Andrew Fisher.  Big Hunger: The Unholy Alliance between Corporate America and Anti-Hunger Groups.  MIT Press, 2017.

This book has a big theme, and I was happy to do a blurb for it:

If you don’t understand why anti-hunger groups hardly ever advocate for higher wages or public health nutrition measures for low-income Americans, see Andy Fisher’s analysis: they owe too much to their food-company donors.  Big Hunger is a call to action, one well worth heeding.

Here’s his interview today in Civil Eats.

Evaluation of the effect of the Berkeley soda tax continues.  The latest results, published in PLoS Medicine, say that one year after implementation of the tax,

Prices of Sugar-Sweetened Beverages (SSBs) increased in many, but not all, settings

• Sugary beverage sales declined by 9.6% in Berkeley stores
• Untaxed beverages sales increased by 3.5% driven by bottled water (up 15.6%)
• Average grocery bills did not increase
• Store revenue did not fall more compared to control cities
• Post-tax self-reported SSB intake did not change significantly compared to baseline

The evaluation was funded by Bloomberg Philanthropies with support from the University of North Carolina’s Population Center and its National grant from the NIH.

The University sent out its own press release.

It also did a short video explaining what the tax is about and its effects.

Michael Jacobson of CSPI says

For Berkeley, Calif., to reduce soda sales by 10 percent—and to raise water sales by 16 percent—is a huge public-health victory.  It shows that the soda tax enacted in Berkeley is working as intended.  And rather than costing the city, the soda tax represents a brand-new revenue stream, which Berkeley is using for important health programs.  We hope voters and policymakers elsewhere in the country will review the findings published in PLoS Medicine and press for soda taxes in their communities.

This study won’t stop Big Soda from claiming that taxes don’t work.  But if soda taxes didn’t make a significant dent in soda consumption, the industry wouldn’t be fighting taxes so hard.

Helena Bottemiller Evich at Politico reports on the response to this study from the American Beverage Association (ABA), which I cannot find online.  The ABA:

pointed out that the reduction in sales of sugar-sweetened beverages in Berkeley yielded a reduction of only 6.4 calories per person, per day. The study also revealed, the group added, that the tax’s first year produced an increase of about 31 calories per person, per day from untaxed beverages. The study’s authors noted the increase appeared to be largely attributable to increased intake of milk and “other” beverages, like yogurt smoothies and milkshakes.

The ABA also argued that Berkeley — a relatively small city with a high median income that wasn’t a soda-consumption hotbed to begin with — is “a challenging place to determine the true impact of a beverage tax, unlike Philadelphia, where the tax has led to significant job losses and economic hardship for working families.”

“This study does, however, confirm that sales of taxed beverages inside the city declined while sales of those same beverages outside the city increased, which is also what is happening in Philadelphia,” the ABA said.

“America’s beverage companies know we must play a role in improving public health, which is why we are taking aggressive actions to help people reduce the sugar and calories they get from beverages,” the group continued, noting the industry has pledged to cut calories from its products across the board — with a special focus on reducing calorie consumption in a few places that have extremely high rates of obesity, including communities in Los Angeles, the Mississippi Delta and rural Alabama.

The soda tax story continues.  It is not over yet.  Stay tuned.

Here are some reports:

• The Daily Mail
• Forbes

The National Library of Medicine (NLM) has quietly announced that it will henceforth include funding and conflict-of-interest statements on the abstracts published on PubMed, its searchable site for scientific publications.

This happened because of a petition organized by the Center for Science in the Public Interest (CSPI), which I signed, and which called for this method of disclosure.  CSPI sent a formal request to the NLM on March 30, 2016.  The NLM announcement came one year later.

CSPI issued a press release:

Hundreds of millions of searches are conducted on PubMed annually by people around the globe.  In a March 2016 letter to NIH and NLM, CSPI and other supporters cited studies published in Cochrane Collaboration, PLoS Medicine, and elsewhere that found that outcomes of studies on drugs, medical devices, and nutrition were often favorable to funders’ interests.

“Adding disclosures about researchers’ financial relationships with drug, food, chemical, and other industries makes PubMed search results even more useful than they already are,” said CSPI president Michael F. Jacobson.  “We thank the National Library of Medicine for adding this feature and hope journalists who rely on PubMed make consistent use of it when reporting on studies related to nutrition and health.”

The press release quotes me:

New York University nutrition scientist Marion Nestle tracked 168 industry-funded studies on her blog, foodpolitics.com.  By her count, 156 of those reported studies favorable to the sponsors’ interests.

“These required extensive library searches to find the disclosure statements,” said Nestle.  “I only looked for papers that seemed industry-funded from their titles, and undoubtedly missed many with both positive and negative results.  This new policy will make this kind of research much easier and more accurate.”

Amen to that.

Bettina Siegel writes with sad news: Dana Woldow died last week.

I will miss her.  Dana was my go-to person for information about school meal funding, a fierce advocate for getting more funding for school food service.  If you wanted to understand school food politics, her columns at Beyond Chron were essential reading.  The last one was posted September 19, 2016 with good and bad news about San Francisco’s school meals.

I often referred to her columns in this blog.  Here are some examples dating back to 2008:

• Feb 20, 2008: Thanks to Dana Woldow of the San Francisco Unified School District for sending this link to resources for making school meals healthier. Check out the salad bar video (way down at the bottom of the list of links). The city now has salad bars in 25 schools.
• Aug 25, 2008: And here’s a commentary in the San Francsico Chronicle from some folks on the front line of school lunches in the San Francisco Bay area.  Even a little more money would go a long way.
• Sept 5, 2009: Dana Woldow’s terrific 3-minute video detailing the situation in San Francisco’s public schools – as seen by kids in that system.  As the kids put it, “We need better school food!”
• May 24, 2013: Fortunately, Dana Woldow, also a long time food advocate, has just posted an interview with Ms. Siegel on just those points.
• Nov 5, 2014: Dana Woldow, who has covered these elections closely on the website Beyond Chron, has this to say about the Berkeley win.
• Feb 17, 2015: As to what all this [the fight over school food] is about, see Dana Woldow’s explanation in Beyond Chron.  As she bluntly puts the matter, “It would be comforting to think that SNA members are making those decisions based on what is most nutritious and healthy for growing kids, but unfortunately they are just as likely to be influenced by the recommendations of Big Food companies peddling processed crap.”
• March 9, 2015: Dana Woldow argues that the school food scene would be much easier if schools actually got enough money to pay for what they serve and for decent wages to school food service workers.
• July 21, 2015: Dana Woldow explains what’s really happening with schools that drop out of the meal programs ostensibly on the grounds that the new standards cost too much.

Dana: I will miss your tough, on-the-ground analysis of school food politics.  You always called it as you saw it.  And you saw plenty.

May others take up your cause.  Now.

The Consumer Goods Forum works with manufacturers and retailers to improve practices that benefit consumers such as food safety and health.

It has just released its latest Health & Wellness Progress report based on a survey it conducted in 2016.  The report is based on responses from 102 food, beverage, and retail companies.

The Forum encourages food companies to address health and wellness challenges: healthier products, the health of employees, consumer information, and responsible marketing.

I was particularly interested in seeing the results on product reformulation:

Here’s what’s being reformulated:

Will product reformulation make a difference to health?

Or, as some say, is it just another corporate political strategy, one aimed at diverting policies from moving towards mandatory approaches.

Product reformulation has been praised as a rare example of a “win-win” for the food and beverage industry and public health efforts to reduce obesity and NCDs [noncommunicable diseases], and has been described as a “pragmatic” nutrition policy…However [there are]…numerous reasons to suggest that voluntary reformulation also plays a role in the industry’s strategy to avoid unfavorable regulatory conditions, and this finding warrants significant consideration.

The latest is Connecticut.

• the bill says
• The Hartford Courant says
• The Connecticut Post says
• David Katz says

Here’s my list of taxes passed (!) and pending (?).  Have I missed any?  Please inform.

• Navajo Nation (!)
• Berkeley (!)
• Albany, CA (!)
• Oakland (!)
• San Francisco (!)
• Philadelphia (!!!) (sorry about forgetting it)
• Boulder (!)
• Chicago (!)
• Santa Fe (?)
• West Virginia (?)
• Seattle (?)
• Portland (?)

Healthy Food America has a handy map.

Addition: Bloomberg News has its own roundup

In response to my commentary in JAMA Internal Medicine late last year, “Food Industry Funding of Nutrition Research: The Relevance of History for Current Debates, the journal published an objecting letter from Morton Satin titled  “Incorrect Impressions Concerning Industry-Sponsored Research.”

Mr. Satin works for The Salt Institute, which promotes the idea that “everything’s better with a little salt.”

Here’s my reply to his letter:

In Reply Mr Satin raises several points in response to my recent Invited Commentary¹ about how food companies fund research for marketing purposes: (1) I give the impression that all industry-funded research is inherently tainted; (2) I ignore the industry’s triumph in fortifying foods with nutrients; (3) I fail to mention intellectual conflicts of interest; and (4) I should consider such issues before stereotyping.

First, my commentary was about research sponsored by food companies specifically to demonstrate the health benefits or lack of harm of a product, or to cast doubt on evidence to the contrary. It referred to a particularly egregious example—the sugar industry’s attempt to manipulate research results.² Although some industry-funded research does produce results contrary to the sponsor’s interests, such instances are rare.³ Most ends up useful in some way to the sponsors’ commercial objectives; it is marketing research, not basic science.

The point by Mr Satin about nutrient fortification has merit, but most of the basic research on nutrients used in fortification was conducted by independent scientists. Mr Satin’s own Salt Institute credits independent scientists for promoting iodization and convincing the industry to cooperate with public health authorities to iodize salt.⁴Pasteurization kills pathogens; iodide and fluoride address geographical deficiencies; and niacin, folic acid, and fiber replace amounts removed from foods by processing in the first place. Once public health authorities recognized the need, they demanded milk pasteurization or the addition of nutrients to flour. When dental researchers discovered that fluoride prevents cavities, Procter & Gamble recognized its marketing potential and funded research on fluoridated toothpaste.⁵

All scientists have intellectual biases—that is how science gets done and why science works best when researchers with different views of science repeat each other’s experiments. But the goals of scientists pursuing intellectual hypotheses differ markedly from those of companies seeking to sell food products.

Questioning food industry funding raises sensitive issues, not least because its influence on researchers occurs unconsciously, is usually unintentional, and is difficult for recipients to recognize.⁶ Food companies are not public health agencies and should not be expected to be; their first priority is to provide profits to owners and shareholders. Funding research helps with that effort. My purpose in writing the Invited Commentary was to bring the contradictions of food industry research funding to the attention of readers.

Conflict of Interest Disclosures: Dr Nestle’s salary from New York University supports her research, manuscript preparation, and website at https://foodpolitics.com. She also earns royalties from books and honoraria and travel from lectures about matters relevant to the initial Invited Commentary and this Letter in Reply.

References

1. Nestle  M.  Food industry funding of nutrition research: the relevance of history for current debates.  JAMA Intern Med 2016;176(11):1685-1686.  PubMedArticle

2.  Kearns  CE, Schmidt  LA, Glantz  SA.  Sugar industry and coronary heart disease research: a historical analysis of internal industry documents.  JAMA Intern Med. 2016;176(11):1680-1685.PubMedArticle

3.  Lesser  LI, Ebbeling  CB, Goozner  M, Wypij  D, Ludwig  DS.  Relationship between funding source and conclusion among nutrition-related scientific articles.  PLoS Med. 2007;4(1):e5. doi:10.1371/journal.pmed.0040005PubMedArticle

4.  The Salt Institute. Iodized salt. http://www.saltinstitute.org/news-articles/iodized-salt/. Published July 13, 2013. Accessed January 17, 2017.

5.  Ksander  Y. The invention of fluoride toothpaste. Indiana Public Media. http://indianapublicmedia.org/momentofindianahistory/the-invention-of-flouride-toothpaste/. Published July 10, 2006. Accessed January 17, 2017.

6.  Lo  B, Field  MJ.  Conflict of Interest in Medical Research, Education, and Practice. Washington, DC: National Academies Press; 2009.

Rolling back nutrition standards #1: Added Sugars

The new administration is hard at work undoing the gains of the last one.

In my post on the nominee for FDA Commissioner, Scott Gottlieb, I noted that he’d been saying nothing about food.  Now he is.

He told Congress this week that he’s open to “pushing back the Nutrition Facts label update deadline [of July 2018] to align it with USDA’s coming GMO labeling regulation.”

The Center for Science in the Public Interest (CSPI) has plenty say about this.  As it explains, the food industry wants the

deadline to be pushed back to align with the USDA’s coming GMO disclosure regulation — a measure that isn’t likely to kick in for a few years (at least)… Gottlieb suggested during the hearing that he may be open to aligning the deadlines…You want to try to consolidate the label changes when you’re making label changes as a matter of public health, he said, adding that requiring companies to update their labels repeatedly is costly.

But wait!  Doesn’t this sound just like what food company leaders said in March in a letter to HHS Secretary Tom Price?

On behalf of the food and beverage industry, we are writing to express our concern with the current compliance deadline of July 2018 for the Nutrition Facts and Serving Size (NFL) rules and to request extending the deadline to May 2021.

May 2021?  Let’s hope we all live that long.

Reminder: Everyone would be healthier eating less sugar.

Rolling back nutrition standards #2: School food

According to Politico, Senate Agriculture Chairman Pat Roberts wants the USDA to undo the school meal nutrition standards put in place by the Obama administration.  In a letter to the USDA Acting Deputy Secretary, Roberts said:

I urge you to act administratively and provide immediate relief from certain egregious aspects of the standards, particularly in regards to the rapidly approaching sodium limits and the dairy and whole grain requirements,..After providing immediate relief, I urge you to provide long-term flexibility and certainty for our schools, our food service directors, and other stakeholders.

Reminder: the school nutrition standards are working just fine.