Search results: dietary guidelines

The Dietary Guidelines Advisory Committee may not think there is much to ultra-processed foods (UPF), but companies making them have just been served with a lawuit.

I learned about this from a tweet (x) from Carlos Monteiro, the Brazilian public health professor who coined the UPF term.

CMonteiro_USP (@Carlos A. Monteiro) posted: A first-of-its-kind lawsuit against 11 UPF industries alleging they engineer their UPF products to be addictive with details on the actions taken to target children including internal memos, meetings & the research conducted to create addictive substances.

The lawsuit, filed by several law firms, is aimed at Big Food: Kraft, Mondelez, Post, Coca-Cola, PepsiCo, General Mills, Nestle, Kellanova, WK Kellogg, Mars, and Conagra.

The suit charges that these firms, through their deliberate marketing, are making people sick.

Due to Defendants’ conduct, Plaintiff regularly, frequently, and chronically ingested their UPF, which caused him to contract Type 2 Diabetes and Non-Alcoholic Fatty Liver Disease Plaintiff is now suffering from these devastating diseases, and will continue to suffer for the rest of his life.

The suit makes interesting reading.

Some examples:

• Big Tobacco companies intentionally designed UPF to hack the physiological structures of our brains.  These formulation strategies were quickly adopted throughout the UPF industry, with the goal of driving consumption, and defendants’ profits, at all costs.
• The same MRI machines used by scientific researchers to study potential cures for addiction are used by UPF companies to engineer their products to be ever more addictive.
• Big Tobacco repurposed marketing strategies designed to sell cigarettes to children and minorities, and aggressively marketed UPF to these groups.
• The UPF industry now spends about $2 billion each year marketing UPF to children.
• UPF increase the risks of disease because they are ultra-processed, not because of how many grams of certain nutrients they contain or how much weight gain they cause. Therefore, even attempts to eat healthfully are undermined by the ultra-processed nature of UPF. One cannot evade the risks caused by UPF simply by selecting UPF with lower calories, fat, salt, sugar, carbohydrates, or other nutrients.
• The UPF industry is well aware of the harms they are causing and has known it for decades. But they continue to inflict massive harm on society in a reckless pursuit of profits.

Can’t wait to see what happens with this one.  Stay tuned.

Resources

Consumer Federation of America: “Ultra-processed Foods: Why They Matter and What to Do About It.”

With government officials reluctant to issue advice on ultra-processed foods (UPFs), Consumer Federation of America aims to raise awareness about research on UPFs, explain the leading theories of how they harm health, and build support for public policies to reduce harms from UPFs in our diet.

The report pushes back on arguments that researchers have not consistently defined UPFs, or that the categorization lacks scientific rigor. In fact, researchers have operationalized the “Nova classification” system behind UPFs in a largely consistent manner, defining foods based on whether they contain ingredients that are “industrial formulations” or “rarely used in home kitchens,” with little serious disagreement about which ingredients should be considered “ultra processed.” Consumers can take CFA’s online quiz to test their knowledge of which ingredients are markers of “ultra processing.”

New research: Trends in Adults’ Intake of Un-processed/Minimally Processed, and Ultra-processed foods at Home and Away from Home in the United States from 2003–2018.  J Nutr 2024, https://doi.org/10.1016/j.tjnut.2024.10.048.  The data show that 50% or more of calories are consumed from UPF at home, away from home, and by pretty much everyone.

New research: Hagerman CJ, Hong AE, Jennings E, Butryn ML. A Pilot Study of a Novel Dietary Intervention Targeting Ultra-Processed Food Intake. Obes Sci Pract. 2024 Dec 8;10(6):e70029. doi: 10.1002/osp4.70029.  Behavioral interventions to reduce UPF intake cut calories by about 600 calories per day.

My post summarizing the three studies demonstrating that diets high in UPF induce intake of an excess of 500, 800, and 1000 calories per day.

Charlotte Bilekoff.  Real Food, Real Facts: Processed Food and the Politics of Knowledge.  University of California Press, 2024.  267 pages.

Food processing is a big issue these days (witness RFK Jr’s pledge to get ultra-processed foods out of school meals) and I was interested to see what food studies scholar Charlotte Biltekoff had to say about it.

Her thesis: When people say they want to eat “real food” rather than highly processed food, the food industry responds with “real facts,” science-based discussions of the benefits of food processing (“food scientism”).

The industry’s response is based on the idea that if you could only correct public ignorance and misperceptions, you could sell your products more easily.

But public concerns are about politics, not science.  And food scientism is a form of antipolitics.

She cites as an example, the FDA’s ongoing inability to define the term “natural.”

Concerned about health, sustainability, and risk and wanting change in the food system, the public sought to act on its values and aspirations in the marketplace.  Narrowly reframing those concerns as demands that could be met through product reformulations and new approaches to marketing—but without serious, systemic engagement with the broader issues they reflected—the food industry produced products that appeared to be more natural, less processed, and therefore better…articles in the industry press and comments to the FDA show that many perceived the consumers of “real food” as irrational and misinformed.  Seen through the lens of food scientism of the Real Facts frame, consumer perceptions of processing and what “natural” meant, or should mean, were further proof that the public lacked the skills and understanding to meaningfully participate in the regulatory processess, let alone act as knowledgeable participants in the governance of technology and the shaping of the food system. (p. 143)

What Biltekoff has done here is to translate the classic two-culture risk communication problem to food.

Her book made me go back and look at what I wrote about the two-culture problem in Safe Food: The Politics of Food Safety.  The book contrasts the differing perceptions of industry and the public about the potential harm of microbial foodborne illness versus GMOs.

These differences in approaching questions of risk were understood long before anyone invented the techniques for genetically modifying foods. In 1959, for example, the scientist and writer C. P. Snow characterized the ways in which people trained in science tend to think about the world—as opposed to those without such training—as representing two distinct cultures separated from one another by a “gulf of mutual incomprehension” [1]. Much more recently, the anthropologist Clifford Geertz wrote, “The ways in which we try to understand and deal with the physical world and those in which we try to understand and deal with the social one are not altogether the same. The methods of research, the aims of inquiry, and the standards of judgment all differ, and nothing but confusion, scorn, and accusation—relativism! Platonism! reductionism! verbalism!—results from failing to see this” [2].  [1. Snow CP. Two Cultures and the Scientific Revolution: The Rede Lecture. London: Cambridge University Press, 1959; 2. Geertz C. Empowering Aristotle (book review). Science 2001;293:53].

Science-based approaches to food safety, I pointed out, count cases and estimate costs, whereas what I called “value-based” approaches, are about feelings of dread and outrage.

Biltekoff’s analysis applies the two-culture framework to public responses to food processing and to the ways the food industry deals with those responses.

Her analysis explains much about the current pushback against the concept of ultra-processed foods from the food industry and some nutritionists.  If you want to understand why the Dietary Guidelines Advisory Committee has chosen not to recommend reducing intake of ulra-processed foods, read this book.

And, amazingly, the book is available as open source.  Read the book online here.

Read Charlotte Biltekoff’s interview with UC Press here.

The House of Lords Food, Diet and Obesity Committee has a lengthy (179 pages) new report ‘Recipe for health: a plan to fix our broken food system’.

Key finding: Obesity and diet-related disease are public health emergencies costing society billions in healthcare costs and lost productivity.

Key recommendation: The Government should develop a comprehensive, integrated long-term new strategy to fix our food system, underpinned by a new legislative framework.

Key actions (selected):

• Require large food businesses to report on the healthfulness of their products
• Exclude businesses making unhealthful products from policy discussions on food, diet and obesity prevention.
• Tax products high in salt and sugar; use revenues to make healthy food cheaper.
• Ban the advertising of less healthy food across all media.

No recommendation on reducing intake of ultra-processed foods?  Despite finding the link between ultra-processed foods and poor health outcome “alarming,” the report ducked the issue and recommended only to fund more research.

It also advised reviewing dietary guidelines with ultra-processed foods in mind.

Still, the recommendation to keep food businesses out of public policy discussions is a good one, not to mention taxes and advertising bans.

This, mind you, is the House of Lords.  Impressive.

LINKS

• Full report
• News story
• Shorthand version of the report
• Video
• Audio (Baroness Walmsley)

Two readers, Tara Kenny and Martin Caraher, sent this one:  Plant-based diets–impacts of consumption of little or no animal-source foods on human health.  by Alice V. Stanton  ^{Front. Nutr., 17 September 2024. Volume 11 – 2024 | https://doi.org/10.3389/fnut.2024.1423925}

The paper argues for the benefits of meat-based diets:

The protections provided by plant-based diets against NCDs [non-communicable diseases] appear to be more strongly associated with reduced intakes of calories and salt, and increased intakes of fruit, vegetables, nuts and whole grains, rather than with reduced intakes of ASFs [animal-source foods]. Any possible absolute adverse effects of red and processed meat consumption on NCDs are very small and uncertain…dietary guidelines should advise moderating excessive consumption, rather than substantially limiting or excluding ASFs from the human diet.

The author’s conflict-of-interest statement:

Alice Stanton was a part-time employee of Devenish Nutrition (2017–2023); and currently owns stock in Devenish Nutrition, an agri-technology company specializing in sustainable food solutions.

Comment

My readers point out that the author’s financial conflicts of interest are understated.  Devinish Nutrition is, in fact, a family business.  The company states it is “an innovator in animal nutrition by providing a wide range of products and services.”  It was acquired this year by EASY BIO a South Korean animal nutrition company.

Both readers also point out that Alice Stanton has pro-meat ideological conflicts of interest, but these concern me much less.  Everyone who does research has beliefs and hypotheses they want to test.  But not everyone stands to benefit financially from the outcome of their research or opinion, which is why full disclosure is so necessary.

The walnut industry must be desperate for greater market share.  Walnuts are great and make a terrific snack if you don’t eat too many of them (calories!).  But this is one-food research.  Can one food really make an important difference to health (yes, if you are seriously deficient in essential nutrients but most Americans are not).

One-food research has to be about marketing more than science.

To wit:

A Cross-Sectional Study on the Association of Walnut Consumption with Obesity and Relative Fat Mass among United States Adolescents and Young Adults in NHANES (2003–2020).  2024 Current Developments in Nutrition.  DOI: https://doi.org/10.1016/j.cdnut.2024.104407

Conclusions: For adolescents girls and young women, dietary intake of walnuts combined with other nuts has the strongest inverse association with measures of obesity.

Funding: This study was funded by the California Walnut Commission.

Comment

The study does not find an association between eating walnuts and obesity in adolescents.  I would not expect it to.  People do not eat that many walnuts.  They get most of their calories from fast and ultraprocessed foods.

The California Walnut Commission would like you to think the calories in walnuts do not count.  In a press release, it points out

Nuts, including walnuts, are nutrient dense and considered a key component of many recommended dietary patterns, including the Mediterranean and vegetarian diets. They are also recommended for daily consumption in the latest U.S. Dietary Guidelines.³ Despite the recommendations, nuts remain under-consumed by the U.S. population,³ perhaps due to nuts being calorie dense, leading to potential concerns that including nuts in the diet could promote weight gain. But new research suggests people, especially Gen Z and millennials, should reconsider nuts, like walnuts.

All true, but nuts in general, not specifically walnuts.  This is about increasing the market share for walnuts as opposed to other nuts.

The FDA is once again asking food companies to voluntarily reduce the sodium in their products.

It says that 40% of food categories have done just that.

Prior to 2021, consumer intake was approximately 3,400 milligrams per day on average, far higher than the limit recommended by the Dietary Guidelines for Americans of 2,300 milligrams per day for those 14 years and older.

If finalized, the new set of voluntary targets would support reducing average individual sodium intake to about 2,750 milligrams per day. This reduction is approximately 20% lower than consumer intake levels prior to 2021.

it has published a report on this progress.

A quick reminder: salt is 40% sodium.  The Dietary Guidelines upper limit target of 2300 mg/day sodium means nearly 6 grams of salt per day, or 1.5 teaspoons.

As for why this matters, Sodium Reduction Is A Proven Strategy That Saves Lives—More Work Is Needed To Hold Industry Accountable.

In 2016, the Food and Drug Administration (FDA) embarked on a sodium reduction strategy, only to meet repeated political hurdles…there has been little industry engagement, minimal public reporting, and no consequences if targets are not achieved.

Salt reduction across the entire food supply is the only measure that will help people reduce sodium intake.  This issue has been around for a long time.

Voluntary reduction is nice, but does not go nearly far enough and it can always be reversed.

The FDA could and should do more.

OK, granted.  Political opposition to salt reduction is fierce—if foods aren’t salty enough, people might not buy them.

But the FDA also has a long history of protection of commercial interests, which it claims it cannot share because it is obliged to protect trade secrets.  It’s time for that to change too.

This one was sent to me by a reader: Animal vs. Plant Protein: New Research Suggests That These Protein Sources Are Not Nutritionally Equivalent: Scientists found that two-ounce-equivalents (oz-eq) of animal-based protein foods provide greater essential amino acids (EAA) bioavailability than the same quantity of plant-based protein foods. The study challenges the Dietary Guidelines for Americans (DGAs) which suggest these protein sources are nutritionally equivalent.

I went right to the study: “Effects of Consuming Ounce-Equivalent Portions of Animal- vs. Plant-Based Protein Foods, as Defined by the Dietary Guidelines for Americans on Essential Amino Acids Bioavailability in Young and Older Adults: Two Cross-Over Randomized Controlled Trials” by Gavin Connolly, Joshua L. Hudson, Robert E. Bergia, Eric M. Davis, Austin S. Hartman, Wenbin Zhu, Chad C. Carroll and Wayne W. Campbell, 25 June 2023, Nutrients. DOI: 10.3390/nu15132870

Oh.  It’s in Nutrients, a journal that might as well be called “The Journal of Industry-Funded Research” (authors have to pay for publication of their articles in this journal–2900 Swiss Francs).

The study was designed to demonstrate that protein from animal sources is better than protein from plant sources, immediately raising the question: Who sponsored this study?

Funding: This research was funded by the Pork Checkoff and the American Egg Board—Egg Nutrition Center. The supporting sources had no role in study design; collection, analysis, and interpretation of data; writing of the report; or submission of the report for publication.

Do the authors report conflicts of interest?  Yes, they do:

Conflicts of Interets: When this research was conducted, W.W.C. received research funding from the following organizations: American Egg Board’s Egg Nutrition Center, Beef Checkoff, Pork Checkoff, North Dakota Beef Commission, Barilla Group, Mushroom Council, and the National Chicken Council. C.C.C. received funding from the Beef Checkoff. R.E.B. is currently employed by Archer-Daniels-Midland (ADM); the research presented in this article was conducted in a former role and has no connection with ADM. G.C., J.L.H., E.M.D., A.S.H. and W.Z. declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

I’m not going to bother going through the methods, results, or other details.  The point here is that industry-funded research has a high probability of producing results favorable to the sponsors’ interests, as happened in this instance.  The statement that the sponsors had no role may or may not be true; it’s hard to know without further investigation, but research on this question demonstrates that the statement is not always accurate.  Funding exerts influence, whether recognized by researchers or not.

I received an e-mailed press release from The Peanut Institute: Peanuts and Peanut Butter Support Women’s Health.

When it comes to health, women face unique challenges that call for unique nutrition. In fact, research has found that women face a higher risk of dying from heart disease than men,¹ and may be at risk for other conditions such as hypertension,² certain cancers,³ and even Alzheimer’s disease.⁴  To help women protect their health, The Peanut Institute is sharing information on the benefits that regular consumption of peanuts and peanut butter delivers to females at every stage of life.

Here are excerpts from those stages.

• Birth to 24 Months:  A child’s first two years are referred to as “B24” and are a critical time in the growth and development of the brain and body. The most recent Dietary Guidelines for Americans highlights peanuts as “an important source of iron, zinc, protein, choline and long chain polyunsaturated fatty acids.”²
• For youngsters and teens: On the subject of protein, at 7 grams per ounce, peanuts have more protein than any other nut.^6. That’s especially important for girls who work out since protein helps muscles grow, recover and stay healthy.⁷ Plus, peanuts are satisfying and an easy, on-the-go snack that can be stowed in a backpack, locker or car.
• For adults and seniors: The Journal of the American Heart Association found that following a plant-based diet with nuts, legumes, fruits and veggies can lower the risk of dying prematurely from multiple causes, including cardiovascular disease, one of the leading causes of death worldwide.⁸ In addition, phytosterols, like those found in peanuts, may inhibit the growth of cancers that affect millions of women, including lung, stomach, ovarian, colon and breast cancers.^9-12

I did not look to see whether the references were funded by the peanut industry, but there is plenty of precedent.  See, for example,

• Industry-funded study of the week: Peanuts
• Annals of industry-funded research: Peanuts this time
• Industry-funded request of the week: prove peanuts healthy

But there’s more.  A reader, Monica Baer, sent me another press release from the Peanut Institute: New Gut Microbiome Research Points to Positive Impact on Memory and Mood from Peanut Consumption

Research from the University of Barcelona on the gut microbiota has found that daily consumption of peanuts and peanut butter can produce compounds in the gut that help improve memory and reduce stress response, including anxiety and depression, in healthy young adults. Findings from the ARISTOTLE study were published online in the Journal of Functional Foods this September and shared by The Peanut Institute. 

I did look up this one: Isabella Parilli-Moser, Ricardo López-Solís, Inés Domínguez-López, Anna Vallverdú-Queralt, Sara Hurtado-Barroso, Rosa M Lamuela-Raventós, Consumption of peanut products enhances the production of microbial phenolic metabolites related with memory and stress response: Results from the ARISTOTLE trial, Journal of Functional Foods, Volume 108, 2023, 105746, https://doi.org/10.1016/j.jff.2023.105746.

Funding: This work was supported by funding from the Peanut Institute.

I like peanuts.  They are legumes and real foods.  But to attribute overall health and memory function to eating peanuts seems a bit far-fetched.  That’s why the Peanut Institute is funding research: to convince you peanuts are a superfood.  There is, of course, no such thing.  Superfood is a marketing term.  Should you eat peanuts?  Sure.  Why not?