fermentation tanks; and now the final frontier: cell-cultured milk…. Read more
  • Chicken: Memphis Meats Re-Brands as UPSIDE Foods, Announces Cultured Chicken as its First Product.  Press release.
  • Caviar: the mass-market health food star of the future? A British company is developing the world’s first lab-grown ‘compassionate’ caviar to allow more people to experience the delicacy’s unique taste and nutritional benefits…. Read more
  • Foie Gras: Gourmey, a start-up based in Paris, received an additional $10 million in seed funding this week. The company hopes to find a market in the United States amid growing concerns about animal cruelty.

The business (follow the money)

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Aug 18 2021

Who is responsible for public distrust of GMOs? Monsanto, anyone?

In my view, one of the strongest reasons for public distrust of GMOs is the behavior of the GMO industry, with the secretive, aggressive, corporate behavior of Monsanto as the most glaring example.

I saw this myself.

In the late 1990s, I was at a meeting of food industry executives, among them the CEOs or high ranking officials of several agricultural biotechnology companies, including Monsanto.

The others were openly furious with Monsanto’s CEO for ruining public trust in their products: “You have ruined this for us.”

But Monsanto’s reputation did not stop Bayer from buying the company in 2018 (for $63 billion, no less), something it—and its stockholders—must surely regret (some are suing the company).

As Carey Gillam of US Right to Know has just reported, “Appeals court rejects Bayer’s bid to overturn Roundup trial loss and slams company for “reckless disregard” for consumer safety.”

In a decision handed down on Monday, the 1st Appellate District in the Court of Appeal for California rejected Monsanto’s bid to overturn the trial loss in a case brought by husband-and-wife plaintiffs, Alva and Alberta Pilliod.

This is the third trial in which juries awarded millions of dollars to plaintiffs who claimed that they developed non-Hodgkin lymphoma as a result of exposure to Monsanto’s Roundup herbicide.

To head off subsequent trials, Bayer said it would pay about $11 billion (yes, billion) to settle about 100,000 pending cases, and would pay $4.5 billion more to offset further liability for Roundup claims.  Bayer also announced it would stop selling Roundup and other glyphosate herbicides for home use in the US by 2023 (but it will still sell Roundup to farmers.  And it is taking its case to the Supreme Court to get a reversal of a cancer-claim case.

What I find remarkable about the Pilliod decision is the judge’s scathing comments on Monsanto’s corporate behavior.  As quoted by Gillam:

  • “Monsanto’s conduct evidenced reckless disregard of the health and safety of the multitude of unsuspecting consumers it kept in the dark. This was not an isolated incident; Monsanto’s conduct involved repeated actions over a period of many years motivated by the desire for sales and profit.”
  • Monsanto acted with a “willful and conscious disregard for the safety of others.” Monsanto “failed to conduct adequate studies on glyphosate and Roundup, thus impeding discouraging, or distorting scientific inquiry concerning glyphosate and Roundup.”
  • “But rather than fairly stating all the relevant evidence, Monsanto has made a lopsided presentation that relies primarily on the evidence in its favor. This type of presentation may work for a jury, but it will not work for the Court of Appeal.”
  •  “Summed up, the evidence shows Monsanto’s intransigent unwillingness to inform the public about the carcinogenic dangers of a product it made abundantly available at hardware stores and garden shops across the country.”

Or try this footnote:

The effects of all this on Bayer’s stock prices?

Other People vs. Monsanto/Bayer cases are in the works.  Stay tuned.

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Aug 17 2021

Splendid news! USDA updates Thrifty Food Plan and SNAP benefits

Yesterday, the USDA issued a press release: USDA Modernizes the Thrifty Food Plan, Updates SNAP Benefits

WASHINGTON, August 16, 2021 – The U.S. Department of Agriculture (USDA) today released a re-evaluation of the Thrifty Food Plan, used to calculate Supplemental Nutrition Assistance Program (SNAP) benefits.

This is a miracle, an event long sought by anti-hunger advocates.

The Thrifty Food Plan is supposed to be “the cost of groceries needed to provide a healthy, budget-conscious diet for a family of four.”

  • It is the basis for establishing SNAP benefits.
  • It was created in 1962.
  • All subsequent updates (until now) only adjusted for inflation but were otherwise required to be cost-neutral.

No wonder SNAP benefits were so inadequate.

Hope for change came with the 2018 Farm Bill.

In January, President Biden issued an Executive Order to review the Thrifty Food Plan.  USDA moved quickly on this in order to increase pandemic benefits permanently.

In its re-evaluation, USDA did as directed by Congress.  It based its report on current food prices, food composition data, consumption patterns, and dietary guidance.

The New York Times has a graphic displaying these changes in greater detail, as well as the effects of these changes on benefits.

This may not seem like much of a difference, but it should help.

No surprise, some members of Congress have objected to the increased expenditures, estimated to amount to $20 billion a year.

SNAP expenditures have always been contentious.   But for now, those who need help will be getting a bit more.

Additional Resources

  • What is the TFP? (Blog)
  • The Thrifty Food Plan and SNAP Benefits (Website)
  • The TFP Re-Evaluation Process (Infographic)
  • Changes in Benefits by State (Tables)
  • TFP Listening Sessions (Summary) (Blog)
  • SNAP Participants’ Barriers to Healthy Eating (Infographic)
  • Barriers that Constrain the Adequacy of SNAP Allotments (Report)
  • SNAP FY 2022 Cost-of-Living Adjustments (Memo)
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Aug 16 2021

Least credible ad of the week: “Beefing Up Sustainability”

My colleague, Lisa Young, forwarded this ad to me from the weekend’s Wall Street Journal.

In case it’s too small for you to read, the ad makes some eyebrow-raising points:

  • “If all U.S. livestock were eliminated and every American followed a vegan diet, greenhouse gas emissions 0would only be reduced by 2%, or 0.36% globally.”
  • “Plus, cattle play an important role in protecting and enhancing our ecosystems by increasing carbon storage, improving soil health, mitigating wildfires, and providing habitat for wildlife.”
  • “We all play a role in a more sustainable future, but eliminating beef is not the answer.”

This, in case it is not instantaneously obvious, is part of the beef industry’s well documented effort to fight concerns about the well documented role of beef production in climate change.

The ad is paid for by the Beef Checkoff, one of the USDA-sponsored marketing and promotion programs funded by what is essentially a tax—the “checkoff”—on producers.  I recently wrote about how the Beef Checkoff funds research in this industry’s interest.

The ad cites research studies supporting its statements, but these are cherry-picked.

Estimates of the percent of greenhouse gases contributed by lifestock production vary, but the most widely accepted range from 14% to 18%.  Beef accounts for at least 10%.

The Food and Agriculture Organization of the UN, for example, says:

Total emissions from global livestock: 7.1 Gigatonnes of Co2-equiv per year, representing 14.5 percent of all anthropogenic GHG emissions…Cattle (raised for both beef and milk, as well as for inedible outputs like manure and draft power) are the animal species responsible for the most emissions, representing about 65% of the livestock sector’s emissions…feed production and processing (this includes land use change) and enteric fermentation from ruminants are the two main sources of emissions, representing 45 and 39 percent of total emissions, respectively.

The New York Times describes foods that have the largest  impact on climate change.

Meat and dairy, particularly from cows, have an outsize impact, with livestock accounting for around 14.5 percent of the world’s greenhouse gases each year. That’s roughly the same amount as the emissions from all the cars, trucks, airplanes and ships combined in the world today.

In general, beef and lamb have the biggest climate footprint per gram of protein, while plant-based foods tend to have the smallest impact. Pork and chicken are somewhere in the middle.

A study published in Science calculated the average greenhouse gas emissions associated with different foods.  The New York Times summarizes its results:

Beef production creates emissions of methane as well as carbon dioxide from multiple sources: feed production, cow burps, manure production, etc.

Beef production that involves grazing on grasslands could meet sustainability goals, but beef cattle raised in feedlots cannot.

There are plenty of environmental reasons for eating less beef, and these are on top of health reasons.

The Beef Checkoff ad does not tell the whole story, alas.

Addition

Lisa reminds me that the cost of a full-page color ad in the Wall Street Journal runs around $200,000.

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Aug 13 2021

Weekend reading: A call to the UN Food Systems Summit: Ultra-processed foods

I am a co-author on a paper published recently by BMJ Global Health 2021;6:e006885.  The need to reshape global food processing: a call to the United Nations Food Systems Summit.  Authors: Carlos Augusto Monteiro, Mark Lawrence, Christopher Millett, Marion Nestle, Barry M Popkin, Gyorgy Scrinis, Boyd Swinburn.

Because this paper is open access, I reproduce its text below.  The link is to the pdf.

Summary box

  • In the modern, globalised food system, useful types of industrial food processing that preserve foods, enhance their sensory properties and make their culinary preparation easier and more diverse, have been and are being replaced by food ultra-processing.

  • The main purpose of food ultra-processing is to increase profits by creating hyperpalatable and convenient food products that are grossly inferior imitations of minimally processed foods and freshly prepared dishes and meals.

  • In the last decades, obesity, type 2 diabetes and related diseases have become global epidemics, leading the health systems of many countries to or beyond breaking point.

  • Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity, type 2 diabetes and related diseases.

  • The 2021 UN Food System has a unique opportunity to urge countries to implement policy interventions required to reduce ultra-processed food production, distribution and consumption, while simultaneously making fresh or minimally processed foods more available, accessible and affordable.

Introduction

The UN Food Systems Summit is taking place later this year at a crucial time. Food systems are manifestly failing to enhance human health, social equity or environmental protection. One symptom is the pandemic of obesity and related non-communicable diseases with their vast consequences. As we show here, one of the main drivers of this pandemic is the transformation in food processing. In the modern, globalised food system, useful types of food processing that preserve foods, enhance their sensory properties and make their culinary preparation easier and more diverse, have been and are being replaced by deleterious types of processing whose main purpose is to increase profits by creating hyperpalatable and convenient products that are grossly inferior imitations of minimally processed foods and freshly prepared dishes and meals. The Summit has a unique opportunity to confront this calamitous change, and to recommend effective policies and actions to UN agencies and member states.

Processing and industry

The key issue here is the nature, purpose and extent of food processing. It is not processing as such. General criticism of food processing is too unspecific to be helpful. Most foods are processed in some way, and culinary preparations of fresh foods are usually made using processed ingredients. Some types of food processing contribute to healthful diets, but others do the opposite.1

At one extreme are minimal processes which mostly preserve or enhance whole foods, such as drying grains, pulses and nuts, grinding grains into flour and pasta, chilling or freezing fruits and vegetables, pasteurising milk and fermenting milk into yoghurt.

At the other extreme are industrial processes that convert food commodities such as wheat, soy, corn, oils and sugar, into chemically or physically transformed food substances, formulated with various classes of additives into generally cheap to make, long duration substitutes to minimally processed foods and freshly prepared dishes and meals. The result is brand-named sugary, fatty and/or salty food and drink products which typically contain little or no whole food, are designed to be ready-to-consume anytime, anywhere and are highly attractive to the senses or even quasi-addictive. These products, including sweet and flavoured drinks, sweet or savoury snacks, reconstituted meat products and shelf-stable or frozen ready meals and desserts, are identified as ultra-processed foods.2

Criticisms of the food industry as a whole are also a mistake. Most of the very many millions of food farming, growing, rearing, making, distributing, selling and catering businesses throughout the world, notably in Asia, Africa and Latin America, deal solely or largely in fresh and minimally processed foods. These businesses and the foods they produce need to be encouraged, defended and supported.

By contrast, ultra-processed foods are mostly enabled, produced and sold by a small number of transnational corporations, some of whose turnovers exceed the revenues of many countries and make annual profits of US$ billions.3 These corporations use their power to formulate, mass manufacture, distribute and aggressively market their products worldwide.4

These corporations shape scientific findings by funding in-house and university-based research, so as to defend and promote ultra-processed foods.5 They also exercise political power by intensive lobbying, donations and sponsorships, and until now have dissuaded most governments from adequately regulating their products and practices.6

Time-series food sales data indicate the explosive growth in manufacturing and consumption of ultra-processed foods worldwide.7 National dietary surveys show that ultra-processed foods already make up 50% or more of total dietary energy intake8 in high-income countries, with even higher consumption among children and adolescents.9 In middle-income countries, they now represent between 15% and 30% of total energy intake8 but sales of ultra-processed foods are increasing fastest in these countries.10

The pandemic of obesity and related diseases and its link with ultra-processing

According to WHO, worldwide prevalence of obesity has nearly tripled since the mid-1970s, and now over 650 million adults are obese, and 1.9 billion adults and over 370 million children and adolescents are overweight or obese (https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight). No country has yet reversed these increases. Closely driven by the increase in obesity is a doubling of worldwide type 2 diabetes prevalence since 1980, now affecting about 420 million people (https://www.who.int/news-room/fact-sheets/detail/diabetes). Obesity, type 2 diabetes and related non-communicable diseases, including cardiovascular diseases and some common cancers, have become pandemics. Pre-COVID-19, health systems in most countries did not have the capacity to effectively treat diet-influenced diseases. Now, many health systems are at or beyond breaking point struggling with COVID-19, the severity of which is significantly higher in people with obesity and related diseases.

Evidence of the general healthfulness of dietary patterns based on fresh and minimally processed foods and culinary preparations, and their protection against all forms of malnutrition, ‘is noteworthy for its breadth, depth, diversity of methods, and consistency of findings’.11

But only in the last decade, with the advent of the NOVA food classification system that distinguishes ultra-processed foods from minimally processed or processed foods,1 has the link between changes in types of food processing and the pandemic of obesity and related diseases been revealed. Evidence here includes:

  • Three meta-analyses of findings from epidemiological studies, including large, long-duration, carefully conducted cohort studies, show dose-response associations between consumption of ultra-processed foods and obesity, abdominal obesity, type 2 diabetes, dyslipidaemias, metabolic syndrome, depression, cardio and cerebrovascular diseases and all-cause mortality.12–14

  • Analysis of national dietary or food purchase surveys in middle-income or high-income countries shows that the higher the dietary share of ultra-processed foods, the higher the obesogenic dietary nutrient profiles. These are characterised by higher energy density, free sugars, unhealthy fats and sodium, and lower protein and dietary fibre.8

  • Epidemiological and experimental studies indicate that ultra-processed foods may increase risks for obesity and related diseases in other ways beyond their nutritional composition. These include structural and physical properties that blunt satiety signalling, organoleptic characteristics associated with higher energy intake rate, neo-formed substances and migrated packaging materials that are endocrine disruptors, additives that promote pro-inflammatory microbiome, and reduced thermic effect that decreases total energy expenditures.12–14

  • A randomised controlled cross-over trial shows that consuming a high ultra-processed diet causes a highly significant increase in ad libitum calorie intake and consequent weight gain. Over a 2-week period, 20 young adults following a diet with 83% of energy from ultra-processed foods consumed approximately 500 more kcal per day than when they followed a diet with no ultra-processed foods. Participants gained 0.9 kg at the end of the 2 weeks with the ultra-processed diet and lost 0.9 kg at the end of the non ultra-processed diet, mostly of body fat.15

  • A longitudinal ecological study of 80 countries from 2002 to 2016 shows a direct association between changes in annual per capita volume sales of ultra-processed foods and corresponding changes in population adult body mass index.16

Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity and related diseases. There is also mounting evidence of the harmful effects of the ultra-processed food industry on the planet, through its global demand for cheap ingredients that destroy forests and savannah, its displacement of sustainable farming, and its resource-intensive manufacturing and packaging.17

Policy responses

To begin with, the UN Food Systems Summit should urge international and national health and food and nutrition authorities to review their dietary guidelines to emphasise preference for fresh or minimally processed foods and avoidance of ultra-processed foods, in line with guidelines developed, for example, by the WHO/Pan American Health Organization,18 and issued in several Latino-American countries, and now also in France, Belgium, and Israel.

At the same time, national governments should be urged to use fiscal measures, marketing regulations, bold mandatory front-of-pack labelling schemes and food procurement policies, all designed to promote the production, accessibility and consumption of a rich variety of fresh or minimally processed foods, and to discourage the production, distribution and consumption of ultra-processed foods, as now done in several countries.19

Current food and nutrition policies are mostly intended to encourage food manufacturers to reformulate their products by reducing the use of salt, sugar or unhealthy fats. There is a role for strong regulations that effectively limit the levels of these components, but reformulation alone will not turn ultra-processed products into healthy foods,20 as in effect recently acknowledged in one internal document from one leading ultra-processed food corporation – “some of our categories and products will never be ‘healthy’ no matter how much we renovate” (https://www.ft.com/content/4c98d410-38b1-4be8-95b2-d029e054f492). Policies should instead stimulate the entire manufacturing industry to maintain, develop or improve processing methods that prolong the duration of whole foods, enhance their sensory properties and make their culinary preparation easier and more diverse. Ultra-processed foods should be replaced by processed foods with limited levels or absence of added salt, sugar or unhealthy fats or, preferably, by minimally processed foods.20

Conclusions

Food systems are failing. This is most clearly shown by what are now the pandemics of obesity and type 2 diabetes, of which ultra-processed food is a main contributor. The UN Food Systems Summit should urge member states to implement multiple policy interventions to reduce ultra-processed food production, distribution and consumption, while simultaneously making fresh or minimally processed foods more available, accessible and affordable.

Data availability statement

All data relevant to the study are included in the article.

Ethics statements

Acknowledgments

This paper expands a one-page submission made by the authors to the UN Food Systems Summit within Solution Cluster 2.2.1 (food environment).

References

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Footnotes

  • Twitter @CMonteiro_USP

  • Contributors All authors contributed to the ideas presented in the manuscript. CAM wrote the manuscript. All authors contributed to redrafting and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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Aug 12 2021

Cocoa and chocolate in the food news

In talking about cocoa and chocolate, it’s a quick move from candy to politics.

New ways to treat yourself on World Chocolate Day July 7: “While we usually think of chocolate as a sweet treat, many cultures and cuisines use chocolate to boost the flavour profiles of their main dishes.”  Suggestions: (1) Mix it into your chilli con carne, (2) Use it as a marinade for meat, (3) Dip your bacon in it, (4) Add it to your Bolognese, (5) Turn it into pasta.  [Comment: I don’t think so].

‘You, the whites, are eating cocoa. You bring the price … you have to give us a chance to sell it at the price that we want’:  ‘I am a cocoa farmer’ is the first in an occasional series by Dr Kristy Leissle, scholar of the cocoa and chocolate industries…Over time, the series will illustrate both the diversity of people who farm cocoa, and the similarities of their circumstances. Read more

Rise in US confectionery sales boosts Fairtrade payments to cocoa farmers: People are paying more attention than ever to the conditions behind the products they buy as a way to make a difference in the world, according to new research findings released by GlobeScan and Fairtrade International…. Read more

Mondelēz and Fairtrade Foundation offer financial support to female cocoa farmers: The new ‘Cadbury Farmer Resilience Fund’ designed to protect cocoa farmer livelihoods during the COVID-19 pandemic is providing grants that will empower thousands of women farmers to start small businesses and earn a decent living…. Read more

Mars Wrigley to meet industry cocoa officials to discuss LID payments:  Barry Parkin, the company’s Chief Procurement and Sustainability Officer, is set to meet with members of the cocoa industry and the governments of Ghana and Cote d’Ivoire this week to discuss the Living Income Differential (LID) and to underscore the company’s commitment to…full payment to farmers and control of supply to prevent cocoa from moving into protected areas. Read more

Can U.S. chocolate companies be liable for child-labor abuses in the global cocoa supply chain?  Chocolate brought Americans sweet respite in 2020—more than usual, according to recent research into pandemic purchasing. But the great irony in our chocolate indulgence is that it’s also a product borne out of great suffering…Within the next few weeks, the U.S. Supreme Court is expected to rule on a pair of consolidated cases known as Nestlé USA, Inc. v. John Doe and Cargill, Inc. v. John Doe. Nestlé is one of the world’s biggest chocolate manufacturers and Cargill, the world’s largest cocoa bean processor.

And here’s the ruling: US Supreme Court rules in favour of cocoa companies Nestle and Cargill in child slavery case:  The US Supreme Court rules that Nestlé USA and Cargill can’t be sued for child slavery on African farms from where they buy their cocoa…. Read more

Comment: The issues in chocolate just won’t go away: unfairly low prices to producers of the raw materials, harsh and unfair working conditions, child labor, and overall power imbalances as displayed in the Supreme Court decision.

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