In a most unusual action, the New England Journal of Medicine has retracted a 2013 study of Mediterranean diets and published a new version of it at the same time.

The studies asked participants to consume one of three diets: (1) a Mediterranean diet supplemented with extra-virgin olive oil, (2) a Mediterranean diet supplemented with mixed nuts, and (3) a control diet with advice to reduce dietary fat.

The authors describe Mediterranean diets as containing a

high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats, and sweets; and wine in moderation, consumed with meals.

The conclusion of the original, widely publicized, but now retracted study:

In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

The conclusion of the newly analyzed version:

In this study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

Looks the same, no?

The most thorough analysis of the study that I have seen comes from Hilda Bastian at PLoS Blogs.

Even for the full group, there was no statistically significant difference on myocardial infarction or CVD mortality – just for stroke. And in the supplementary information, there wasn’t a difference in the Kaplan Meier analysis for stroke either.

What are we to make of all this?

Diet trials are notoriously difficult to conduct and interpret and the Mediterranean diet—largely vegetarian with olive oil as the principal fat—was associated with great health and longevity based on studies of people who lived on the island of Crete immediately after the Second World War; they did not have much food to eat and were highly physically active.

And then there’s the matter of who paid for the study.  The retracted study and its revision were funded independently.  But a study published on June 13 concludes:

Adults who are overweight or moderately obese may improve multiple cardiometabolic disease risk factors by adopting a Mediterranean-style eating pattern with or without reductions in red meat intake when red meats are lean and unprocessed.

The funder?  The Beef Checkoff and the National Pork Board.

Overall, the 2015-2020 Dietary Guidelines for Americans recommends Mediterranean dietary patterns for their health benefits, defines what goes into them in Table 1.2 (p. 35), and provides more details in Appendix 4 (starting on p. 83).

Mediterranean diets are delicious.  While the scientists are arguing about exactly how healthy they might be, enjoy!

Let’s start with FERN’s (Food and Agriculture Reporting Network) truly helpful, 7-minute video explaining what the Farm Bill is about.

And then there’s my overview from Politico.

With all that said, the House and Senate agriculture committees have each produced their own versions of the bill and we are waiting for the votes.  So these are preliminary, pending arguments, amendments, changes, and, eventually, reconciliation.

• The Senate bill
• The Senate summary section-by-section
• General information about the Senate bill
• The House bill
• The House summary section-by-section
• General information about the House bill
• Congressional Research Service comparison of the House bill to the 2014 Farm Bill

The big food movement issues are the SNAP and Horticulture (translation: fruit, vegetable, and organics) titles.  Browse around and see what Congress is and is not doing to link agricultural policy to health policy.

More to come when we see what gets passed.

Access to Nutrition has just published its 2018 global report.  Its Global Index:

Measures companies’ contributions to good nutrition against international norms and standards and includes a separate ranking of the world´s leading manufacturers of breast-milk substitutes (BMS).

The report summarizes its findings:

The 2018 Index shows the world’s biggest F&B companies have stepped up their efforts to encourage better diets, mostly through new and updated nutrition strategies and policies, improved commitments on affordability and accessibility, better performance on nutrition labeling and health and nutrition claims, and more disclosure of information across categories. Nevertheless, ATNF has serious concerns about the healthiness of the world’s largest global F&B manufacturers’ product portfolios.

Access to Nutrition ranks the European companies, Nestlé, Unilever, and Danone, highest on its lists.

Its “serious concerns”?

• Poorly defined reformulation targets
• Unclear approaches to making healthy products for affordable and accessibe
• Continued irresponsible marketing to children
• Inadequate employee education programs
• Inadequate support to breastfeeding mothers
• Inadequate labeling
• Inadequate support for public health measures

On this last one:

Indeed.

With all of the talk these days about avoiding ultraprocessed foods, questions come up about what that means.  After I posted about the added colors involved in processing plant-based meats, I received a tweeted question:

This got me thinking about tofu. Is it highly processed? Love your thoughts on it!

Like everything else about nutrition, the answer depends—in this case about what you consider processing.  All foods are processed to some extent, if you count washing and cutting.

Ultraprocessing, however, refers to foods that look nothing like what they started out as, and are loaded with added sugars, salt, and artificial colors and flavors.

Commercial tofu is minimally processed; it is just soybeans and a coagulating agent.  Here is one recipe, for example:

• Soak the soybeans: in water to soften them for 12 to 14 hours.
• Process the beans to a slurry.
• Boil the slurry to inactivate lectins and other undesirable soy compounds.
• Extract the soy liquid (“milk”) with a roller press to separate it from the soybean pulp.
• Mix a coagulating agent—calcium sulfate, magnesium chloride, or nigari.—into the soy milk.
• Press the liquid out of the curds.

The tofu you might make at home seems minimally processed, as it is made from just commercial soymilk and lemon juice.  Commercial soymilk, however, contains far more than just soybean liquid:

INGREDIENTS: Soymilk (Filtered Water, Soybeans), Cane Sugar, Contains 2% or less of: Vitamin and Mineral Blend (Tricalcium Phosphate, Calcium Carbonate, Vitamin A Palmitate, Vitamin D2, Riboflavin [B2], Vitamin B12), Sea Salt, Natural Flavor, Gellan Gum.

I consider good-quality commercial tofu to be minimally processed.  Commercial soymilk is another matter.  Sugar is its second ingredient.  Gellan Gum is its last ingredient.

I wasn’t familiar with Gellan Gum, but I love the Wikipedia definition: “a water-soluble anionic polysaccharide produced by the bacterium Sphingomonas elodea (formerly Pseudomonas elodea),” that substitutes for agar and carrageenan.

A 1988 study of its effects on humans concluded that “the ingestion of gellan gum at a high level for 23 days caused no adverse dietary or physiological effects in any of the volunteers.”  No surprise here: Financial support for the study came from Kelco, Inc., a company that supplies Gellan Gum.

If you want your tofu unsweetened and minimally processed, buy a freshly made commercial variety.

The Environmental Working Group, ever on the job, has a new analysis of subsidy payments to farmers.

Nearly 28,000 farmers got USDA payments worth $19 billion since 1985.

EWG says:

Between 1985 and 2016, farm subsidy programs paid farmers when crop prices fell below price guarantees set in the federal farm bill or, more recently, when crop revenue fell below historic averages. In addition, “direct” subsidy payments linked to historic crop production were made between 1996 and 2014. Disaster payments have been paid through both annual spending bills and permanent disaster programs.

Forbes has published a ranking of the top 2000 global companies (all kinds, not just food) by a composite score of revenue, profit, assets, and market value.

Forbes summarizes some of the information for food processing companies.  By its measure, Anheuser Busch, Nestlé, and PepsiCo are the top three.

Coca-Cola, however, ranks #209, a big drop from last year’s #86.  It did not have a good year last year.

You can sort the list by name or category.  I did that for four categories: Beverage, Food processing, Food retail, and Restaurants.

Walmart does not show up as a food retailer; Forbes considers it a Discount Store, even though food accounts for nearly half of Walmart’s revenues, nearly $200 billion a year.

Here are the food, beverage, retail, and restaurants that show up as among the top 250 companies, worldwide.  I only included sales and profits in this  table; you would have to add in assets and market value to understand the ranking system.

Food, beverage, retail, and restaurant companies among the biggest 250 companies worldwide.

*About 40% of sales are from food.

This is why Walmart is the elephant in the food-business room.

The industry newsletter ConfectionaryNews.com has a collection of articles on “functional” candy.  In this context, “functional” means the addition of something not originally present to enhance the food’s nutritional value.

In the U.S., confectioners have to be careful not to violate the FDA’s so-called “jelly bean rule,” one that says you cannot add nutrients to foods (like jelly beans) just to make them appear to be healthy.

But wouldn’t it be great if candy was a health food?  Spirulina chocolate?  Read on.

Special Edition: Functional Confectionery

The consumer trend towards better-for-you snacks gives confections made with functional ingredients an opportunity to scoop up their share in the health and wellness market.

As part of this special edition on Functional Confectionery, ConfectioneryNews talks to YouBar about its nutrition bars that meet individualized recipes for dietary and nutritional needs; Rainmaker which is currently testing its first line of branded protein confectionery products in the UK and Ireland; and Supertreats’ carob powder which is a healthy alternative to cocoa.

• Michigan food incubator bets big on protein for confectionery startups’ growth:  Food incubator Rainmaker said incoming confectioners should mimic the snack category using protein as a functional ingredient to drive their sales… Read
• Carob’s health halo beats cocoa for kids confectionery, says UK start-up:  Far from being cocoa’s poor cousin, carob powder is the ideal ingredient for healthy confectionery for kids, mimicking the “shine, snap and silky smooth texture” of milk chocolate without the stimulants caffeine and theobromine, says Supertreats founder… Read 
• YouBar increases production for nutrition bars for individualized dietary needs:  YouBar has seen increased demand for its ready-for-market nutrition bars that meet individualized recipes for a range of dietary and nutritional needs… Read 
• Functional formulation: Turkish team hunt for recipe to better quality omega-3 chocolate:  Both white and dark chocolate can be used as a carrier matrix for bioactive substances like omega-3, say researchers. However the type of EPA and DHA used may have a major impact on quality, they warn… Read 
• Going for gum: Vitamin drinks brand expands into vitamin chewing gum:  A vitamin drinks brand is expanding into confectionery with its vitamin chewing gum: seeing the potential of both products to appeal to on-the-go consumers… Read 
• Spirulina finds success in Dutch start-up’s algae chocolate:  Dutch start-up The Algae Factory is pushing the foodpairing boundaries with its algae chocolate that contains sustainably sourced spirulina… Read

Public Health England has a report out on how the country’s food industry is doing with its pledges to reduce sugar.

The goal was to reduce sugar in the most popular food products by 20% by 2020:

The results: about a 2% reduction in food products, but an 11% reduction in drinks.

Public Health England considers this an “encouraging start.”

The Guardian says the food industry has failed to meet its targets.

Here’s how Public Health England explains all this:

If this is going to work, all food companies must set targets and take action to meet them.

We could do this here….?