Search results: almonds

Nuts are demonstrably good for health.  They have high proportions of fat and, therefore, calories, and the calories can add up quickly.  But a small handful makes a great healthy snack.

Why their trade associations feel they need to produce favorable research is beyond me, but as far as I can tell, they are all competing with each other for market share.

Here are a few examples of nut studies funded by trade associations to convince you to eat more nuts.

The point: Whenever you see a study showing amazing health benefits from one single food, there’s a good chance its trade association paid for it.

NUTS IN GENERAL

The study: Mixed Tree Nuts, Cognition, and Gut Microbiota: A 4-Week, Placebo-Controlled, Randomized Crossover Trial in Healthy Nonelderly Adults.  J. Nutrition.   VOLUME 152, ISSUE 12, P2778-2788, DECEMBER 2022.  DOI:https://doi.org/10.1093/jn/nxac228

Conclusions: These findings indicate a positive effect of nut on cognition following only 4 wk of consumption in a healthy nonelderly sample, as well as upregulation of a microbial taxa associated with gut health. The effects appear to be independent of one another, but further exploration is required in those experiencing cognitive decline and/or gut dysbiosis.

Funding: This study was supported by funding from the INC (International Nut and Dried Fruit Council).

ALMONDS

The study: Almond intake alters the acute plasma dihydroxy-octadecenoic acid (DiHOME) response to eccentric exercise.  Front. Nutr., 09 January 2023. Volume 9 – 2022 | https://doi.org/10.3389/fnut.2022.1042719.

Conclusions: In general, the elevated post-exercise plasma levels of 12,13-DiHOME with almond intake support positive metabolic outcomes for adults engaging in unaccustomed eccentric exercise bouts. Other almond-related benefits for exercisers revealed in this study include reduced feelings of fatigue and tension, better leg-back strength during recovery, and decreased muscle damage during the first day of recovery.

Funding: This work was supported by Almond Board of California, Modesto, CA. The funder had no role in the study design, data collection, analysis and interpretation, the preparation of the manuscript, or in the decision to submit the article for publication.

MACADAMIAS

The study: Macadamia nut effects on cardiometabolic risk factors: a randomised trial  J Nutr Sci. 2023.

Conclusion: Daily consumption of macadamia nuts does not lead to gains in weight or body fat under free-living conditions in overweight or obese adults; non-significant cholesterol lowering occurred without altering saturated fat intake of similar magnitude to cholesterol lowering seen with other nuts.

Funding: This study was funded by Hort Innovation, Sydney, Australia (Project code MC17005).  J. J., K. O. and F. M. – None; J. S., S. R. and C. H. have received research funding through their institution from Hort Innovation, Sydney, Australia.  Note: Hort Innovation is a grower-owned, not-for-profit research and development corporation with the goal of creating value for horticulture growers and those across the horticulture supply chain. It invests more than $120 million in R&D, marketing and trade programs on behalf of industry.

PEANUTS

The study:  Urinary Phenolic Metabolites Associated with Peanut Consumption May Have a Beneficial Impact on Vascular Health Biomarkers. Antioxidants. 2023; 12(3):698. https://doi.org/10.3390/antiox12030698.

Conclusion:  the present study shows for the first time that regular peanut and peanut butter consumption could have a positive impact on vascular biomarkers in healthy young adults.

Funding: This research was supported by funding from the Peanut Institute

Really, I can’t make this stuff up.

Thanks to Jim Krieger of HealthyFoodAmerica.org for sending me to Food Navigator-USA: Post launches the first-ever cereal designed to promote sleep.

A cereal meant to be consumed at bedtime?  I wanted it for my cereal box collection, and there hasn’t been a good one like this for a long time since the FDA started discouraging ridiculous health claims.  I went straight to the Ithaca Walmart and scored a box.

Sweet Dreams, the box tells you, is “part of a healthy sleep routine.”

The front-of-package claims:

• Made with whole grains
• Supports natural melatonin production with zinc, folic acid, and B vitamins
• Excellent source of Vitamin E for neuroprotection

The back-of-package claims:

• Sleep…We want to help you enjoy it.  With delicious wholesome ingredients, curated vitamins and minerals, and a specially formulated night-time herbal blend, our dreamy cereal is part of a healthy sleep routine.
• Made with a night-time herbal blend containing a touch of lavender and chamomile

I looked up the website:

For 130 million American adults, a good night’s sleep is elusive. You deserve good sleep, and we want to help you enjoy it! So, we made Sweet Dreams cereal, the first ready-to-eat cereal specially designed to support a good sleep routine and a fresh start to the next day…Available in Blueberry Midnight and Honey Moonglow flavors, make Sweet Dreams cereal a part of your bedtime routine and enable a better sleep cycle while satisfying those nighttime food cravings.

Comment:

I hardly know where to begin: “curated vitamins and minerals”?  “Supports natural melatonin production”?

This last is a structure/function claim like those for supplements.  It requires only the barest hint of scientific substantiation.

Reader, I ate it.

The cereal is crunchy, with occasionally visible almonds, but is cloyingly sweet (to my taste): A cup of cereal has nearly a tablespoon (13 grams) of added sugar– 24% of a day’s total sugar allowance.

No wonder it’s so sweet.  Sugars appear seven times on the ingredient list.

Whole Grain Wheat, Rice, Cane Sugar, Almonds, Whole Grain Rolled Oats, Canola and/or Soybean Oil, Flavor Clusters (Sugar, Corn Syrup, Degermed Corn, Palm Oil, Natural Flavor, Cocoa (processed with alkali)(for color), Blueberry and Carrot Concentrates (for color)), Salt, Honey, Corn Syrup, Barley Malt Extract, Molasses, Tocopherols (Vitamin E) to maintain freshness, Natural Flavor.

Post must be trying to sell more cereal.  Eat cereal at night?  Well, if you have sleep problems I suppose you can give it a try.

I ate this cereal in the morning.  It did not make me feel sleepy.

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At long last, the FDA revealed its proposed decision about whether plant-based milks can be called milk.

• FDA’s draft guidance.
• The Federal Register notice
• For comment, post here 

As the FDA puts it:

This draft guidance, when finalized, will represent the current thinking of the Food and Drug Administration (FDA or we) on this topic. It does not establish any rights for any person and is not binding on FDA or the public. You can use an alternative approach if it satisfies the requirements of the applicable statutes and regulations.

What this is about

Simple.  The dairy industry does not like concoctions made from soy, almonds, cashews, macadamias, oats, peas, or other such plants to get to be called “milk.”  It argues that they are not as nutritious as milk and will confuse consumers into thinking they are the same.  Most surveys show that the public understands the difference quite well and has reasons for choosing plant-based alternatives that may or may not have anything to do with nutrient contents (think: animal welfare, dairy fat, environmental protection, industrial production, or what have you).

This puts the FDA in the awkward position of trying to please the public and the dairy industry at the same time.  Its solution to this dilemma is to invoke nutritionism (the use of nutrients to stand for the whole food):

• Plant-based milks can use the word “milk” (the dairy industry doesn’t like this)
• But they have to say which nutrients they don’t have as much of (producers of plant-based milks don’t like this).

What this will look like

The FDA says this is a voluntary, non-binding recommendation.

In case that’s too small to see:

Really, people who buy plant-based dairy alternatives are not at nutritional risk and don’t need to be told about single nutrients in products that have a great many.  This is an out-and-out caving in to the dairy industry’s fears that plant-based alternatives will further cut into milk sales at a time when milk sales are declining.

It puts plant-based milk manufacturers at risk of lawsuits if they use Milk without confessing nutritional weaknesses (for an excellent discussion of this liklihood, see Elaine Watson’s account in AgFunderNews.  She quotes lawyer Rebecca Cross:

the draft guidance, “is actually quite shocking, as it treats plant-based milks unlike any other food product.  If finalized, the guidance should not survive a First Amendment challenge.”

She added: “Although the recommended nutrient statements are not mandatory—or finalized—the draft guidance here may, unfortunately, result in frivolous class actions [plaintiffs would claim brands are misleading reasonable consumers if they choose not to make the nutrient statements recommended in the guidance]. The FDA should recognize this as well, but it seems they have unfortunately succumbed to dairy industry pressure.

So it seems.

My opinion, for whatever it’s worth: The FDA should permit plant-based milks to be called milks.  They are what they are and most people should have no trouble telling the difference between them and dairy milk.

For the record, I like dairy products.  But the dairy industry is a mess (overproduced, increasingly consolidated, fighting public health and animal welfare concerns) and needs to get its act together.  The FDA is not helping it get there with this decision.

So many people send me these things that I can hardly keep up.  Let’s take a look at two this time.  Thanks to Hugh Joseph and Matthew Kirby for these:

I.  The impact of almonds and almond processing on gastrointestinal physiology, luminal microbiology, and gastrointestinal symptoms: a randomized controlled trial and mastication study   Alice C Creedon, Eirini Dimidi, Estella S Hung, Megan Rossi, Christopher Probert, Terri Grassby, Jesus Miguens-Blanco, Julian R Marchesi, S Mark Scott, Sarah E Berry, Kevin Whelan.  The American Journal of Clinical Nutrition, Volume 116, Issue 6, December 2022, Pages 1790–1804, https://doi.org/10.1093/ajcn/nqac265

• Conclusions: “Almond consumption has limited impact on microbiota composition but increases butyrate in adults, suggesting positive alterations to microbiota functionality. Almonds can be incorporated into the diet to increase fiber consumption without gut symptoms.”
• Funding: Supported by an Almond Board of California grant (to KW). The funders provided financial support, and the whole and ground almonds consumed by participants in the trial, but had no role in study design, conduct, analysis, interpretation, or decision to publish.
• Author disclosures: ACC was funded by a PhD studentship funded by Almond Board of California. ED has received an education grant from Alpro, research funding from the British Dietetic Association, Almond Board of California, the International Nut and Dried Fruit Council, and Nestec Ltd, and has served as a consultant for Puratos. MR and KW have received research funding from Almond Board of California, Danone, and International Dried Fruit and Nut Council, and are co-inventors of volatile organic compounds in the diagnosis and dietary management of irritable bowel syndrome. MR is also cofounder of Bio&Me, a gut health food brand. TG supervises PhD students partially funded by Mondelez and McCain Foods Ltd, and has previously received research funding from Almond Board of California. SEB has received grant funding from Almond Board of California, Malaysian Palm Oil Board, and ZOE Ltd, and receives consultancy and options from ZOE Ltd. All other authors report no conflicts of interest.
• Comment: The Almond Board is doing its job, apparently.

II. Almond intake alters the acute plasma dihydroxy-octadecenoic acid (DiHOME) response to eccentric exercise.   David C. Nieman^1*,  Ashraf M. Omar²,  Colin D. Kay³,  Deepak M. Kasote³,  Camila A. Sakaguchi¹,  Ankhbayar Lkhagva²,  Mehari Muuz Weldemariam² and  Qibin Zhang. Front. Nutr., 09 January 2023. https://doi.org/10.3389/fnut.2022.1042719

• Conclusions: “These data support some positive effects of almond intake in improving mood state, retaining strength, decreasing muscle damage, increasing the generation of gut-derived phenolic metabolites, and altering the plasma oxylipin DiHOME response to unaccustomed eccentric exercise in untrained adults. The elevated post-exercise plasma levels of 12,13-DiHOME with almond intake support positive metabolic outcomes for adults engaging in unaccustomed eccentric exercise bouts.”
• Funding: “This work was supported by Almond Board of California, Modesto, CA. The funder had no role in the study design, data collection, analysis and interpretation, the preparation of the manuscript, or in the decision to submit the article for publication.”
• Conflict of Interest: “The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.”
• Comment:  I disagree.  The fact that the Almond Board funded the study if nothing else gives the appearance of conflicted interests, especially because studies so clearly document the influence of funding whether recognized by recipients or not.

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As regular readers know, I subscribe to the weekly newsletter, Obesity and Energetics Offerings, and particularly enjoy its section on Headline vs Study.

Here’s a particularly amusing example, which right away triggers my question: Who paid for this?

Headline vs Study

• Headline: Snacking on Almonds Can Help People Reduce Calorie Intake: Study.  
• Press Release: Believe It or ‘Nut’, Almonds Can Help You Cut Calories, Study Finds.  
• Study: “There was no significant difference in total energy intake ([…] p = 0.286) or energy from core ([…] p = 0.860) or discretionary foods ([…] p = 0.158) between [almonds and an isocaloric carbohydrate-rich snack bar].”

Let’s take a look.

Headline: Snacking on Almonds Can Help People Reduce Calorie Intake: Study.

A handful of almonds may be the latest weight loss hack, new research suggests.

A new study from the University of South Australia found that eating 30 to 50 grams of almonds could regulate appetite, leading to less calories consumed each day.

The research, which examined both the hormones that regulate appetite and how almonds could aid in controlling hunger, discovered that the consumption of the nut ultimately led to about 300 fewer calories [sic*]consumed at the following meal.

Press Release: Believe It or ‘Nut’, Almonds Can Help You Cut Calories, Study Finds.

Examining how almonds can affect appetite, researchers found that a snack of 30-50 grams of almonds could help people cut back on the number of kilojoules they consume each day.

Published in the European Journal of Nutrition, the study found that people who consumed almonds — as opposed to an energy-equivalent carbohydrate snack — lowered their energy intake by 300 kilojoules (most of which came from junk food) at the subsequent meal.

Study:  Acute feeding with almonds compared to a carbohydrate-based snack improves appetite-regulating hormones with no effect on self-reported appetite sensations: a randomised controlled trial. Carter, S., Hill, A.M., Buckley, J.D. et al.Eur J Nutr (2022). https://doi.org/10.1007/s00394-022-03027-2

Results: “…Cholecystokinin, ghrelin, glucagon-like peptide-1, leptin and polypeptide YY AUCs were not different between groups. Self-reported appetite ratings and energy intake following the buffet did not differ between groups.”

Conclusion: “More favourable appetite-regulating hormone responses to AL did not translate into better self-reported appetite or reduced short-term energy consumption. Future studies should investigate implications for longer term appetite regulation.”

Funding: “This work was funded by the Almond Board of California. This funding source had no role in the design of this study or the analysis and interpretation of the data.”

Conflict of interest: “AMC has consulted for Nuts for Life (an initiative of the Australian Tree Nut Industry). S-YT has previously been involved in studies funded by the Californian Walnut Commission. AMC, JDB and S-YT have previously been involved in studies funded by International Nut and Dried Fruit Council.”

*Comment: How could the headline get it so wrong?  The authors write: “Although not significant, the AL group consumed 300 kJ less energy in the meal challenge than the SB group, 270 kJ of which came from discretionary foods, which may be a clinically important benefit in weight management.”  The sic partly explains the problem.  The 300 refers to kilojoules (kj), not calories.  300 kj = 72 calories, not 300.  No wonder the result wasn’t statistically significant.

But the press release and resulting headline explain why the nut industry funds studies like this.  Even when the result shows no difference, the PR people can spin the data to produce the expected favorable result.

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I learned about this one from a PR tweet from @Brigham Research: “Dr. JoAnn Manson…& colleagues report the main findings of the first ever randomized trial of a cocoa flavanol supplement on cardiovascular disease endpoints.”

Its spectacular results:  Supplementation with cocoa flavanols led to a 27% reduction in deaths from cardiovascular disease among all participants taking the supplement, and a 39% reduction in those deaths when they excluded participants who did not take the pills properly.

From taking cocoa flavanol supplements?

Who paid for this?

Bingo.

The study (still in preprint): Effect of Cocoa Flavanol Supplementation for Prevention of Cardiovascular Disease Events: The COSMOS Randomized Clinical Trial.  Sesso HD, et al.  American Journal of Clinical Nutrition, nqac055, https://doi.org/10.1093/ajcn/nqac055

Conclusion: “Cocoa extract supplementation did not significantly reduce total cardiovascular events among older adults but reduced CVD death by 27%….”

Funding: “The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging…[and other sources].

Conflicts of interest: Drs. Sesso and Manson reported receiving investigatorinitiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, for infrastructure support and donation of COSMOS study pills and packaging,
Pfizer Consumer Healthcare (now part of GSK Consumer Healthcare) for donation of COSMOS study pills and packaging during the conduct of the study. Dr. Sesso additionally reported receiving investigator-initiated grants from Pure Encapsulations and Pfizer Inc. and honoraria
and/or travel for lectures from the Council for Responsible Nutrition, BASF, NIH, and American Society of Nutrition during the conduct of the study. No other authors reported any conflicts of interest.

Comment: Déjà vu all over again.

Mars, as I described in detail in Unsavory Truth, has been trying to make you think that chocolate is a health food (M&Ms!) for decades. It created a special brand, CocoaVia, for this purpose.  Here is an excerpt:

In 1982, Mars established a chocolate research center in Brazil.[i]  Its scientists were particularly interested in cocoa flavanols, a category of flavonoids with antioxidant, anti-inflammatory, and other heart-healthy effects.  Through the 1980s and 1990s, Mars’ scientists produced studies suggesting such benefits.

Alas, cocoa flavanols come with complications.  They taste bitter (dark chocolate contains more of them).  They are present in such small amounts that you would have to eat a quarter to a full pound of chocolate a day to achieve cardiovascular benefits.[ii]  Worse, they are destroyed by traditional chocolate processing.[iii]  The losses may explain why a Hershey-funded clinical trial failed to find neuropsychological or cardiovascular benefits from eating dark chocolate when compared to a placebo.[iv]

But to return to CocoaVia: Mars developed a process to preserve the cocoa flavanols during processing, and combined the rescued flavanols with cholesterol-lowering plant sterols to make chocolate bars and chocolate-covered almonds.  By 2002, the company decided that it had enough research to promote CocoaVia candies as heart-healthy.[v]  As the New York Times put it, Mars was on a “corporate quest to transform chocolate into a healthy indulgence.”[vi]  Mars marketed the candy bars—two a day, no less—as a means to increase blood flow, lower blood pressure, and reduce the risk for heart disease.

The FDA takes a dim view of unproven claims like “chocolate prevents heart disease.”  In 2006, the agency sent Mars a warning letter complaining that claims like “promotes a healthy heart” and “now you can have real chocolate pleasure with real heart health benefits,” were false, misleading, and easily misinterpreted…Chocolate, the FDA pointed out, is high in saturated fat (it didn’t mention sugar).   Furthermore, the claim “Cocoa Via Chocolate Bars contain natural plant extracts that have been proven to reduce bad cholesterol (LDL) by up to 8%,” meant that Mars was advertising chocolate as a drug.  If Mars wanted to make drug claims, it would need to conduct clinical trials to prove that eating CocoaVia chocolate bars prevented heart disease.[vii]

Rather than run the financial and scientific risk of doing that, Mars gave up on candy bars and began marketing CocoaVia in pills and powder as a “daily cocoa extract supplement.”  In doing this, Mars could take advantage of the more lenient marketing claims allowed by the Dietary Supplement Health and Education Act (DSHEA) of 1994. This act permits “structure/function” claims, those proposing that a supplement is good for some structure or function of the body.  Under DSHEA, the labels of CocoaVia are allowed to say that these supplements “promote a healthy heart by supporting healthy blood flow.”

To convince people to take CocoaVia supplements, Mars funds research.  In 2015, it funded studies demonstrating that cocoa flavanols are well tolerated in healthy men and women,[viii] support healthy cognitive function in aging,[ix] can reverse cardiovascular risk in the healthy elderly,[x] and improve biomarkers of cardiovascular risk.[xi]

Lest the “eat more chocolate” implications of these studies be missed, Mars issued a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”[xii]  The company followed this announcement with a full-page ad in the New York Times quoting a dietitian: flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”  …The ad directed readers to more information on a paid ad on the Times’ Website.  You have to look hard in these ads to discover that Mars owns CocoaVia; the company’s name only appears in barely legible print as part of the trademark.[xiii]

But Mars, which already has funded “more than 150 peer-reviewed scientific papers and [has] approximately 100 patents globally in the field of cocoa flavanols”[xiv] has more ambitious research plans.  In 2014, the company announced that in partnership with the National Heart, Lung, and Blood Institute it would provide “financial infrastructure support “ for an ambitious placebo-controlled, randomized trial of the effects of cocoa flavanols alone or in combination with vitamin supplements, on heart disease and cancer risk in 18,000 men and women over the age of 60.[xv]  The five-year trial, called the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), has evolved somewhat since then.  It now lists Brigham and Women’s Hospital in Boston as the sponsor, and Mars as a “collaborator” along with the Fred Hutchinson Cancer Research Center in Seattle and Pfizer. NIH seems no longer to be involved.[xvi]

We now have the result of this trial.  Even though cocoa flavanol supplements did not reduce cardiovascular events, Mars got its money’s worth from what must have been a very expensive study.

Tomorrow: a second report from this trial, with surprising results.

References

[i] Mars, Inc.  The history of CocoaVia.  CocoaVia.com

https://www.cocoavia.com/how-we-make-it/history-of-cocoavia

[ii] Vlachojannis J, Erne P, Zimmermann B, Chrubasik-Hausmann S.  The impact of cocoa flavanols on cardiovascular health.  Phytother Res.  2016;30(10):1641-57.

[iii] Andres-LaCueva C, Monagas M, Khan N, et al.  Flavanol and flavonol contents of cocoa powder products: influence of the manufacturing process.  J Agric Food Chem. 2008;56:3111-17.

[iv] Crews WD, Harrison DW, Wright JW.  A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults.  Am J Clin Nutr. 2008;87(4):872-80.

[v] Meek J.  Chocolate is good for you (or how Mars tried to sell us this as health food).  The Guardian, Dec 23, 2002.

https://www.theguardian.com/uk/2002/dec/23/research.highereducation

[vi] Barrionuevo A.  An apple a day for health?  Mars recommends two bars of chocolate.  NY Times, Oct 31, 2005.

The FDA considers candy bars to be foods labeled with Nutrition Facts panels.  Supplements are labeled with Supplement Fact panels.

[vii] FDA.  Inspections, compliance, enforcement, and criminal investigations.  Warning letter to Mr. John Helferich, Masterfoods USA.  FDA, May 31, 2006.  http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2006/ucm075927.htm

[viii] Ottaviani JI, Balz M, Kimball J, et al. Safety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trial.  Am J Clin Nutr. 2015;102(6):1425-35.

[ix] Necozione S, Raffaele A, Pistacchio L, et al.  Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial  Am J Clin Nutr. 2015; 101:538-48.

[x] Heiss C, Sansone R, Karimi H, et al.  Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Age. 2015;37:56.

[xi] Sansone R, Rodriguez-Mateos A, Heuel J, et al.  Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Brit J Nutr. 2015;114(8):1246-55.

[xii] Mars Center for Cocoa Health Science.  Press release: Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.  MarsCocoaScience.com, Sep 9, 2015.  http://www.marscocoascience.com/news/cocoa-flavanols-lower-blood-pressure-and-increase-blood-vessel-function-in-healthy-people.

[xiii] CocoaVia.  Cocoa’s past and present: a new era for heart health.  NY Times, Sep 27, 2015.  http://paidpost.nytimes.com/cocoavia/cocoas-past-and-present-a-new-era-for-heart-health.html?_r=0

[xiv] Mars Symbioscience.  Explore Mars Symbioscience.  Mars.com.

http://www.mars.com/global/brands/symbioscience

[xv] Mars.  Largest nutritional intervention trial of cocoa flavanols and hearth (sic) health to be launched.  MarsCocoaScience.com, Mar 17, 2014.

http://www.marscocoascience.com/news/largest-nutritional-intervention-trial

[xvi] The trial is registered at COcoa Supplement and Multivitamin Outcomes Study (COSMOS).    ClinicalTrials.gov.

https://clinicaltrials.gov/ct2/show/NCT02422745

[xvii] ASRC (Advertising Self-Regulatory Council).  NAD recommends Mars modify certain claims for CocoaVia cocoa extract.  ASRCReviews.org, Aug 11, 2016.

http://www.asrcreviews.org/nad-recommends-mars-modify-certain-claims-for-cocoavia-cocoa-extract/

On July 19, I did a post on a recent study comparing the nutrient composition of plant-based meat alternatives to that of grass-fed beef.  I was not surprised that the study found nutritional differences; they are to be expected.

I was surprised that “From the abstract and conclusion, the study appears to suggest that meat is nutritionally better,” but the authors said the two types “could be viewed as complementary in terms of provided nutrients. It cannot be determined from our data if either source is healthier to consume.”   That confused me.  I also was confused by the authors’ reported conflicts of interest and said so.

One reader wrote to say that I was being unfair to the authors, who are excellent scientists.

Indeed, the authors followed up with an explanation, which I offered to post here without further comment.  They agreed to that.

Dear Dr. Nestle,

Many thanks for posting about our work. We have the utmost respect for your work and we have cited your work in our papers and books (e.g., Provenza’s Nourishment). You are an influential and well-respected person, and as you noted, your followers wanted you to inform them about this paper. When reading the post about our work, we were particularly surprised that you didn’t send us an email to fact-check your points, especially since we were introduced by email on 7/7 that noted: “I’ve copied two of the researchers involved Stephan van Vliet and Fred Provenza. That way if you have any further questions, you can pose those to the researchers directly.” If you disagree, c’est la vie, but at least that would have enabled you to write an informed critique, rather than one that is speculative and, at times, incorrect.

An off-hand and speculative statement such as this one: “maybe the vegetarian was responsible for the hedging comments?” would easily have been addressed by simply sending us an email inquiring about this. We would have gladly told you that it was three of the omnivores (SVV, FDP, SK) who were particularly concerned that people would over extrapolate the data. We were especially concerned that people would interpret our data as beef being “better”. That is not what the data indicate (more on what the data does indicate below). Hence our clear and repeated statement: “It cannot be determined from our data if either source is healthier to consume.”

We are writing you this friendly note to put some context to the points that you made. We hope that you will take them as our attempt to reinforce points that we were careful to develop so our paper was not one-sided.

“So, they’re framing everything with the baseline that animal meat is “proper nutrition” which seems like a pretty obvious bias right out of the gate…”

The two words you quoted are from a much more nuanced sentence, which reads: “This has raised questions of whether plant-based meat alternatives represent proper nutritional replacements to animal meat”. This statement refers to a number of papers by different research groups (see our paper for citations) who pose that very question, which we were interested in exploring. This is much more nuanced statement than what you suggest in the blogpost, which simply states animal meat is “proper nutrition”, which, to us, feels like a twisting of our carefully chosen words.

That we are not framing meat as “proper nutrition” is further illustrated by the stated goal of this work at the end of the introduction: “Given the scientific and commercial interest in plant-based meat alternatives, the goal of our study was to use untargeted metabolomics to provide an in-depth comparison of the metabolite profiles of grass-fed ground beef and a popular plant-based meat alternative, both of which are sometimes considered as healthier and more environmentally friendly sources of “beef”.

Furthermore, we also have to be realistic here and not dance around the obvious; the goal of plant-based meat alternatives is to provide a sensory and nutritional replacement for meat, as illustrated in press releases such as Impossible’s “We are Meat”. If one were to add carotenoids and fiber to a meat sausage (see Arby’s Marrot https://www.foodandwine.com/news/arbys-meat-carrots) and consider this a replacement to a carrot…. We would ask the same question: to what extent do a carrot and a meat-based carrot alternative differ nutritionally? It would be reasonable to take the carrot as the benchmark. All in all, we argue that our framing of the research question is much more nuanced than you suggested in your blogpost. “

To the question of nutritional differences, duh, indeed. Why would anyone not expect nutritional differences? From the abstract and conclusion, the study appears to suggest that meat is nutritionally better.”

As we acknowledge in the abstract “Important nutritional differences may exist between beef and novel plant-based alternatives; however, this has not been thoroughly assessed.” Please give us some credit. One of us (Fred Provenza) has studied plants and animals for over 50 years. Of course, we expected meat from a cow to differ from meat from soybeans, but the extent to which this may be the case had not been studied. Nor is this clear to the consumer who is simply looking at Nutrition Facts panels, another very important reason why we did the research. Another issue is that foods are often considered equivalent simply based on their protein content (even in dietary guidelines), but “protein foods” can be vastly different in terms of the non-protein nutrients they provide. We recommend Dr. Courtney-Martin’s editorial in AJCN titled “Is a peanut really an egg”. (https://academic.oup.com/jn/article/151/5/1055/6217441). She discusses these issues in such an elegant way.

We do not suggest that meat is nutritionally better, we clearly state the following in the abstract (something you cite in your blogpost): “Amongst identified metabolites were various nutrients (amino acids, phenols, vitamins, unsaturated fatty acids, and dipeptides) with potentially important physiological, anti-inflammatory, and/or immunomodulatory roles—many of which remained absent in the plant-based meat alternative when compared to beef and vice versa. Our data indicates that these products should not be viewed as nutritionally interchangeable, but could be viewed as complementary in terms of provided nutrients. It cannot be determined from our data if either source is healthier to consume.”

The italicized portions are key: we state that some nutrients are not found in the plant-based meat alternative and some nutrients are not found in the meat. Nothing more and nothing less. We also clearly state that we cannot determine from this metabolomics analysis if one is healthier than the other. We intend to pursue that question in research with people, but based on current research we also have to be realistic and we, therefore, highlight the following: “Further work is needed to inform these discussions; however, we consider it important to not lose sight of the “bigger picture” in these discussions, which is the overall dietary pattern in which individual foods are consumed. That is arguably the predominant factor dictating health outcomes to individual foods. Of note is a recent 8-week randomized controlled trial that found that a “flexitarian approach” (swapping moderate amounts of meat with novel plant-based alternatives as part of an omnivorous diet) may have positive benefits in terms of weight control and lipoprotein profiles (e.g., LDL-cholesterol).” (https://doi.org/10.1093/ajcn/nqaa203).

We are not particularly touting the superiority of meat in the discussion. We mention many of the potential health benefits of the compounds found in plant-based meat alternatives such as phytosterols, tocopherols, and other phenolic anti-oxidants, which were more abundant or exclusively found in the plant-based meat alternative.

“Really? If they can’t figure out which is better, why do this study?”

It is not a question of which one is better. It is about understanding potential similarities and differences. Is an almond better than an orange? That depends on the types of nutrients you are looking to get. If you want Vitamin C, an orange is preferred over an almond. If you want Vitamin E, consume the almonds. But there is also nutritional overlap, because both provide fiber and they have complementary phytonutrient profiles. A silly example perhaps when you put it like that, but that’s analogues to what we are stating in the paper.

“As for the conflicted interests: My first reaction to seeing this study was to ask: “Who paid for this?”

No funding was received for this work. The cost of the meat and plant-based meat alternatives (~$600) was paid with my [Dr. Stephan van Vliet] personal credit card (I am a post-doc and had no grant or start-up funds when I first arrived at Duke). The cost of metabolomics (~$200 per sample) was waived by Duke Molecular Physiology Institute’s Metabolomics Core. This was generously done to provide an early career investigator like myself to generate pilot data for a publication and grants.

The North Dakota Beef Association grant that I am the PI on [Dr. Stephan van Vliet] is $135k (not a very big grant) and supports a 4-week RCT that studies cardiovascular risk biomarkers and metabolome profiles in response to eating beef as part of a traditional (whole food) vs standard American diet. Various epidemiological studies suggest that when red meat is consumed as part of a whole foods diet, the associated risk with CVD becomes neutral, whereas eating red meat as part of a standard American diet is associated with increased disease risk. We are testing/falsifying this hypothesis prospectively in a short-term RCT and are exploring potential mechanisms by which this may or may not be the case. This work has nothing to do with plant-based meat alternatives.

The Turner Institute of Ecoagriculture ($27.5k) and the Dixon Foundation ($12.5k) are pilot grants to run metabolomics on grass-fed vs grain-fed bison and beef, respectively. The USDA-NIFA-SARE grant is collecting both plant (crops + fruit) and animal (eggs + beef) food samples from farms that use agroecological principles such as integrated crop-livestock systems. Here we are asking the question: How do practices that potentially stimulate soil health and plant diversity impact the healthfulness of animal and plant foods for human consumption? To be clear, we are also studying crop samples (soy, corn, and peas) some of which may go into alternative protein production.

My [Stephan van Vliet] conflict-of-interest policy is also essentially similar to yours: I accept funding for travel, hotels, meals, and meeting registrations, but I do not accept personal honoraria, consulting fees, or any other financial payments from such groups. A simple email could have cleared that up, but I will make sure that I state this more clearly in future papers.

Of course, we understand the public suspicion about research funding and undue influence. If a certain funding agency doesn’t like the data or the proposal and they don’t want to fund any of our projects then that is what it is, but we would not risk our reputation and career for a few research dollars or to please the funding agency. That’s why we are pushing back on this. Fred Provenza, especially, has been critical of the way beef is produced in confinement feeding operations (e.g., see recent paper https://doi.org/10.3389/fsufs.2021.547822), so the suggestion that we are beef industry defendants rather than independent scientists does sting a bit.

At the same time, we would also be lying if we didn’t think about where funding comes from. However, the harsh reality is that without foundation/commodity funds for scientific research, there would be much less research, much of which has also proven valuable over time. Even with our USDA grant, one could argue that the reason we are funded is because we wrote a good proposal, but also because our proposed work can presumably benefit the US Farm Bill. Is that true independence? All we know is that we should be transparent (hence our detailed competing interest statement) and let the data speak for itself (hence we attached our full data set as supplementary materials and deposited raw data files on metabolomics workbench), which is what we aimed to do in our Sci Rep paper.

We appreciate your concerns. We will certainly take these into account as we move forward and continue to be critical of our work. We hope you also consider our concerns and are willing to keep an open and friendly dialogue.

Sincerely,

Stephan van Vliet

Fred Provenza

Scott Kronberg

I swear I’m not making this up.

The study: Effect of Nut Consumption on Erectile and Sexual Function in Healthy Males: A Secondary Outcome:  Analysis of the FERTINUTS Randomized Controlled Trial.  Albert Salas-Huetos, Jananee Muralidharan, Serena Galiè, Jordi Salas-Salvadó, and Mònica Bulló.  Nutrients 2019, 11(6), 1372; https://doi.org/10.3390/nu11061372.

The conclusion: “Including nuts in a regular diet significantly improved auto-reported orgasmic function and sexual desire.”

The funder: “This work was partially supported by the International Nut and Dried Fruit Council (INC)…INC is a non-profit entity registered at the Register of Foundations of Catalonia, Spain. Nuts were supplied by Crisolar, Spain.

Comment: I love these results, and have no doubt that the funder did too.  I can only imagine the ads based on this study.  News accounts too (here’s a good one from London’sDaily Mail).

The results were so interesting that a separate group reviewed the data and confirmed that the numbers led to the same results.  This is not surprising.  Most studies of bias in research show that it turns up mainly in the way the research question is framed or in the interpretation of the data, not in the conduct of the science or collection of data.

Hey guys: have problems?  Eat a mixture of raw walnuts, almonds, and hazelnuts and collect your own data!