At the insistence of Jerry Mande, I watched the meeting of the President’s Council of Advisors on Science and Technology (PCAST) to learn about the Federal Vision for Advancing Nutrition Science in the United States.

This Vision derives from last year’s White House Conference on Hunger, Nutrition, and Health and its pillar on enhancing nutrition research.

Cathie Woteki, who introduced the report, made a forceful case for the importance of chronic disease prevention.  Her committee was shocked  that the majority of Americans are overweight or obese, and at a cost of $500 billion annually.  She pointed out the lack of focus and coordination of 200 existing programs that ought to be addressing this issue.

The conclusion: not enough research on chronic disease and more funding needed.

No question about that.  Yes, we need more nutrition research and more funding for it.  A lot more.

But the White House request for the Office of Nutrition Research is only $1.3 million (see p. 26).  Surely this  is some kind of joke?  It’s hardly even a rounding error in federal terms.

As for the PCAST report’s efforts needed:  That’s all?

Yes we can use more data and research on personal eating habits and individual behavior, but what about the food environment?

Maybe PCAST is under political constrainsts but this sure does feel like a lost opportunity.

The report —as yet unpublished—appears to say nothing about:

• The effects of ultra-processed foods on individual food choices and weight. (the word “ultra-processed” was not mentioned)
• The need to change the food environment to make it easier and less expensive for individuals to make healthier food choices.
• Policies to requirie food companies to produce healthier foods and reduce serving sizes.
• Policies to stop the food industry from marketing ultra-processed foods to kids.
• Programs to achieve the existing 2030 health objectives to prevent obesity and chronic disease (these were not mentioned).

The committee said it consulted widely to produce this report.  Not widely enough, I’d say.

Compare this to what the UK House of Lords is doing in its hearings on  Food, Diet and Obesity.  Take a look at who they are listening to.

If the PCAST committee talked to any of these people, their comments are not showing up.

PCAST has a real opportunity here to push for a strong research and policy agenda to address obesity and its related chronic diseases.

What kind? Here are my suggestions.

Today I’m participating on a panel discussion on Ozempic at 12:30 EDT.  See announcement to the right; register for it here. 

I watched the Oprah special on the obesity drugs.

Its messages:

• Obesity is a disease, requiring treatment.
• These drugs offer treatment.
• The drugs are effective; side effects are minimal.
• Yes they are expensive and therefore, promote inequality; therefore, the government should pay for them.

The program was a one-hour, prime-time commercial for the drugs.

The physicians who testified on their behalf consult for the drug companies.

The program has already had an effect.  cause the FDA says semaglutide helps prevent heart attacks, strokes, and deaths in overweigth people, the government will now authorize payment through Medicare Part D.

Here’s what was not discussed.

• The fortunes the drug companies spent on getting doctors, health professionals, and influencers to promote the drugs and minimize their side effects.  See Reuters for US doctors and The Guardian for European influencers.
• The sharp rise in obesity prevalence between 1980 and 2000 and the environmental and commercial reasons for it.
• Anything about prevention. and changing that food environment.
• Anything serious about the down side of taking the drugs (lifetime treatment, cost, side effects, loss of joy in eating).

An editorial in The Lancet says:

A simple pill or injection will undoubtedly help some patients, but it cannot be the sole basis for addressing the complexities of obesity. Obesity is a product of not only an individual’s circumstances and behaviour, but also society at large, shaped by global food markets and trade agreements. Multidimensional approaches are needed to curb the effects of the obesogenic environment, particularly against an international industry that promotes overproduction of cheap food and drinks. Physical activity needs to increase; walking and cycling for journeys to work or school should be normalised and made easier and safer. Sugar taxes and curbs on marketing of high-energy, high-fat, ultra-processed foods need to be implemented. Prevention must be the foundation upon which everything else follows.

Other comments

• The New York Times account focuses on stigma.
• USA Today says people are suing the drug companies over side effects.

Much to be said about all this.  Stay tuned.

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.

Austin Frerick.  Barons: Money, Power, and the Corruption of America’s Food Industry.  Island Press, 2024.  With an Introduction by Eric Schlosser.

Wow.  This is one important book.

Frerick’s thesis is that a small number of individuals or families have been allowed to accumulate unconscionable levels of wealth by exploiting or getting around laws (mostly legally but sometimes with bribes), pressuring government to collude, and doing everything possible to enrich themselves at the expense of community and worker welfare—all in the name of low food prices for consumers whether or not they are the reality.

Frerick takes on family enterprises in pigs, grain, coffee, dairy, berries, animal slaughter, and groceries.

This is one tough book.  Frerick structures the chapters to describe the rise of the families’ fortunes, how they exploited rules and customs, and how that got government to collude in giving these companies so much market share and power.

I learned a lot from every chapter, so much that I found myself checking references—-these are extensive—constantly to find our where he had gotten information I’d never seen before.

.About Walmart’s payment of low wages to employees, for example,  Frerick writes,

These low wages also obscure a generous hidden subsidy that the company receives from taxpayers. Many Walmart employees depend on government public assistance programs such as Medicaid (health care), Earned Income Tax Credit (a low-wage tax subsidy), Section 8 vouchers (housing assistance), LIOHEAP (energy assistance), and SNAP (food assistance), among others. In 2013, one estimate by congressional House Democrats found that taxpayers subsidized Walmart to the tune of more than $5000 per employee each year….In effect, instead of paying a living wage to these employees, the Walton family shifts the burden to taxpayers.

Not only that, but SNAP users spend a lot of their benefits at Walmart.

With some back-of-the-envelope math, I came up with a rough estimate that Walmart now receives somewhere around $26.8 billion each year from SNAP.

The chapter on JBS, the Brazilian company now one of four companies controlling 85 percent of meat slaughtering, is particularly worth reading for its documentation of the company’s use of bribery to achieve its ends.

If you want to know how corporations control the food supply, start here.

I learned about this from reading a headline in FoodNavigator-Asia: Mediterranean diet linked to reduced neurodegeneration in elderly Chinese.

This got my attention: Why would anyone be studying the Mediterranean diet in Chinese people.  The traditional Chinese diet, like that of the Mediterranean diet, is largely plant-based and strongly associated with health and longevity.

But here we have it.  Basically, they want to know if this diet works in Chinese as well as North American and Oceanic populations.  As so it does.

The study: Association of adherence to the Chinese version of the MIND diet with reduced cognitive decline in older Chinese individuals: Analysis of the Chinese Longitudinal Healthy Longevity Survey.  The Journal of nutrition, health and aging.  Available online 1 January 2024, 100024

• Purpose: This study aimed to assess the correlation between the Chinese version of the MIND (cMIND) diet and cognitive impairment in older Chinese individuals.  [MIND = Mediterranean-Dietary Approaches to Stop Hypertension (DASH) diet intervention for Neurodegenerative Delay].
• Method: The cMIND diet score (cMINDDS) was calculated by assessing dietary patterns based on survey responses.
• Results: The increased cMINDDS was associated with a reduced risk of cognitive impairment. Higher consumption of fresh fruits and nuts was associated with a decreased risk of cognitive impairment (OR = 0.77, 95% CI: [0.66, 0.89] and OR = 0.70, 95% CI [0.58, 0.86], respectively).
• Conclusion: Adherence to the cMIND diet was associated with lower risks of cognitive impairment in older Chinese individuals.

About the diets

The MIND diet recommended 10 brain-healthy food groups (green leafy vegetables, other vegetables, nuts, berries, soybeans, whole grains, not fried fish, not fried poultry, olive oil, and wine) while avoiding five unhealthy groups (red meat and products, butter/margarine, cheese, pastries and sweets, and fast fried foods).

The cMIND diet comprises 12 components: staple food composition, quantity, fresh vegetables, mushrooms or algae, fresh fruits, fish, cooking oil, soybeans, nuts, garlic, tea, and sugar.

Here’s a quick comparison:

Comment:  Both diets are healthy.

Bottom line (can’t be emphasized enough, apparently): Eating a healthy diet is good for health.

In case you haven’t been keeping track, virtually all corn, cotton, and soybeans (and sugar beets not on this graph) are genetically modified. 

Not only that, but they take up more than half of all cropland in the United States.

And half the corn is used to fuel automobiles.

Monoculture, control of the food supply, and lack of biodiversity, anyone?

Science Magazine has this editorial headline: Reverse EU’s growing greenlash**

I learned about this one from a commentary from Yoni Freedhoff, MD: Kimchi: Not Magically Protective Against Weight Gain.

• The study: Association between kimchi consumption and obesity based on BMI and abdominal obesity in Korean adults: a cross-sectional analysis of the Health Examinees study.  BMJ Open.  2024 Jan 30;14(2):e076650.  doi: 10.1136/bmjopen-2023-076650.
• Participants: “This study analysed 115 726 participants aged 40-69 years enrolled in the Health Examinees study in Korea.”
• Results: “In men, total kimchi consumption of 1-3 servings/day was related to a lower prevalence of obesity (OR: 0.875 in 1-2 servings/day and OR: 0.893 in 2-3 servings/day) compared with total kimchi consumption of <1 serving/day. Also, men with the highest baechu kimchi (cabbage kimchi) consumption had 10% lower odds of obesity and abdominal obesity. Participants who consumed kkakdugi (radish kimchi) ≥median were inversely associated with 8% in men and 11% in women with lower odds of abdominal obesity compared with non-consumers, respectively.”
• Conclusions:  “This large cross-sectional study described the association between kimchi consumption and obesity. In conclusion, total kimchi consumption of 1–3 servings/day was shown to be reversely associated with obesity in men. Regarding the type of kimchi, baechu kimchi was associated with a lower prevalence of obesity in men, and kkakdugi was associated with a lower prevalence of abdominal obesity in both men and women. However, since all results showed a ‘J-shaped’ association, excessive consumption suggests the potential for an increase in obesity prevalence. As kimchi is one of the major sources of sodium intake, a moderate amount of kimchi should be recommended for the health benefits of its other components. In addition, further investigation and prospective studies are needed to confirm the relationship between kimchi consumption and obesity.”
• Competing interests: “HJ and SS have no conflicts of interest to declare for this study. Y-RY and SWH are members of the staff at the World Institute of Kimchi.”
• Funding: “This research was supported by grants from the World Institute of Kimchi (KE2201-1) funded by the Ministry of Science and ICT, Republic of Korea.”

Dr. Freedhoff ‘s analysis of the data:

According to the paper, men who reported eating two to three servings of kimchi per day were found to have lower rates of obesity, whereas men who reported eating three to five servings of kimchi per day were not. But these are overlapping groups! Also found was that men consuming more than five servings of kimchi per day have higher rates of obesity. When taken together, these findings do not demonstrate a statistically significant trend of kimchi intake on obesity in men. Whereas in women, things are worse in that the more kimchi reportedly consumed, the more obesity, in a trend that did (just) reach statistical significance.

Comment: Why anyone would expect kimchi (spicy fermented vegetables such as cabbage) to affect obesity one way or the other is beyond me, but the World Institute of Kimchi must want more people to eat it.  Does anyone need an excuse to eat kimchi?  It’s great on its own without needing this kind of claim.  This study is about marketing, not science.