Search results: american journal of clinical nutrition

Happy Anniversary Food Politics.

The Tenth Anniversary Edition is out with a new Foreword by Michael Pollan.  It also has new Preface and a new Afterword, in which I bring food politics up to date.

Order from your local independent bookstore or Amazon or UC Press or Barnes & Noble

Summary

We all witness, in advertising and on supermarket shelves, the fierce competition for our food dollars. In this engrossing exposé, Marion Nestle goes behind the scenes to reveal how the competition really works and how it affects our health. The abundance of food in the United States—enough calories to meet the needs of every man, woman, and child twice over—has a downside. Our overefficient food industry must do everything possible to persuade people to eat more—more food, more often, and in larger portions—no matter what it does to waistlines or well-being.

Like manufacturing cigarettes or building weapons, making food is very big business. Food companies in 2000 generated nearly $900 billion in sales. They have stakeholders to please, shareholders to satisfy, and government regulations to deal with. It is nevertheless shocking to learn precisely how food companies lobby officials, co-opt experts, and expand sales by marketing to children, members of minority groups, and people in developing countries. We learn that the food industry plays politics as well as or better than other industries, not least because so much of its activity takes place outside the public view.

Editor of the 1988 Surgeon General’s Report on Nutrition and Health, Nestle is uniquely qualified to lead us through the maze of food industry interests and influences. She vividly illustrates food politics in action: watered-down government dietary advice, schools pushing soft drinks, diet supplements promoted as if they were First Amendment rights.When it comes to the mass production and consumption of food, strategic decisions are driven by economics—not science, not common sense, and certainly not health.

No wonder most of us are thoroughly confused about what to eat to stay healthy. An accessible and balanced account, Food Politics will forever change the way we respond to food industry marketing practices. By explaining how much the food industry influences government nutrition policies and how cleverly it links its interests to those of nutrition experts, this pathbreaking book helps us understand more clearly than ever.

Blurbs

“In this fascinating book we learn how powerful, intrusive, influential, and invasive big industry is and how alert we must constantly be to prevent it from influencing not only our own personal nutritional choices, but those of our government agencies. Marion Nestle has presented us with a courageous and masterful exposé.” — Julia Child

“This remarkable book is essential reading for anyone who wishes to understand how it has come to be that the richest nation in the world is eating itself to death. . . . Straight reporting about the shaping of food policy, as this volume makes clear, is certain to offend some very powerful players.” — Joan Dye Gussow, author of This Organic Life

“Food politics underlie all politics in the United States. There is no industry more important to Americans, more fundamentally linked to our well-being and the future well-being of our children. Nestle reveals how corporate control of the nation’s food system limits our choices and threatens our health. If you eat, you should read this book.” — Eric Schlosser, author of Fast Food Nation

“‘Blockbuster’ is one of the best ways that I could describe this book. . . . A major contribution to understanding the interaction of politics and science, especially the science of nutrition, it is of extreme value to virtually all policy makers and to everyone concerned with the American diet.” — Sheldon Margen, editor of the Berkeley Wellness Letter

“A devastating analysis of how the naked self-interest of America’s largest industry influences and compromises nutrition policy and government regulation of food safety. . . . A clear translation of often obscure studies and cases, the writing is accessible and lively.” — Warren Belasco, author of Appetite for Change

Reviews and Commentary

• Food Politics: Worse Than You Thought Durham Independent 5/21/03
• Resource Review – Food Politics Dietitians of Canada Members Online Newsletter 5/03
• Marketing, Not Health Townsend Letter for Doctors and Patients 5/03
• Book Review Journal of the American Dietetic Association 4/03
• Have Fat, Will Sue Financial Times 12/12/03
• Book Review The American Journal of Clinical Nutrition 12/02
• Expert Blames Obesity on Food-Industry Marketing The Seattle Times 11/6/02
• The Hunger for Profit World Watch 9/02 – 10/02
• The Soft Sell: How the Food Industry Shapes Our Diets Nutrition Action Health Letter 9/02
• Schools Teach 3 C’s: Candy, Cookies and Chips The New York Times 9/24/02
• Barbecue of the Vanities The Guardian 8/19/02
• The Food Pushers Science 7/12/02
• Digesting the Message International Association for the Study of Obesity Newsletter 2002
• Book Review The New England Journal of Medicine 6/20/02
• Exposé from a Food Policy Insider Veg Source 6/5/02
• Weighing Our Health: Epidemic of Obesity San Francisco Chronicle 5/26/02
• Food Politics Blames Industry for Obesity Epidemic Food Chemical News 5/20/02
• Food in the USA: Something to Chew Over The Lancet 5/18/02
• Food Industry Tempts us to Overeat, Professor Says Columbia Daily Tribune 5/15/02
• Book Draws Protests from Food Leaders Elsevier Food International 5/15/02
• One Woman’s Showdown with the Food Industry The New York Times 5/15/02
• Heavy Duty The New Republic 5/13/02
• Lean on Me The Economist 5/11/02
• Big Food’s Real Appetites The Nation 5/6/02
• She’s a ‘Nag’ for Detailing Big Food’s Deviousness The Philadelphia Inquirer 4/17/02
• The Campaign Against Big Food townhall.com 4/2/02
• Feeding Frenzy The Village Voice 3/26/02
• Big Fat San Francisco Bay Guardian 3/8/02
• Obesity: Should Food Industry Be Blamed? CNSNews.com 2/26/02
• Sugar-Coating the Facts (Lesson Plan) The New York Times 2/19/02
• Food for Thought for a Fat Nation USA Today 2/19/02

The study: Mixed nut consumption improves brain insulin sensitivity: a randomized, single-blinded, controlled, crossover trial in older adults with overweight or obesity.  American Journal of Clinical Nutrition.  https://doi.org/10.1016/j.ajcnut.2023.12.010

Objective: “This study aimed to investigate longer-term effects of mixed nuts on brain insulin sensitivity in older individuals with overweight/obesity.”

Methods: “In a randomized, single-blinded, controlled, crossover trial, twenty-eight healthy adults (mean±SD; 65±3 years; BMI: 27.9±2.3 kg/m²) received either daily 60 g mixed nuts (15 g of walnuts, pistachio, cashew, and hazelnuts) or no nuts (control) for 16 weeks, separated by an 8-week washout period.”

Results: “Compared with control, mixed nut consumption improved regional brain insulin action in five clusters located in the left…and right occipital lobe.

Conclusions: “Longer-term mixed nut consumption affected insulin action in brain regions involved in the modulation of metabolic and cognitive processes in older adults with overweight/obesity.”

Funding: “This study was supported by a grant obtained from the International Nuts and Dried Fruit Council (INC). The INC had no role in the study design, data collection or analysis, decision to publish, or preparation of the manuscript.”

Comment: Does this study have any clinical significance?  Body weight and composition did not change. I’m all for nut-eating—love them—but for this reason?  Hardly.  Despite what this study implies, nuts have calories and they most definitely count.

As I pretty much demonstrate every Monday, industry-funded studies almost invariably produce results favoring the sponsor’s interests.

But here we have a rare exception to the rule:

• The study: Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.  The American Journal of Clinical Nutrition,Volume 119, Issue 1, January 2024, Pages 39-48.
• Objective: “To test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y.”
• Conclusions: “Among 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study.”
• 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. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging.

Comment: Why anyone would think that cocoa extract would have any efffect at all on cognitive function is beyond me, but I, in sharp contrast to Mars, am not trying to sell cocoa extract or convince anyone that M&Ms are a health food.  But, as seems invariably the case, the investigators did give Mars a small break in favorably finding “possible” cognitive benefits of cocoa extract for people eating terrible diets.  My prediction: further studies will not find benefits of cocoa extract—or M&Ms—on cognitive function even though eating M&Ms can be lots of fun.

I’ve posted several studies sponsored by the blueberry industry , most recently on their effects on menopausal symptoms.  Blueberry trade associations, as I discuss in my book Unsavory Truth: How the Food Industry Skews the Science of What We Eat, led the way in promoting research suggesting this fruit is a “superfood.”

If only.

They are still at it, apparently, but sponsorship does not always guarantee the desired outcome.  Here is a rare exception to the rule that industry-sponsored studies almost invariably give results favorable to the sponsor’s marketing interest.  Let’s give credit where it is due.

• The study:  Chronic and postprandial effect of blueberries on cognitive function, alertness, and mood in participants with metabolic syndrome – results from a six-month, double-blind, randomized controlled trial.  The American Journal of Clinical Nutrition.  Available online 6 February 2024, https://doi.org/10.1016/j.ajcnut.2023.12.006
• Methods: “A double-blind, randomized controlled trial was conducted, assessing the primary effect of consuming freeze-dried blueberry powder, compared against an isocaloric placebo, on cardiometabolic health >6 mo and a 24 h postprandial period (at baseline).”
• Results: “Postprandial self-rated calmness significantly improved after 1 cup of blueberries (P = 0.01; q = 0.04; with an 11.6% improvement compared with baseline between 0 and 24 h for the 1 cup group), but all other mood, sleep, and cognitive function parameters were unaffected after postprandial and 6-mo blueberries.”
• Conclusion: “Although self-rated calmness improved postprandially, and significant cognition-metabolite associations were identified, our data did not support strong cognitive, mood, alertness, or sleep quality improvements in MetS participants after blueberry intervention.”
• Conflict of interest: “AC reports financial support provided by the US Highbush Blueberry Council (USHBC) and Biotechnology and Biological Sciences Research Council (BBSRC, UK). AC and EBR both act as advisors and consultants to the United States Highbush Blueberry Council grant committee. All other authors report no conflicts of interest.”
• Funding: “This work was supported by the United States Highbush Blueberry Council with oversight from the USDA and the Biotechnology and Biological Sciences Research Council (United Kingdom). The funders of this research had no involvement in this publication and have placed no restrictions on the publication of these data.”

Comment: In this instance, the last statement could well be correct (it isn’t always, alas).  I like blueberries but they are not a superfood.  There is no such thing as a superfood.  If you want to eat healthfully, by all means eat fruit—and enjoy the ones you like best.

Here’s another one that several readers have asked me about: Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial.  Authors: Lok-Kin Yeung, Daniel M. Alschuler, Melanie Wall, Howard D. Sesso, JoAnn E. Manson, Adam M. Brickman.  American Journal of Clinical Nutrition. DOI:https://doi.org/10.1016/j.ajcnut.2023.05.011

The study: “Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y.”  Primary outcome measure: change in episodic memory (immediate recall performance on the ModRey test, after 1 y of intervention).  Secondary outcome measures: changes in episodic memory over 3 y of follow-up,  and in performance on neuropsychological tasks of novel object recognition and executive function over 3 y.

Results: “Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes…we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change.”

Conflict of interest: HDS, JEM, and AMB received investigator-initiated grant support to their institutions from Mars Edge. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. HDS received 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 the
American Society of Nutrition during the conduct of the study. No funding sources had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Funding: This work was supported by an investigator-initiated grant from Mars Edge, a segment of Mars Inc dedicated to nutrition research. Pfizer Consumer Healthcare (now Haleon) provided support through the
partial provision of study pills and packaging.

Comment:  This study continues to surprise me.  As I’ve written before, it is part of the COSMOS trial, which is also supported by grants from NIH and a private foundation.  In my previous post on it, I noted that despite being funded by Pfizer (which makes Centrum Silver multivitamin supplements), the study did not show benefits of the supplement for prevention of cardiovascular disease or cancer—a rare exception to the rule that industry-funded studies tend to favor the sponsor’s interests.  But here we go again, this time with an equally surprising result but for a different reason: most multivitamin studies have shown no benefits whereas this one says if you take Centrum Silver, it will give you another three years of no loss in memory.  Wow!  I’ll be Pfizer is thrilled.

Here’s what the NIH National Center for Complementary and Integrative Health says about multivitamins:

Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss.  Faidon Magkos, Sidse I Rasmussen, Mads F Hjorth, Sarah Asping, Maria I Rosenkrans, Anders M Sjödin, Arne V Astrup, Nina R W Geiker. The American Journal of Clinical Nutrition, Volume 116, Issue 6, December 2022, Pages 1820–1830, https://doi.org/10.1093/ajcn/nqac152

Methods: In this 5-mo parallel randomized intervention trial, 108 adults with BMI 28–40 kg/m² (45 males/63 females) underwent an 8-wk rapid weight loss period, and those who lost ≥8% body weight (n = 80) continued to ad libitum weight maintenance diets for 12 wk: a moderate-protein diet with 25 g beef/d (B25, n = 45) or a high-protein diet with 150 g beef/d (B150, n = 35).

Conclusions: Healthy diets consumed ad libitum that contain a little or a lot of unprocessed beef have similar effects on body weight, energy metabolism, and cardiovascular risk factors during the first 3 mo after clinically significant rapid weight loss.

Funding: The study was supported by The Beef Checkoff (a program of the National Cattlemen’s Beef Association, CO, USA) and the Danish Agriculture & Food Council (Copenhagen, Denmark). Lighter Life (Essex, UK) sponsored very-low-calorie diet products for the weight-loss phase of the study. The sponsors had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Conflicts of interest: NRWG has received funding from The Beef Checkoff program (National Cattlemen’s Beef Association, CO, USA) and the Danish Agriculture & Food Council (Copenhagen, Denmark) to conduct additional studies relevant to the role of meat in the diet. AVA is a member of the scientific advisory board for Weight Watchers, USA; congressional chairman for RNCP (Répertoire National des Certifications Professionnelles), France; co-owner of the University of Copenhagen spin-off Flax-Slim ApS; co-inventor on a pending provisional patent application for the use of biomarkers to predict responses to weight-loss diets; and co-inventor of other related patents and patent applications that are all owned by the University of Copenhagen, in accordance with Danish law. All other authors report no conflicts of interest.

Comment: The conclusion of this beef industry-funded study is that you can eat as much beef as you like without its having any effect on your body weight or metabolic risk factors, as long as you first lose weight and keep it off.  This is a perfect example of why looking at one food at a time makes no sense without also taking into consideration everything else you are eating and how much.  The Beef Checkoff got the answer it wanted, so money well spent.

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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My theme for this week is meat, poultry, and their alternatives, starting today with this:

The study: Unprocessed red meat in the dietary treatment of obesity: a randomized controlled trial of beef supplementation during weight maintenance after successful weight loss.  Faidon Magkos, Sidse I Rasmussen, Mads F Hjorth, Sarah Asping, Maria I Rosenkrans, Anders M Sjödin, Arne V Astrup, Nina R W Geiker.  The American Journal of Clinical Nutrition, nqac152, https://doi.org/10.1093/ajcn/nqac152.  

Objectives: “We sought to investigate the effects of healthy diets that include small or large amounts of red meat on the maintenance of lost weight after successful weight loss….”