Search results: a life in food

Yet another study confirms the obvious: kids prefer foods with cartoons on the package. Why should this be obvious?  Why else would the cartoons be there if not to sell products to kids?

The latest study comes from the Archives of Pediatrics and Adolescent Medicine.

It says pretty much the same thing as the study published in Pediatrics last year by investigators from the Yale Rudd Center.

The newer study did something cute. It invented a cereal box and tested kids’ responses to it and variations with and without cartoons of the penguins Mumble and Gloria from the movie Happy Feet .

The results:

• Kids preferred the taste of the cereals with cartoons
• They preferred boxes labeled “Healthy Bits” more than “Sugar Bits”
• They most preferred “Healthy Bits” with a cartoon
• They least preferred “Sugar Bits” without a cartoon

This is why is would be a good idea to just say no to cartoons on food packages aimed at kids.

I was pleased to see the article in last Sunday’s New York Times about New York City’s efforts to improve school food.   The story focused on PS 56, a school that serves low-income kids in Brooklyn.

The article  describes the food revolution that is taking place in New York City schools, one described in an excellent report by Hunter College faculty.

In singling out PS 56, the writer chose a good example.

I visited there a year or so ago, and wrote about it at the time under the title “School food: it can be done!”  Its cafeteria is an astonishing place.  The food smelled good.  It tasted good.  The staff cared whether the kids ate what they cooked.

When I asked whether this school was typical, the answer was “not exactly.”  How come it worked?  Everyone pointed to the principal, Deborah Clark-Johnson, who believes it’s important to feed kids well and who totally supported the cafeteria staff.

So one way to improve school food is to recruit caring staff.

Another, for older kids, is to encourage them to make better choices.  An article in the Boston Globe discusses Cornell professor Brian Wansink’s work in this area:

But it turns out that students are susceptible to the same marketing strategies that grocery stores have been using for years. Several experiments have shown that children will be more likely to eat items if they see them early in the lunch line and find them attractive and convenient to pick up. Putting fruit in a good-looking bowl works. So does putting a salad bar in a prominent place. Calling your carrots “X-ray vision carrots” can double sales.

I’ve discussed Professor Wansink’s work on lunch line redesign in an earlier post.  It raises an interesting question: is this the right strategy, or should schools just serve healthy food in the first place?

This is worth discussion.  Want to weigh in?

I write a monthly (first Sunday) Food Matters column for the San Francisco Chronicle.  Today’s is about the difficulties of doing nutrition research.  The Chronicle headline writer titled it, “Be skeptical of food studies.”  Oops.

I’m not skeptical about Food Studies—the capitalized field of study—at all.  My NYU department started undergraduate, master’s, and doctoral programs in Food Studies in 1996 and they have flourished ever since.

The column is about small-letter food studies, meaning nutrition and food research studies:

Q: You were quoted saying that you didn’t believe newspaper reports linking diet sodas to an increased risk of stroke and heart disease. How do you decide whether research is good or bad?

A: This one was easy. I didn’t think it made sense. Mind you, I’m no fan of diet sodas. They violate my rule never to eat anything artificial. And I don’t like the taste of artificial sweeteners.

Whenever a study comes out claiming harm – or benefits – from eating a single food or ingredient, I get skeptical. That’s why I also questioned these recent study results: high-fructose corn syrup (HFCS) makes rats gain weight faster than sucrose (table sugar); zinc supplements prevent symptoms of the common cold; and pomegranate juice has greater health benefits than any other kind of fruit.

When I read about single-factor studies, I want to know three things: Is the result biologically plausible? Did the study control for other dietary, behavioral or lifestyle factors that could have influenced the result? And who sponsored it?

Plausibility: The diet soda study used a self-reported questionnaire to find out how often people reported drinking diet sodas. Nine years later, people who reported habitually drinking diet sodas had a 60 percent higher rate of stroke and heart attacks. The rate was somewhat lower when controlled for age, sex, race, smoking, exercise, alcohol, daily calories and metabolic syndrome.

Leaving aside the unreliability of self-reported dietary intake, the study raises a more important question. Was it designed to investigate the link between diet sodas and stroke or was this just an accidental finding? The questionnaire undoubtedly asked hundreds of questions about diet and other matters. Just by chance, some of them could be giving results that look meaningful. And the increase in stroke risk seems surprisingly high for something not previously known to be a stroke risk factor.

Mostly, I can’t think of a biological reason why diet sodas might lead to cardiovascular disease unless they are an indicator for some other stroke risk factor such as obesity, high blood pressure or binge drinking. It would take a study designed to test this idea specifically – and a good biological explanation – to convince me that diet sodas cause strokes.

The plausibility issue also rises in the HFCS study. Again, I’m not a fan of HFCS – we would all be healthier if we ate less sugar – but from a biochemical standpoint, HFCS and table sugar are pretty much the same. They have similar amounts of glucose and fructose, are digested as quickly and are metabolized the same way. Even the average amounts consumed are about the same. That soda companies are replacing HFCS with sucrose is strictly about marketing, not health.

Controls: The zinc-and-colds study was a comprehensive review (a “meta-analysis”) of previous studies done since the first one in 1984. Eleven studies have showed some benefit; seven have not. All of them were placebo controlled, double-blind. This meant that half the participants were given a dummy pill, and neither participants nor investigators were supposed to know who was taking what.

But in some studies, the zinc takers complained about the taste of the pills, hinting that they knew what they were.

I’ve heard this before. In the early 1970s, National Institutes of Health investigators did a study of vitamin C and the common cold. They got about 300 NIH employees to take either vitamin C or a placebo, double-blind. The tantalizing result: People taking vitamin C reported fewer colds and milder symptoms than people taking placebos.

Alas, many participants withdrew from the study before it ended. When asked why, they admitted tasting the pills. The investigators reanalyzed the results. Bingo! No matter what pill the participants actually took, those who thought they were taking vitamin C reported fewer colds and milder symptoms.

If the studies were not really blinded, the zinc results are questionable. I have no doubt that many people feel better when they take zinc supplements, but I’m not sure whether that’s because of something zinc really does or just its placebo effect.

Sponsorship: Vested interests influence the design and interpretation of studies. The best-designed studies control for factors that might influence results. Even so, their results require interpretation. Interpretation requires interpreters. Interpreters bring their own biases into the interpretation.

I mention pomegranate juice because one of its major producers sponsors studies to hype its benefits. Yes, pomegranates are delicious, but antioxidant powerhouses? So are most fruits. Pomegranates may have high antioxidant activity, but compared with what? Its maker does not say. Sponsored research is also about marketing, not health.

Nutrition research is hard to do, which makes study design and interpretation particularly challenging. Nutrition is a thinking person’s field, requiring careful analysis at every step. When you hear a result that sounds too good to be true, it usually is.

After a snow-induced stranding in Miami, the vacation ends, and FoodPolitics.com resumes by catching up on missed events.

Other missed events will follow, but let’s start with USDA’s announcement that it is requiring Nutrition Facts labels on meat and poultry products.

In the Final Rule published on its website, USDA says it will require labeling of fat and calorie content on all industrially packaged intact or ground, single-ingredient, raw meat and poultry by January 1, 2012.  USDA’s rule exempts small producers, however.

Nutrition Facts on meat and poultry have been a long time coming. USDA seriously considered such labels in 1990 when Congress passed the Nutrition Labeling and Education Act.  That act only required Nutrition Facts labels on FDA-regulated foods, which include pretty much everything except USDA-regulated meat and poultry.

By the time the USDA finally got around to proposing its own version in 2001, the agency made labeling voluntary.

You can guess what happened.  Meat and poultry producers happily volunteered not to label their products.

Why not?  Meat producers greatly prefer that you remain ignorant of the amount of fat and calories meat contains.

As is evident from this label example, meat labeling raises issues related to calories, fat, saturated fat, and serving size.

Calories: this particular ground meat contains 21 grams of protein and 11 grams of fat.  These provide 190 calories, per serving.

Fat: Fat is the major determinant of calories (9 per gram as compared to 4 per gram for protein). That is why more than 50% of the calories in this ground beef come from fat.

Saturated fat: The 4.5 grams of saturated fat in this meat account for 22% of the Daily Value, a lot or a little depending on what else you eat.

Serving size: The serving size is a quite reasonable 4 ounces (like a quarter-pounder).  It represents, however, a substantial increase over previous USDA serving size suggestions.  Since 1958, the USDA has considered a meat serving to include just 2-to-3 ounces.

As I discuss in Food Politics, pressures from meat producers over the years induced government agencies to steadily increase the amount of meat (or meat substitutes) recommended for daily intake.

• 1958 to 1989 (USDA food guides): two daily servings of 2-3 ounces for a total of 4-to-6 ounces
• 1990 (Dietary Guidelines): two daily servings of 2-3 ounces for a total of 6 ounces
• 1992 (Food Guide Pyramid): two-to-three daily servings for a total of 5-to-7 ounces
• 1995-2005 (Dietary Guidelines): two-to-three daily servings for a total of 4-to-9 ounces

If advice to consume two-to-three daily servings of meat (or meat substitutes) still holds, the recommendation will now be 8-to-12 ounces.

The 2010 edition of the Dietary Guidelines is overdue and should be released any day now.   In its report last June, the Dietary Guidelines Advisory Committee said:

Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. In addition, increase the intake of seafood and fat-free and low-fat milk and milk products and consume only moderate amounts of lean meats, poultry, and eggs.

What will the new guidelines say about the amount of meat we should all be eating?  I can’t wait to find out.

Happy new year to all!

Addition, 1-1-11: I forgot to cite the USA Today story on this (I’m quoted).

Food politics in action: The CDC announced yesterday that its scientists had recalculated the extent of foodborne illnesses in the United States and cut the estimates by nearly half.

The old mantra (1999):

• 76 million cases of illness
• 325,000 hospitalizations
• 5,000 deaths

The new mantra (2010):

• 48 million illnesses
• 128,000 hospitalizations
• 3,000 deaths

But no, the new figures do not mean that the food supply is safer.  The reduction, says the CDC, is no cause for celebration.  Instead, it only means that tracking methods have improved.     As the editorial accompanying the CDC reports puts it,

Bottom line: with the exception of Vibrio spp., things don’t seem to be getting worse; however, after the initial decline since the USDA regulatory changes in 1995, one does not see evidence of sustained improvement.

The Politics

OK.  Very interesting.  The old estimates weren’t as good as the new estimates.  But why announce what appears to be a huge reduction in foodborne illness now, especially if it really isn’t a reduction?

Is the CDC unaware that a highly contentious food safety bill still lingers in Congress, with only days to go until the congressional term ends?

I sat in on the press conference call yesterday and heard CDC’s weak attempts to minimize the drop in numbers and maximize the fact that foodborne illnesses are still way too high (“one in six Americans”).

I’m not the only one concerned about the timing.  The headline and first sentence in Food Chemical News:

Lower CDC foodborne illness numbers could undercut food safety bill. Just as Congress seems to be on the edge of passing the biggest food safety bill in decades, the Centers for Disease Control and Prevention released today two new studies that reduce the previous estimates of people suffering from foodborne illness in the United States.

CDC officials must be worried.  I hear rumors that CDC press people are complaining to reporters who lead off their stories with the reduced numbers, as most did.

William Neuman in the New York Times, for example, correctly reported:

The federal government on Wednesday significantly cut its estimate of how many Americans get sick every year from tainted food.  But that does not mean that food poisoning is declining or that farms and factories are producing safer food. Instead, officials said, the government’s researchers are just getting better at calculating how much foodborne illness is out there.

And here is USA Today’s Beth Weise, also correctly:

Food isn’t making us as sick as we thought — almost 40% less, in fact. It’s not that the numbers of foodborne illnesses have suddenly decreased, but the Centers for Disease Control and Prevention says its methods for counting have become more precise.

Weise noted: “The new figures are long awaited in the food industry, which believed the previous numbers to be too high.”

Right.  That’s why the timing isn’t so good.

Why is the CDC doing this now?  Maybe this is just a matter of journal publication dates but it would be painfully ironic if CDC’s “better” numbers undercut enactment of the food safety bill.

The Science

That said, the CDC has done a splendid job of making the rationale for these estimates accessible on its main web page for this topic.  The page links to the two scientific papers, one on estimates of illnesses caused by  major pathogens, and the second on unspecified (unidentified) agents.

CDC also presents a detailed table comparing the 1999 and 2010 estimates.

But the 2010 estimates, like the 1999 estimates, are still guesses—just better ones based on methods that were not available in 1999.

Much remains uncertain about the extent of foodborne illness, because they are so difficult to  track:

• Many pathogenic organisms cause foodborne illness; some are characterized, some not.
• Gastrointestinal illness is not always due to food poisoning.
• Most people with foodborne illnesses do not report them to doctors.
• Doctors rarely take stool samples.
• Laboratories test stool samples for only the most frequent pathogens.
• Laboratory tests for pathogens are not always reliable.

Indeed, the CDC estimates that 80% of foodborne illnesses are due to unspecified causes, as are 56% of foodborne hospitalizations and deaths.

The CDC’s conclusion: the burden of foodborne illness is high and keeping pathogens out of the food system is still a good idea.

That, of course, is precisely why it is so important that Congress enact the food safety bill.   Its measures require preventive controls that should apply to pathogens, known and unknown.

Let’s hope Congress understands that foodborne illness is still a serious problem, does not misinterpret the CDC’s new numbers, and passes the legislation as its gift to the new year.

“Minimally processed food a health goal” is the title of today’s Food Matters column in the San Francisco Chronicle.

Q: I may be preaching to the choir here, but isn’t eating a variety of unprocessed (or at least minimally processed) foods the best way to make sure your diet is healthy?

A: Indeed it is, and processing is the healthful food movement’s new frontier. Processed is code for “junk” foods – foods of minimal nutritional value. These crowd the center aisles of supermarkets, add loads of unneeded calories, rely on added nutrients for health benefits, last forever on the shelves and generate enormous profits for their makers.

Sodas are the obvious examples. They have no nutrients (unless fortified), and all their calories come from added sugars.

The food industry will insist that practically everything you eat is processed in some way. Unprocessed foods are rare exceptions – fruits direct from the tree or vine, vegetables pulled from the ground, nuts from wherever they come from, and raw meat, fish, eggs or milk.

Everything else is at least minimally processed – washed, aged, dried, frozen, canned, pasteurized or cooked. But these cause little, if any, loss of nutritional value and make some nutrients more available to the body.

In contrast, more extreme processing changes foods. It reduces the nutritional value of basic food ingredients, adds calories from fats and sugars, and disguises losses in taste and texture with additives such as salt, colors, flavors and other chemicals. Manufacturers add vitamins, minerals, antioxidants, omega-3s and probiotics expressly to make health claims.

Manufacturers say they make the products to give you what you demand: cheap, easy-to-eat-anywhere foods that require no preparation and give you the tastes you love. They back these contentions with increasingly far-fetched health claims, billions of advertising dollars and lobbyists galore.

The big issue is “ultra-processing,” says Carlos Monteiro of the University of São Paulo in Brazil. Writing in the November issue of the online Journal of the World Public Health Nutrition Association, Monteiro ranks the effects of food processing on health as the most important issue in public health nutrition today.

Ultra-processed foods, he says, are the primary cause of the rapid rise in obesity and associated diseases throughout the world.

He charges the food industry with creating durable, convenient, attractive, ready-to-eat or ready-to-heat products that are so palatable that they are habit-forming. And they are meant to be eaten everywhere – in fast-food places, on the street and while watching television, working or driving.

Ultra-processed foods are much higher in calories for their nutrients than unprocessed and minimally processed foods. They have loads of fat, sugars and salt, but are low in vitamins, minerals and fiber.

They are often cheaper than relatively unprocessed foods, especially when sold in supersize portions at discounted prices. And they are often the only foods available in convenience stores or vending machines.

He notes that virtually unregulated advertising identifies ultra-processed foods and drinks as necessary – and, when nutrients are added, as essential – to modern lifestyles and health. Overall, Monteiro says, their high palatability, along with aggressive and sophisticated marketing, undermine the normal processes of appetite control and cause adults and children to overeat.

This is just another way of saying what former Food and Drug Administration head David Kessler says in his provocative book, “The End of Overeating.” Kessler argues that processed and fast foods high in fat, sugars and salt have turned us into a nation of “conditioned overeaters” unable to recognize hunger or satiety.

Current policies ensure that ultra-processed foods stay cheap, and it’s no accident that the relative cost of fruits and vegetables has gone up by 40 percent since the 1980s, while the relative price of sodas and fast food has declined.

If you can afford it, choosing relatively unprocessed foods is good advice. As I wrote in “What to Eat,” it’s best to stick to the real foods around the supermarket perimeter. My only slightly facetious shopping rules: Avoid processed foods with more than five ingredients, ingredients you can’t pronounce, and those with cartoons on the package aimed at marketing to kids.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

This article appeared on page L – 3 of the San Francisco Chronicle

A new middle-school curriculum guide released by WorldLink and the Center for Ecoliteracy invites students and teachers to ask, “What’s the story of my food?” Nourish: Food + Community, they say, is part of a national initiative—one that combines PBS programming, curriculum resources, website content, teacher seminars, and youth summits.  Its purpose?  To increase food literacy.

We want students to explore the question: How do the food choices we make—individually and as a society—affect the health of people and the environment?

The Center for Ecoliteracy is a nonprofit dedicated to education for sustainable living.  It also publishes the guide, Rethinking School Lunch, the curriculum guide to the film, Food, Inc. and other useful publications.

I get asked all the time for resources about how to fix school lunches.  Thanks to the Center for making this easier.

In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes “The big issue is ultra-processing.”  Because his Commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.

The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.

Monteiro makes it clear that all foods and drinks are processed to some extent.  Fresh apples are washed and, sometimes, waxed.  Drinking water is filtered.  Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:

• Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
• Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt.  These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
• Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).

The purpose of Type 3 ultra-processing is to create:

durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration (‘long shelf life’), to be transportable for long distances, to be extremely palatable (‘high organoleptic quality’) and often to be habit-forming. Typically they are designed to be consumed anywhere – in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.

Monteiro argues: “the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world.”

As evidence, he notes that ultra-processed products as a group are:

• Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
• [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
• Relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy.
• Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
• Available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
• The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.
• Promoted by lightly regulated or practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being of children.

Overall, he says:

Their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.

His groups the main points of his argument in three theses:

• Diets mainly made up from combinations of processed ingredients and unprocessed and minimally processed foods, are superior to diets including substantial amounts of ultra-processed products.
• Almost all types of ultra-processed product, including those advertised as ‘light’, ‘premium’, supplemented, ‘fortified’, or healthy in other ways, are intrinsically unhealthy.
• Significant improvement and maintenance of public health always requires the use of law. The swamping of food systems by ultra-processed products can be controlled and prevented only by statutory regulation.

Lest there be any confusion about the significance of this proposal for public health nutrition, an accompanying editorial (unsigned but assumed to be by Geoffrey Cannon) poses a serious challenge: “Nutrition science: time to start again.”

This editorial is about the significance of food processing, and in particular of ‘ultra-processed’ food and drink products. It is also about the nature, purpose, scope and value of nutrition science, which as conventionally taught and practiced, is now widely perceived to have run into the buffers or, to change metaphor, to have painted itself into a corner.

The editorial argues that nutritionists’ focus on nutrients, rather than foods, has led to the assumption that if foods contain the same nutrients, they are the same—even though it is never possible to replicate the nutritional content of foods because too much about their chemical composition is still unknown.

This notion is an exquisite combination of stupidity and arrogance, or else of intelligence and cunning. For a start, similar results can only be of those chemical constituents that are at the time known, and actually measured.

These are important ideas, well worth consideration and debate.  I am struck by their relevance to the latest survey of soft drink availability in American elementary schools.  Despite the efforts of the Clinton Foundation and the voluntary actions of Coca-Cola and Pepsi-Cola, the availability of soft drinks to young school children increased from 49.% to 61% just in the year from 2006-07 to 2008-09.  Soft drinks, in Monteiro’s terms, are ultra-processed.  Doing something about them requires statutory regulation.

Consideration of the effects of ultra-processing might help us look at what we feed our kids in a more constructive way.  This is important work.

Addition: I should have mentioned that Monteiro’s approach is consistent with that of the people (including me) who worked with the Strategic Alliance in Oakland, CA to write Setting the Record Straight: Nutritionists and Health Professionals ” Define Healthful Food.

The Alliance is California’s network of food and activity advocates, we’ve developed a definition of healthy food that asserts that truly healthful food comes from a food system where food is produced, processed, transported, and marketed in ways that are environmentally sound, sustainable, and just.

If you agree with Setting the Record Straight, you can endorse it on the Strategic Alliance’s website.