Search results: Cereal

A couple of weeks ago, I mentioned several new studies that elicited much media attention.  I am now getting around to them.

Let’s start with the article in the BMJ about newly discovered data from the Minnesota Heart Study purportedly casting doubt on the risks of saturated fat (here’s what the Washington Post said about it).

The BMJ article concluded:

Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.

I’ve been at this game long enough to guess that any statement suggesting that everything you thought you knew about nutrition is wrong ought to raise red flags and call for more than the usual degree of skepticism.

Here are some sensible and, yes, skeptical comments about this study:

From Julia Belluz of Vox

But there were a few major problems with the research. The study involved men and women of an average age of 52 who had been admitted to a nursing home and six state mental health hospitals because they were sick. The researchers who conducted the meta-analysis note the “results are not necessarily generalizable to populations without mental illnesses or living outside nursing homes.”

Another issue: The study followed 9,423 women and men, but only a quarter of the participants followed the diets for more than a year. Altering one’s diet for a short period of time — especially in old age — would not necessarily affect one’s long-term health risks….

…Some of the biggest controversies surround saturated fats. Scientists disagree about the extent to which saturated fats contribute to important health outcomes like heart disease, stroke, and cancer. The available research does suggest, however, that there are health benefits from replacing saturated fats with unsaturated fats in the diet, and that eating lots of nutrient-poor carbs (like sugary cereals, soda, and white bread) instead of fat is a bad idea.

From David Katz, to whom I am often grateful for taking on such things, writes that this study

tested something that nobody expert in nutrition is recommending: an extremely high dose of omega-6, linoleic acid…we already got the memo that this is a dubious proposition.

With all due respect to the BMJ authors, I personally found it a bit odd that they stated the following: “A key component of dietary guidelines has long been to replace saturated fat with oils rich in linoleic acid…” The current Dietary Guidelines for Americans, let alone the far better 2015 Dietary Guidelines Advisory Committee Report, make no such recommendation. Searching for any mention of linoleic acid, I found it only in the appendices in the context of descriptions and definitions, not in any of the actionable guidance. While the current Dietary Guidelines do recommend limiting saturated fat intake, the replacement encouraged is a balance of healthful oils, such as olive, and the fats found natively in, as noted, nuts, seeds, avocado, and fish.

From Martijn Katan, the Dutch lipid biochemist who did the original work demonstrating the cholesterol-raising effects of trans fats, writes in an e-mail:

I have not had time to study the BMJ article on the Minnesota Heart Study in detail. However, some of my colleagues did, and I think that their conclusions are correct:

1. The randomized trial itself showed no effect on disease or death
2. This was to be expected because most subjects were on the diet for less than 1 year. This was due to the change in regime for psychiatric patients that took place during that period, which essentially caused the trial to fail. Lowering cholesterol by 14% for one year does not noticably affect CVD risk.
3. The relation of a larger fall in cholesterol with a larger risk of mortality did not emerge from the randomized study; subjects were not randomized to various levels of cholesterol lowering. It is an observational association. The question than arises which causes which. Various occult diseases, notably cancer, cause cholesterol to fall as the disease progresses. This also explains the association seen in observational studies between low cholesterol and cancer. That observation led me to think up in 1985 the technique now known as ‘Mendelian Randomization’ [1]. Application of that technique showed that the association of low cholesterol and cancer is indeed spurious [2].

The only new thing about the present study is that they revived the long disproved hypothesis that lowering cholesterol causes various diseases. Hundreds of thousands of patients in statin trials have proven this wrong….

[1] Katan, M.B., 1986. Apolipoprotein E isoforms, serum cholesterol, and cancer. Lancet 1, 507–8.

[2] Trompet, S.,et al ., 2009. Apolipoprotein E genotype, plasma cholesterol, and cancer: a Mendelian randomization study. Am J Epidemiol 170, 1415–21.

My bottom line on this one

It confirms the value of basic dietary advice: Eat a variety of relatively unprocessed foods, mostly plants (fruits, vegetables, grains, beans, nuts), balance calories, and enjoy what you eat!

Do this and food fatty acids will balance out too and you won’t need to give them another thought.

The moral

Whenever you read a headline suggesting that everything you know about nutrition is wrong, roll your eyes, eat something delicious, and wait for confirming studies to come along before deciding to ignore that basic advice.

This morning, I received a query from a scientist:

I have been following your documentation of industry-funded research on health benefits. I’ve been thinking about this issue from the perspective of fruits and vegetables. We know that they are good in general, but how does one fund research to demonstrate that clinically? In particular, how does one get specific about the form and amount that his helpful for specific health benefits?  You may be interested in this press release from the raspberry industry telling about the papers at the Society for Experimental Biology meetings that are relevant to the health benefits of eating raspberries. This seems to be approaching what a good model might look like. I’m interested in your perspective. Furthermore, are the results relevant to nutritionists?

Here’s how I answered it:

Thanks for sending.  I guess my question would be something along the lines of why getting specific about form and amount of specific fruits and vegetables is important for public health.  People don’t eat just raspberries.  They put them in cereal or on desserts.  Raspberries are expensive.  Wealthy, educated and, therefore, healthy people are likely to consume them.  So this looks like marketing research to me—selling raspberries as a superfood.  If you think there is a special benefit to raspberries and that it would be good to quantify it, the best strategy would be to get the research funded by an independent agency.  Otherwise, it’s clearly marketing research (hence the press release).   At least that’s how I see it.

This, of course, gets us back to the question of sponsored research which, as my collection of sponsored studies has shown, almost inevitably produce results favorable to the sponsor.  I love raspberries and don’t doubt for a minute that they are healthy, but a superfood?  I don’t think so.

I’m still working on the descriptive analysis of the year’s collection of sponsored studies.  I will also be giving more thought to such questions, so send them along.

Australia has government-sponsored front-of-package nutrient labeling—the Health Star system—that looks a lot like the U.S. grocery industry’s Facts Up Front, but is even more favorable to manufacturers of processed foods.

As I explained a few years ago, Facts Up Front was a successful scheme by the Grocery Manufacturers and Food Marketing Associations to head off the FDA’s attempts to put traffic-light signals on the front of processed food products (here’s more of the back story).

Like the U.S. system, the Australian system is voluntary.  Unlike it, Health Stars are prominent and convey the impression that the more starts, the better.

A year into the program, Australian newspapers are writing about how companies are “gaming” the system:

Deakin University professor of public health nutrition Mark Lawrence said the health star rating system was being exploited as a marketing tool by junk food manufacturers to make consumers think their food was healthy. He said the scheme for packaged food undermined the public health message that people should eat fresh, unprocessed food.

This article quotes a statement by Kellogg that sales of Nutrigrain cereal went up after the company reformulated the product to raise its rating from 2 to 4 stars.

But isn’t reformulation a good thing?  It could be but just because a processed food is “better-for-you,” does not necessarily make it a good choice.

Professor Mark Lawrence of Deakin and Christina Pollard of Curtin University write:

Its main design limitation is that it simplistically frames the cause of, and solution to, dietary imbalances in terms of nutrients. This is fundamentally at odds with the latest nutrition advice, which uses a food-based approach…So what the health star rating system ends up doing is encouraging marketing of unhealthy or discretionary foods, as healthy options.

Overall, they point out:

Part of the problem is that the campaign’s main message – “the more stars the better” – is misleading…The actual health message is to eat more of these [recommended healthy] foods; it’s not that we should try to eat food with more stars.

Good advice.

Thanks to a reader for sending these items from a journal that I don’t usually come across.  These bring the casually collected total since last March to 145 studies favorable to the sponsor versus 12 that are not.

Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States: diet modeling study based on NHANES 2007–2010.  Erin E Quann, Victor L Fulgoni III and Nancy Auestad. Nutrition Journal 2015; 14:90 DOI: 10.1186/s12937-015-0057-5

• Conclusion: Increasing dairy food consumption to recommended amounts is one practical dietary change that could significantly improve the population’s adequacy for certain vitamins and minerals that are currently under-consumed, as well as have a positive impact on health.
• Funding: The study and the writing of the manuscript were supported by Dairy Management Inc.

Association of lunch meat consumption with nutrient intake, diet quality and health risk factors in U.S. children and adults: NHANES 2007–201Sanjiv Agarwal, Victor L. Fulgoni III and Eric P. Berg. Nutrition Journal. 2015;14:128.  DOI: 10.1186/s12937-015-011f8-9

• Conclusions: The results of this study may provide insight into how to better utilize lunch meats in the diets of U.S. children and adults.
• Funding: The present study was funded by North American Meat Institute.

A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer.  Lauren C. Bylsma and Dominik D. Alexander.  Nutrition Journal. 2015;14:125. DOI: 10.1186/s12937-015-0111-3

• Conclusion: Dose-response analyses did not reveal significant patterns of associations between red or processed meat and prostate cancer….although we observed a weak positive summary estimate for processed meats.
• Funding: This work was supported in part by the National Cattlemen’s Beef Association (NCBA), a contractor to the Beef Checkoff. NCBA did not contribute to the writing, analysis, interpretation of the research findings, or the decision to publish…LCB and DDA are employees of EpidStat Institute. EpidStat received partial funding from the National Cattlemen’s Beef Association (NCBA), a contractor to the Beef Checkoff, for work related to this manuscript. The conceptualization, writing, analysis, and interpretation of research findings was performed independently.

Are restrictive guidelines for added sugars science based?  Jennifer Erickson and Joanne Slavin.  Nutrition Journal. 2015;14:124.  DOI: 10.1186/s12937-015-0114-0

• Conclusion: However, there is currently no evidence stating that added sugar is more harmful than excess calories from any other food source. The addition of restrictive added sugar recommendations may not be the most effective intervention in the treatment and prevention of obesity and other health concerns.
• Disclosure: Jennifer Erickson, is a PhD student in Nutrition at the University of Minnesota working with Dr. Joanne Slavin. Joanne Slavin is a professor in the Department of Food Science and Nutrition, University of Minnesota.  In the past 5 years, she has given 150 scientific presentations in 13 countries. Many of these meetings received sponsorship from companies and associations with an interest in carbohydrates and nutritive sweeteners…Her research funding for the past 5 years has included grants from General Mills, Inc., Tate and Lyle, Nestle Health Sciences, Kellogg Company, USA Rice, USA Pears, Minnesota Beef Council, Minnesota Cultivated Wild Rice Council, Barilla Company, USDA, American Egg Board, American Pulse Association, MNDrive Global Food Ventures, International Life Science Institute (ILSI), and the Mushroom Council. She serves on the scientific advisory board for Tate and Lyle, Kerry Ingredients, Atkins Nutritionals, Midwest Dairy Association and the Alliance for Potato Research and Education (APRE). She holds a 1/3 interest in the Slavin Sisters Farm LLC, a 119 acre farm in Walworth, WI.

Cow’s milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCT.  M. V. Pontes, T. C. M. Ribeiro, H. Ribeiro, A. P. de Mattos, I. R. Almeida, V. M. Leal, G. N. Cabral, S. Stolz, W. Zhuang and D. M. F. Scalabrin.  Nutrition Journal. 2016;15:19.  DOI: 10.1186/s12937-016-0138-0

• Conclusion: A cow’s milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract.
• Funding: This study was funded by Mead Johnson Nutrition…The study products were provided by Mead Johnson Nutrition. Dr. Scalabrin, S. Stolz, and W. Zhuang work in Clinical Research, Department of Medical Affairs at Mead Johnson Nutrition. All of the remaining authors have no financial relationships to disclose.

Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001–2012.  Ann M. Albertson, Marla Reicks, Nandan Joshi and Carolyn K. Gugger.  Nutrition Journal 2016;15:8.  DOI: 10.1186/s12937-016-0126-4

• Conclusions: The data from the current study suggest that greater whole grain consumption is associated with better intakes of nutrients and healthier body weight in children and adults. Continued efforts to promote increased intake of whole grain foods are warranted.
• Competing interests:  Marla Reicks received an unrestricted gift from the General Mills Bell Institute of Health and Nutrition during the manuscript preparation to support research at the University of Minnesota.  Carolyn Gugger and Nandan Joshi are current employees and stockholders of General Mills, Inc.  Ann Albertson was an employee of General Mills, Inc during the conception, analysis and initial preparation of the manuscript. She is currently retired from General Mills.
• Non-financial competing interests: General Mills, Inc is a global consumer foods company that manufactures and sells products across a broad variety of food categories, including grain-based foods. General Mills product portfolio includes ready-to-eat cereals, cereal bars, baked goods, flour, and salty snacks that may contain whole grain.

You’ve heard of cola wars?  Try yogurt.

Here’s Chobani’s opening salvo from the New York Times on January 10, and Stephanie Strom’s account of it:

The ad says:

Did you know that not all yogurts are equally good for you?…

Look, there’s potassium sorbate as a preservative in Yoplait Greek 100.  

Potassium sorbate.  Really.  That stuff is used to kill bugs.

There’s sucralose used as a sweetener in Dannon Light & Fit Greek.  

Sucralose?  Why?  That stuff has chlorine added to it!…

Chobani simply 100 is the only 100-Calorie Greek Yogurt without a trace of any artifical sweeteners or artificial preservatives.

Shades of The Food Babe!

Will yogurt wars help Chobani’s bottom line?

According to Politico Pro

Chobani has taken its dispute over yogurt ingredients with rival Dannon to court, filing a lawsuit Friday that asks a federal judge to declare that claims made in its advertisements “do not constitute false, misleading, disparaging, or deceptive statements”…Chobani’s lawsuit, filed in the U.S. District Court for the Northern District of New York, follows a letter sent by Dannon on Jan. 7 asking Chobani to discontinue the advertisements.

General Mills, which owns Yoplait, has also sued on the grounds that Chobani’s claims are false and misleading (here are General Mills’ complaint and supporting memo).

And here’s Chobani’s response.

We shall see.

Update, January 29

The Court ruled that Chobani cannot criticize its rivals’ ingredients but can promote its products as natural.  The case is Chobani LLC v The Dannon Company, 3:16-cv-00030, filed in the Northern District of New York on January 8; and 0:16-cv-00052-MJD-BRT filed in the US District Court District Of Minnesota on Jan 10.

Chobani’s press release puts a positive spin on the ruling (sent via e-mail):

Chobani Continues to Fight the Good Fight 

Continues to inform consumers about what’s in their cup

NORWICH, N.Y., Jan. 29, 2016 /PRNewswire/ — Chobani, LLC, (“Chobani”), maker of the #1 Greek Yogurt Brand in America, said today that, while it awaits its day in court, it will continue its mission to call on food makers to use only natural ingredients. Chobani will respect the Court’s preliminary decision as it continues its campaign to provide consumers with more information about natural ingredients versus artificial ingredients. As part of the ruling, the Judge said Chobani is free to continue to spread its message about the value of selecting natural ingredients.

“This is not a marketing campaign, it’s a mindset campaign, and it outlines the difference between using only natural ingredients versus artificial ingredients,” said Peter McGuinness, Chief Marketing and Brand Officer, Chobani. “While we’re disappointed by the preliminary ruling, we’re committed to continuing the conversation and it’s good to see big food companies like General Mills starting to remove artificial ingredients from some of their products, like their cereals. In the end, if we can give more people more information while helping other food companies make better food, everyone wins.”

Chobani launched its Chobani Simply 100 Greek Yogurt campaign on January 6, 2016, to help people make more informed decisions about their food choices. Chobani still believes that highlighting the difference between natural and artificial ingredients, specifically sweeteners and preservatives, is important.

Chobani is committed to making high quality Greek Yogurt with simple, authentic, and only natural ingredients, such as fresh milk from local farmers and wholesome fruit. Chobani Simply 100 Greek Yogurt is the only nationally distributed brand of reduced calorie Greek Yogurt that does not contain artificial sweeteners or artificial preservatives.

My latest Viewpoint, “Corporate funding of food and nutrition research: science or marketing,” was published yesterday in JAMA Internal Medicine 2016;176 (1):13-14.  doi:10.1001/jamainternmed.2015.6667.

Systematic Review of Pears and Health. Holly Reiland, BS Joanne Slavin, PhD, RD.  Nutrition Today November/December 2015 – Volume 50 – Issue 6 – p 301–305.  doi: 10.1097/NT.0000000000000112.  

• Conclusions: Animal studies with pears suggest that pears may regulate alcohol metabolism, protect against ulcers, and lower plasma lipids. Human feeding studies with pears have not been conducted. In epidemiological studies, pears are combined with all fresh fruits or with apples, because they are most similar in composition. The high content of dietary fiber in pears and their effects on gut health set pears apart from other fruit and deserves study.
• Funding: The authors received a grant from USA Pears in the past. The authors provided their own funding to allow this article to publish as Open Access.
• Comment: Pears are a great fruit but the marketing purpose of this study is evident from this press release from the Pear Bureau Northwest: “While the body of evidence connecting pear intake and health outcomes is still limited, USA Pears has been contributing to research efforts by commissioning independent studies to learn and affirm the heath attributes of pears. Visit www.usapears.org for additional pear research, nutrition resources and recipes.”

Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents – Findings from the MyBreakfast Study.  Norimah AK , H. C. Koo, Hamid Jan JM, Mohd Nasir MT, S. Y. Tan, Mahendran Appukutty, Nurliyana AR, Frank Thielecke, Sinead Hopkins, M. K. Ong, C. Ning, E. S. Tee.  PLoS ONE 10(10): e0138247. doi:10.1371/journal.pone.0138247

• Conclusion: Whole grain is consumed by only a minority of Malaysian children and adolescents and even among consumers, intakes are well below recommendations. Efforts are needed to firstly understand the barriers to whole grain consumption among Malaysian children in order to design effective health promotion initiatives to promote an increase in whole grain consumption.
• Funding: The Nutrition Society of Malaysia received an unrestricted research grant from Cereal Partners Worldwide, Switzerland and Nestleé R&D Center, Singapore. This financial support was provided in the form of salaries for authors but the funders did not have any additional role in the study design, data collection and analysis or decision to publish. Frank Thielecke was an employee of Cereal Partners Worldwide at the time this study was conducted. He now works for Nestec SA. Sinead Hopkins is employed by Cereal Partners Worldwide (CPW), Switzerland and Moi Kim Ong and Celila Ning are employed by Nestleé R&D Center, Singapore….Nestlé and Cereal Partners Worldwide have a commercial interest in breakfast cereals.
• Comment: I learned about this study from a comment on Retraction Watch, which reported that PLoS One had filed a correction to the funding section.  The correction says that the salaries were for research assistants, not authors.

Walnuts Consumed by Healthy Adults Provide Less Available Energy than Predicted by the Atwater Factors.  David J Baer*, Sarah K Gebauer, and Janet A Novotny. J Nutrition First published November 18, 2015, doi: 10.3945/​jn.115.217372.

• Conclusion: Consistent with other tree nuts, Atwater factors overestimate the metabolizable energy value of walnuts. These results could help explain the observations that consumers of nuts do not gain excessive weight and could improve the accuracy of food labeling.
• Funding: This research was funded by the USDA and the California Walnut Commission… DJ Baer was funded by the USDA and the California Walnut Commission.

Cardiorespiratory Fitness, Body Fatness, and Submaximal Systolic Blood Pressure Among Young Adult Women.  Prasad Vivek Kumar, Drenowatz Clemens, Hand Gregory A., Lavie Carl J., Sui Xuemei, Demello Madison, and Blair Steven N.  Journal of Women’s Health, 2015 ahead of print. doi:10.1089/jwh.2015.5307.

• Conclusion: CRF, BF%, and BMI seem to have critical roles in determining SSBP with CRF and BF% being more potent at lower intensity exercise, whereas BMI was more strongly associated at higher intensity exercise.
• Funding for this project was provided through an unrestricted grant from The Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis, and interpretation, or preparation and submission of this article. The authors thank the Energy Balance staff and study participants for their contributions. No competing financial interests exist. 
• Comment: This is one of the papers produced by participants in the now defunct Global Energy Balance Network formerly sponsored by Coca-Cola.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including metaanalyses, of the evidence from human and animal studies. PJ Rogers, PS Hogenkamp, C de Graaf , S Higgs , A Lluch , AR Ness , C Penfold , R Perry , P Putz , MR Yeomans and DJ Mela.  International Journal of Obesity advance online publication, 10 November 2015; doi:10.1038/ijo.2015.177

• Conclusion¨The preponderance of evidence from all human randomized controlled trials indicates that LES [low-energy sweeteners] do not increase EI [energy intake] or BW [body weight], whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.
• Conflict: This work was conducted by an expert group of the European branch of the International Life Science Institute (ILSI Europe). The expert group received funding from the ILSI Europe Eating Behaviour and Energy Balance Task Force. Industry members of this task force are listed on the ILSI Europe website at www.ilsi.eu.
• Comment: ILSI is funded by food companies.

I am often asked about the potential dangers of arsenic in rice.  As with all such questions, I start with the FDA.

The FDA says the amounts of arsenic it finds in foods do not pose a risk at current levels of consumption.  Brown rice, it finds, has levels of arsenic much higher than those in white rice.

Consumer Reports also tested rice samples.  It recommends against feeding rice cereals to children.  It calls on the FDA to set standards for arsenic levels in rice products.  These, according to the tests, vary widely.  Basmati rice from California, India and Pakistan and U.S.-grown sushi rice are “better choices.”  Just one serving of rice cereal or rice pasta could put a child over CR’s recommended weekly limit

On this basis, Congresswoman Rosa DeLauro (D-CT) introduced legislation— The R.I.C.E (Reducing food-based Inorganic Compounds Exposure) Act— to limit the amount of inorganic arsenic, the most toxic form of arsenic in rice foods.  The act would require the FDA to set limits on arsenic in rice.

Politico reported that the US Rice Federation questioned the science behind the Consumer Reports story:

Arsenic in our food supply is a challenging, yet unavoidable, situation which is why we support the FDA studying the issue carefully,” said Betsy Ward, president and CEO of the USA Rice Federation.  “But CR’s new consumption recommendations aren’t supported by any science that we’ve seen.”

How does arsenic get into rice?  Lots of ways, apparently: naturally occurring, but also from arsenic pesticides that persist in soil.  The flooding makes rice especially susceptible.

What to do while waiting for a resolution to safety questions?  Prepare rice in a coffee percolator says a recent study.  This flushes out a lot of the arsenic.

And everything in moderation, of course.