Search results: food strategy

Louise Fisher, a dietitian and food and nutrition consultant in Australia, writes:

I’ve loved your recent blog posts on Coca Cola’s sponsorship of research that fortuitously concludes that it’s not Coke that’s making us fat, it’s lack of exercise.  It’s no surprise to see that the alcohol industry here in Australia is running the same line. I just received a link to a guide to “get the facts on alcohol” Beer the beautiful truth from Lion, one of our biggest suppliers of beer. And what do you know, beer doesn’t make you fat, you just need to be more active.

Under Myth Busters on page 4:

DOES ALCOHOL CAUSE WEIGHT GAIN? DOES BEER MAKE ME FAT? It’s not the alcohol per se that causes weight gain. Eating or drinking more calories/kilojoules (energy) than you burn, from any food or drink, can contribute to weight gain. It is important to balance the calories we eat and drink with those we burn through physical activity and basic functioning like breathing and sleeping.

If you do drink, it’s important to know the calories in alcohol mainly come from the alcohol content, as well as the carbohydrate and sugars content. For example, a low strength beer will typically have less calories than a full strength beer. So really, it comes down to how much and what type of alcohol you have and what you eat with it – the chips, the kebab. Plus how active you are.

Hey.  If this strategy works for Coca-Cola….

I wrote this piece for The Guardian in response to the New York Times article earlier this week about Coca-Cola’s funding of scientists who think obesity is more about exercise than drinking sodas:

These days, you almost have to feel sorry for soda companies. Sales of sugar-sweetened and diet drinks have been falling for a decade in the United States, and a new Gallup Poll says 60% of Americans are trying to avoid drinking soda. In attempts to reverse these trends and deflect concerns about the health effects of sugary drinks, the soda industry invokes elements of the tobacco industry’s classic playbook: cast doubt on the science, discredit critics, invoke nanny statism and attribute obesity to personal irresponsibility.

Casting doubt on the science is especially important to soda makers. Overwhelming evidence links habitual consumption of sugary drinks to poor health. So many studies have identified sodas as key contributors to chronic health conditions – most notably obesity, type-2 diabetes and coronary artery disease – that the first thing anyone trying to stay healthy should do is to stop drinking them.

Soda companies know this. For at least the last 10 years, Coca-Cola’s annual reports to the US Securities and Exchange Commission have listed obesity and its health consequences as the single greatest threat to the company profits. The industry counters this threat with intensive marketing, lobbying and millions of dollars poured into fighting campaigns to tax or cap the size of sugary drinks.

But it is also pours millions into convincing researchers and health professionals to view sodas as benign.

Just last month, the Mayo Clinic Proceedings published a study arguing that the results of national dietary surveys, such as those that link sugary drinks to type-2 diabetes, are so flawed that they constitute a major misuse of public funds. The authors report honoraria, speaking and consulting fees from Coca-Cola.

This week’s revelation of Coca-Cola’s funding of the Global Energy Balance Network is only the latest example of this strategy in action. The Network promotes the idea that to prevent obesity you don’t need to bother about eating less or drinking less soda. You just have to be more active. Never mind that most people can’t lose weight without also reducing their intake.

A reporter who looked into this group discovered that Coca-Cola had funded the research of the scientists behind it, and generously. The network’s website was registered to Coca-Cola. None of this, however, had been made explicit.

Most nutrition professional journals now require researchers to declare who funds their studies, making it possible to compare study outcomes with funding sources. Studies sponsored by Coca-Cola almost invariably report no association of sugary drinks with diabetes, they question the validity of studies that do find such associations or, as in the case of Global Energy Balance Network investigators, they find activity to be the most important determinant of body weight.

Analyses of studies funded by Coca-Cola or its trade association demonstrate that they have an 83% probability of producing results suggesting no harm from soda consumption. In contrast, the same percentage of studies funded by government agencies or independent foundations find clear linkages between sugary beverages and such conditions. Coincidence? I don’t think so.

Since March, I’ve been posting industry-funded studies with results that favor the sponsor’s interests every time I find five of them. They are easy to find. Despite pleas to readers to send me industry-funded studies that do not favor the sponsor, I hardly ever get them. Whenever I come across a study that shows no harm from sodas, I immediately look to see who paid for it.

Soda companies spend generously to convince researchers and health professionals not to worry about sodas’ health effects. But why do researchers take the money? It is too simplistic to say that they are “bought.” Industry-funded investigators say they believe the funding has no effect on the design, conduct or interpretation of their research. But research involves choices of questions, assumptions and methods. It is not difficult to carry out a study that appears to meet high scientific standards yet fails to include critical controls that might lead to alternative conclusions.

Researchers funded by Coca-Cola need to take special care to control for unconscious biases but can only do this if they recognize the possibility. Many do not. Neither do many peer reviewers or editors of scientific journals. Although food-company financial support should not necessarily bias results, it appears to do so in practice.

Industry-funded scientists resent questioning of the influence of sponsorship on the quality of their science. They charge that investigators who find adverse effects of sodas on health are equally biased by career goals, righteous zeal or anti-corporate morality. Yes, independent scientists may have biases of their own, but their overarching research goal is to improve public health. In contrast, the goal of soda companies is to use research as a marketing tool.

Disclosure is essential. If a study is funded by Coca-Cola, caveat emptor.

Because transportation from rural areas is expensive and trucks are few and far between (one result of the U.S. embargo), the Cuban government is promoting urban agriculture.  Our Food First tour group went to a small organic farm and store (Organopónico) in Havana:

The farm grows a wide variety of vegetable crops, some outdoors but some under mesh.  The sun is hot.

The farm sells produce to local residents.  I watched a steady procession of people coming to shop, only to be disappointed at the scarcity of items available.  It’s too hot to grow much this time of year.

The board lists prices in pesos (indicated by $)—$4 to $10 a pound.

Another of the many Cuban contradictions: Cuba has two currencies, pesos and CUCs (Cuban Convertables).  A CUC is roughly equivalent to one dollar, or 24 pesos.  Salaries are paid in pesos.  Markets sell in CUCs or, recently, both.  This system, designed to take advantage of tourist dollars, is slated to end soon.

To put vegetable prices in context: the average Cuban salary is about 470 pesos a month, or $20 (but note that Cubans are given free food rations, education, and health care).

We also visited the much larger 25-acre farm in Havana’s Alamar neighborhood.

You can see the surrounding apartments in this photo, but not the next one.

With no money for gas or tractors, plowing gets done with oxen.

This farm also has a store.

I waited on a long line to buy a glass of freshly squeezed sugar cane juice.

This was incredibly delicious and totally worth the wait.

How much sugar is in this?  I searched for, but cannot find reliable Nutrition Facts for fresh cane juice.  If you happen to know where to find this, please send.*

On Monday, I’ll file the last of these Cuba posts, this one on food availability.

Note: the resumption of diplomatic relations and agreement to reopen embassies yesterday should make travel much easier.

*Answer to query: Thanks to Andy Bellatti and Cara Wilking for sending this link to a Nutrition Facts label for cane juice.  No wonder it was so good: 30 grams of sugar in 8 ounces!

Thanks to Courtney Scott, a doctoral student at University of North Carolina, for sending me this account of the fate of Britain’s salt reduction strategies, published in the BMJ (British Medical Journal).

The lead author on the article is Dr. Graham MacGregor, Britain’s leading advocate for diets lower in salt.  It is about the derailing of Britain’s remarkable successful salt reduction strategy.

Under the auspices of Britain’s Food Standards Agency (FSA), the salt reduction program initiated in the early 2000s—getting companies to slowly but steadily reduce the salt in their products—was working well.

Most impressive: salt intake, blood pressure, heart disease, and stroke declined in parallel with the decline in salt in the food supply.

But in 2010, Britain elected a more conservative government.

Andrew Lansley was appointed secretary of state for health, and he moved the responsibility for nutrition from the FSA to the Department of Health. This disrupted the salt reduction programme, making it unclear who would be responsible for the policy. In 2011 Lansley launched the responsibility deal, whereby he made the alcohol and food industries responsible for reducing alcohol consumption and improving nutrition, respectively. As a result, salt reduction lost momentum.

The key points of the article:

• Most of the foods that industry currently provide are very high in salt, fat, and sugars and are therefore more likely to cause cardiovascular disease and predispose to cancer than healthier alternatives.

• The UK’s salt reduction programme…led to a significant reduction in population salt intake, accompanied by reductions in blood pressure and cardiovascular mortality.

• The programme has been set back by the coalition government’s decision to hand power back to the food industry as part of the responsibility deal.

• An independent agency for nutrition with a transparent monitoring programme is urgently needed to improve the food that we eat.

As I’ve explained previously, most salt—80% or more—in American diets is already in processed and prepared foods when they are presented to us.  That’s where the salt reduction has to come from.  As the authors explain,

Members of the food industry have said that they are keen to reformulate their foods to make them healthier. All they require is to be on a “level playing field” with the other major companies, so that they can make their foods healthier in a structured, incremental way. They need to be assured that there are proper reporting mechanisms in place and that all of the companies are being monitored equally. Enforcement is required, and if it doesn’t work, regulation or legislation must be enacted.

The debates over salt may be the most contentious in the field of nutrition (as the Washington Post puts it), but the parallels between the British decline in salt intake and in salt-related disease are impressive.

On a population basis, eating less salt is healthier.

This is something you can’t easily do on your own.  The food industry has to do it.  And food companies don’t want to, for obvious reasons.

Hence: the need for regulation.

A new study in PLoS Medicine provides documentary evidence of sugar industry manipulation of research on dental caries in the 1960s and 1970s.

The paper is a formal presentation of an article in Mother Jones (which I wrote about in a previous post).

The researchers are at UCSF, which sent out a press release:

A newly discovered cache of industry documents reveals that the sugar industry worked closely with the National Institutes of Health in the 1960s and ‘70s to develop a federal research program focused on approaches other than sugar reduction to prevent tooth decay in American children.

The archive of 319 industry documents, which were uncovered in a public collection at the University of Illinois, revealed that a sugar industry trade organization representing 30 international members had accepted the fact that sugar caused tooth decay as early as 1950, and adopted a strategy aimed at identifying alternative approaches to reducing tooth decay.

These approaches, as the article explains, involved encouraging the NIH to do research on mitigating or preventing tooth decay, which is fine in theory, but in practice distracted the dental research community from trying to discourage sugar consumption.

The analysis showed that in the late 1960s and early 1970s, the sugar industry funded research in collaboration with allied food industries on enzymes to break up dental plaque and a vaccine against tooth decay. It also shows they cultivated relationships with the NIDR and that a sugar industry expert panel overlapped by all but one member with the NIDR panel that influenced the priorities for the NIH tooth decay program. The majority of the research priorities and initial projects largely failed to produce results on a large scale, the authors found.

Understandably, the Sugar Association is not pleased.  Here is what the Sugar Association told Time Magazine:

It is challenging for the current Sugar Association staff to comment directly on documents and events that allegedly occurred before and during Richard Nixon’s presidency, given the staff has changed entirely since the 1970s. However, we are confused as to the relevance of attempts to dredge up history when decades of modern science has provided answers regarding the role of diet in the pathogenesis of dental caries… A combined approach of reducing the amount of time sugars and starches are in the mouth, drinking fluoridated water, and brushing and flossing teeth, is the most effective way to reduce dental caries.

As Stan Glantz pointed out in his blog post, “This sounds similar to the statement from Brown and Williamson Tobacco put out in 1995 in response to our first papers based on tobacco industry documents.”

Distracting researchers from focusing on underlying causes is a strategy perfected by the tobacco industry and copied widely by other industries making potentially harmful products, as shown clearly in the just released film, Merchants of Doubt (a must-see).

The New England Journal of Medicine has a new study that suggests the need to rethink whether to feed peanuts to babies.

As the Wall Street Journal explains, peanut allergies can be life-threatening and they are increasing among the population.

Dr. Gideon Lack and his colleagues randomly assigned infants to be fed peanuts (really, peanut butter) until they were five years old.  The children fed peanuts had far fewer peanut allergies than those who were not exposed to peanuts.

Of the more than 500 infants who showed no signs of peanut allergies at the start of the trial, the prevalence of peanut allergies at age 5 was 13.7% in the avoidance group and only 1.9% in the consumption group (see the journal’s video for an easy explanation).

A result like this is extremely unlikely to have occurred by chance.

Dr. Lack got the idea for the study when he noticed that peanut allergies were rare in Israel.  Israeli infants are routinely offered foods made with peanuts, whereas British and American parents have been told not to feed peanuts to young children.

The authors conclude:

Our findings showed that early, sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants. Conversely, peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption, which raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy.

The implications are clear: expose young children to peanut butter (the accompanying editorial explains how to do this safely).  And to prevent choking, don’t give them peanuts until they can chew.

Other newspaper articles on this topic:

• USA Today
• Washington Post
• New York Times

A reader, Alice Campbell, writes:

Dr. Nestle,

Coca-Cola’s new product marketing, “Share a Coke with “insert name here”” has got me thinking. I will admit, initially my thought on the topic was limited to disappointment at the limited chances of finding a can with my name on it. However, I have been pondering, is this marketing strategy an attempt by Coca-Cola to avoid responsibility for the health consequences associated with selling an sugar filled, unhealthy product? Will they attempt to claim that that the suggested serving sizes is half of the container because they are suggesting you share? I have not observed an increase in people sharing their can of Coke. Your thoughts on the issue would be appreciated.

Love the question, particularly because I was given one of these, name made to order.  This can is most definitely not to share, not least because it’s the 7.5-ounce size (nevertheless, 90 calories and a whopping 25 grams of sugar).

Don’t you wish you had one with your name on it?

That’s the point.  This has been one of Coke’s most successful public releations campaigns, ever.

But Share a Coke has generated criticism that it violates Coke’s promise not to market to kids.  In Ireland, the cans appear with the 100 most popular names of children ages 7 and 8.

In countries like Pakistan, the cans are labeled with “mama” or “papa,” again raising questions about the target age group.

The campaign may be generating buzz—it’s fun to see your name on a Coke can— but once you have one, that’s it.  Share a Coke is fizzling as a sales generator.

Better get your collectors’ item now!