Search results: a life in food

Shannon Saia sent me copies of three books in the series, Gertie in the Garden, aimed at kids ages 6-9.  Here’s one:

The other two are Going Offbeet and Making Peas (puns intentional).

She asked if I would blurb the series.  Once I read them, I was happy to:

The Gertie in the Garden series is so engaging that kids will catch on right away to why growing vegetables and even playing with them will encourage kids to view healthy foods as helping them negotiate their way in the world.  Kids will love these books (and parents will too).

I have to admit to not liking most books aimed at getting kids to like vegetables.  But I liked these a lot.  For one thing, they are focused on Gertie’s struggles to figure out how to get along with others (not easy, in her case), and her social awkwardness feels real—and fixable.

For another, learning how to garden with her grandmother is a relief from those struggles and integrated into her life in a way that again seems authentic.

I think it would be fun to read these to young kids not yet ready to read them on their own.  And the stories raise plenty of issues to talk about as well as offering practical advice about how to grow these vegetables.

Shannon tells me these are available in the usual way through bookstores and online.

This photo was just sent to me by Murray Carpenter (@Murray_journo).  I don’t know him personally but he is the author of  Caffeinated, which I blurbed and wrote about in 2014.

He wrote that ILSI, a well known front group for the food industry, must have hired someone to track media reception to my 2018 book, Unsavory Truth: How the Food Industry Skews the Science of What We Eat.  ILSI is the International Life Sciences Institute, which has since changed its name to the Institute for the Advancemement of Food and Nutrition Sciences.

Murray said that on January 19, 2019, he was in the audience for the annual ILSI conference  in Clearwater, Florida.  He sent me this account of that occasion [my emphasis in red below]:

As the conference ground on, attendance fell off. So there were plenty of empty seats when Clare Thorp took the podium. Thorp had newly assumed the position of executive director of ILSI North America. She talked about scientific integrity ad nauseam. The emphasis seemed a corrective, an effort to reinforce the message among the membership. Because for an organization that prides itself on independence and integrity, ILSI kept getting caught doing the bidding of its members, over and over again. It just couldn’t seem to rein itself in.

It wasn’t just that ILSI’s Applebaum, Hill, and Sievenpiper had become the public faces of pseudoscience [Note: scientists caught up in conflicts of interest with Coca-Cola]. Thorp also referenced the Mars situation. The corporation had first criticized ILSI-funded science, then left the group entirely.

“Our membership comes with some major challenges and opportunities,” Thorp said. “We’ve lost a major member. It happens. We keep going.”

Unwittingly, Thorp worked doggedly to prove the aforementioned axiom—the degree to which you have scientific integrity is inversely related to the number of times you claim it.

“I have a passion for sound science…I come from a family of scientists, whether practitioners or academics,” she said. The science statements came out in torrents. “Unbiased and credible research…Scientific integrity is not something we made up overnight, it’s a journey.” She displayed a slide touting the Scientific Integrity Consortium, in partnership with the USDA, which she called “a coalition of the willing.”

“We are not an advocacy or a lobbying organization. But we are actually something entirely different,” she said.

“ILSI is an industry-funded organization where these companies support research that doesn’t directly serve their private interests. They agree to be hands-off…and they bravely commit to publishing the data, no matter what it says. This is very scary. And then, why would they do it?…It’s actually altruistic. They genuinely believe it’s important. They also believe that having a collaborative forum where everyone’s voice can be heard is really necessary.”

But it wasn’t enough to just focus on the science. Thorp also considered the public perception of ILSI. She said she wanted to communicate their work more broadly, to step outside this circle of friends and take a more proactive approach.

“We need to have a better understanding of who ILSI North America is, and what we do, and how we do it.” In response, ILSI was developing more communications materials, she said, and new website graphics.

Then she displayed a slide showing an elaborate, graphically elegant word cloud. Some of the big words in the center of the cloud: “science,” “truth,” “food,” “unsavory,” “industry,” “Nestle,” “Marion.”

It turned out that the nonprofit had chosen to spend some of its money to hire a media tracker to follow the press coverage of Marion Nestle’s recent book Unsavory Truth. The book focused on corporate influence in nutrition policy. The word cloud represented an analysis of the press coverage.

And here, Thorp was actually pleased. “The themes of manipulation, deception, and conspiracy that Nestle is promoting are not coming through as main themes in the media coverage.”

Thorp said that one of ILSI’s challenges was the public perception that it’s an industry front group, and that gets onto the web. “We are working very hard to get our Wikipedia page updated, and then it gets changed again, and then we have to update it again, but it’s important,” she said.

Leading ILSI had become a tough gig. Thorp would not last a year at the helm.

Comment

Of course the word cloud did not include maniputlation, deception, or conspiracy; those words do not appear in Unsavory Truth.  The whole point of conflicts of interest induced by food industry sponsorship—which is what the book is about—is that the conflicts are almost always unintentional, unrecognized, and denied.  Researchers who take industry funding do not believe it influences their science, despite the overwhelming evidence to the contrary reviewed in my book.

What’s especially interesting to me about this is that from my perspective, Unsavory Truth had little impact.  It generated much less media coverage than most of my books, and led to few speaking invitations.  I thought it had disappeared without a trace.

Apparently not.  I am pleased and honored to learn about this incident.

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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.

The Lancet has just published its commissioned series on breastfeeding, vs the commercial formula industry: three papers, an editorial, and a comment.

Breastfeeding has proven health benefits for both mothers and babies in high-income and low-income settings alike. Yet, less than 50% of babies worldwide are breastfed according to WHO recommendations. For decades, the commercial milk formula industry has used underhand marketing strategies, designed to prey on parents’ fears and concerns, to turn the feeding of infants and young children into a multibillion-dollar business—generating revenues of about $55 billion each year.

Editorial: Unveiling the predatory tactics of the formula milk industry

For decades, the commercial milk formula (CMF) industry has used underhand marketing strategies, designed to prey on parents’ fears and concerns at a vulnerable time, to turn the feeding of young children into a multibillion-dollar business. The immense economic power accrued by CMF manufacturers is deployed politically to ensure the industry is under-regulated and services supporting breastfeeding are under-resourced.

Breastfeeding: crucially important, but increasingly challenged in a market-driven world. R Pérez-Escamilla,, et al.

In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding.

Marketing of commercial milk formula: a system to capture parents, communities, science, and policy.  N Rollins et al.

We report how CMF sales are driven by multifaceted, well resourced marketing strategies that portray CMF products, with little or no supporting evidence, as solutions to common infant health and developmental challenges in ways that systematically undermine breastfeeding. Digital platforms substantially extend the reach and influence of marketing while circumventing the International Code of Marketing of Breast-milk Substitutes.

The political economy of infant and young child feeding: confronting corporate power, overcoming structural barriers, and accelerating progress.  P Baker, et al.

First, this paper highlights the power of the commercial milk formula (CMF) industry to commodify the feeding of infants and young children; influence policy at both national and international levels in ways that grow and sustain CMF markets; and externalise the social, environmental, and economic costs of CMF. Second, this paper examines how breastfeeding is undermined by economic policies and systems that ignore the value of care work by women, including breastfeeding, and by the inadequacy of maternity rights protection across the world, especially for poorer women. Third, this paper presents three reasons why health systems often do not provide adequate breastfeeding protection, promotion, and support.

Comment: Stemming commercial milk formula marketing: now is the time for radical transformation to build resilience for breastfeeding, by Tanya Doherty et al.

One of the striking messages of the Lancet Breastfeeding Series is that the consumption of commercial milk formula (CMF) by infants and young children has been normalised. More children are consuming CMF than ever before. Only 48% of the world’s infants and young children are breastfed as recommended, despite the huge body of evidence on the lifelong benefits of breastfeeding. This situation reflects the stranglehold the CMF industry has on governments, health professionals, academic institutions, and increasingly on caregivers and families through pervasive social media.

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So many readers have asked me to comment on the American Academy of Pediatrics’ Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity that I thought I ought to say something about it.

The guideline report is so long and detailed that I cannot imagine anyone actually reading it.  I started with the introduction, which summarizes basic facts.

• 14.4 million children and adolescents are affected by obesity.
• Obesity is a chronic disease with potentially serious health consequences
• Childhood obesity is strongly affected by social determinants of health (poor education, poverty, racism, exposure to toxins, etc)
• Childhood obesity is stigmatized in ways that fail to acknowledge social determinants.

What got press attention—and the attention of readers of this blog—is the AAP’s endorsement of drug and bariatric surgical treatment of obese children.

I cut right to the chase and looked at Appendix I, which gives the AAP’s algorithm for deciding on treatment options.  

The report’s major conclusions expand on this chart (the report does not define KAS, but I think it means Knowledge, Attitudes, and Skills):

KAS 9.  Pediatricians and other PHCPs should treat overweight (BMI ≥ 85th percentile to <95th percentile) and obesity (BMI ≥ 95th percentile) in children and adolescents, following the principles of the medical home and the chronic care model, using a family-centered and nonstigmatizing approach that acknowledges obesity’s biologic, social, and structural drivers.

KAS 10.  Pediatricians and other PHCPs should use motivational interviewing (MI) to engage patients and families in treating overweight (BMI ≥ 85th percentile to <95th percentile) and obesity (BMI ≥ 95th percentile).

KAS 11.  Pediatricians and other PHCPs should provide or refer children 6 y and older (Grade B) and may provide or refer children 2 through 5 y of age (Grade C) with overweight (BMI ≥ 85th percentile to <95th percentile) and obesity (BMI ≥ 95th percentile) to intensive health behavior and lifestyle treatment. Health behavior and lifestyle treatment is more effective with greater contact hours; the most effective treatment includes 26 or more hours of face-to-face, family-based, multicomponent treatment over a 3- to 12-mo period.

KAS 12.  Pediatricians and other PHCPs should offer adolescents 12 y and older with obesity (BMI ≥ 95th percentile) weight loss pharmacotherapy, according to medication indications, risks, and benefits, as an adjunct to health behavior and lifestyle treatment.

KAS 13.  Pediatricians and other PHCPs should offer referral for adolescents 13 y and older with severe obesity (BMI ≥ 120% of the 95th percentile for age and sex) for evaluation for metabolic and bariatric surgery to local or regional comprehensive multidisciplinary pediatric metabolic and bariatric surgery centers.

What is not in this guideline is anything that addresses the social determinants of childhood obesity.  What we have here is a focus on treating the symptoms, but getting nowhere near the cause.

It is difficult for someone like me who is not affected by those determinants to even imagine how drugs and surgery could be thought even remotely acceptable for children, even those over the age of 12, but I am not treating these kids.

Providers who do treat obese children tell me they are relieved to be able to offer options that might help kids achieve healthier weights.

As I see it, these should be absolute last resorts if used at all. And this is without even getting into issues of cost or our dysfunctional health care system.

In public health terms, drugs and surgery are “downstream” solutions to a problem that began way upstream with all those societal determinants.

If ever we needed upstream approaches, chldhood obesity is a prime example.

Upstream means policy changes that make healthy eating more appealing, accessible, and affordable  That’s what pediatricians need to be calling for.

This AAP report deliberately separates treatment from prevention.  It promises a discussion of prevention in a subsequent report.  I hope it is as hard hitting as any AAP report has ever been.

If childhood obesity teaches us anything, it is that our society needs to change in ways that are healthier for our children.

Additional supporting documents

• Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity
• Appraisal of Clinical Care Practices for Child Obesity Treatment. Part I: Interventions
• Appraisal of Clinical Care Practices for Child Obesity Treatment. Part II: Comorbidities

Thanks to all the people who wrote me about this.  Much appreciated.

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I saw this on NutraIngredients.com, one of those newsletters I read regularly: Study: Mulberry extract shrinks blood sugar spike by 40%.  

That headline was all I needed: Who paid for this?

Fortunately, the study was readily available: Mulberry leaf extract improves glycaemic response and insulaemic response to sucrose in healthy subjects: results of a randomized, double blind, placebo‑controlled study.  Pariyarath Sangeetha Thondre Helen Lightowler, Lis Ahlstrom,  Andrew Gallagher.  Nutr Metab (Lond). .2021 Apr 15;18(1):41.   doi: 10.1186/s12986-021-00571-2.

Conclusion: “Mulberry leaf extract can be used as part of lifestyle changes that may lead to healthy blood glucose levels.”

Acknowledgements:  The authors would like to thank Dr Chen Xie (CX) and Mrs Hongwen Yu (HY) for technical input during the conceptualization of the study and editorial commentary on the draft publication. CX and HY are both employees of Phynova Group Limited.

Funding: The work in this study was funded by Phynova Group Ltd, a privately held company that is the developer of Reducose® mulberry leaf extract. Phynova was involved in the study design and manuscript preparation but had no role in data collection and analysis.

Competing of interest: AG is an employee of Phynova Group Limited, the funder of the study. He was involved in the development of the product, design of the study and drafting of the manuscript, but was not involved in the collection, analysis or interpretation of data. PST, HL, and LA have declared they have no conflicts of interest.

Comment:  This degree of industry involvement turns this study into industry-funded marketing research, no matter how beautifully the science is conducted.  Please refer to my book, Unsavory Truth, for references to the studies backing up that statement.

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The Federal Trade Commission has issued a Health Products Compliance Guide.

This amazing publication takes on the Dietary Supplement Health and Education Act of 1994.  That act effectively removed the FDA from regulating dietary supplements.  It also allowed supplement labels to make “structure/function” claims that the supplement supported some structure or function of the body, whether or not there was much in the way of scientific evidence to back up those claims (in contrast, FDA-authorized claims must be scientifically substantiated).

Now the FTC is saying:

Marketers of health-related products, including dietary supplements, should be familiar with the requirements under both FDA law and FTC law that labeling and advertising claims be truthful, not misleading, and substantiated.  The FTC approach generally requires that health-related claims be backed by competent and reliable scientific evidence substantiating that the representations are true.

Marketers cannot suggest unsubstantiated benefits, safety, or other characteristics.

Example 4:  An ad for an infant formula states that an ingredient added to the formula can reduce the symptoms of colic.  The ad includes an unrelated chart from a pediatric journal showing that, as a general principle, the length of time that colicky babies cry tends to decrease over the first 12 weeks of life…Using the graph in an ad for the infant formula likely implies that the formula, rather than the babies’ ages, causes the decrease in crying time.

Claims have to be qualified.

Example 10:  An energy drink contains an ingredient that, when consumed daily over an extended period, can result in a significant increase in blood pressure.  Even absent any representation about the product’s safety, the marketer should disclose this potentially serious risk.

Qualifying information must be clear and straightforward.

Example 13:  A company has results from two studies suggesting that its supplement helps to maintain healthy cholesterol levels.  There are, however, significant limitations to each of the studies… The company makes a claim in advertising that “promising, preliminary scientific studies show that our product may be effective in reducing cholesterol.”  The use of the words “promising,” “preliminary,” and “may” is unlikely to sufficiently convey the limitations of the science.

Assertions about the strength of evidence must be accurate.

Example 16: An ad for a supplement includes the statement “Scientists Now Agree!” in discussing the product’s benefit.  This statement likely conveys to consumers that the state of science supporting the benefit has reached the level of scientific consensus.  Unless the advertiser possesses evidence demonstrating that scientists have reached that consensus, the claim is false.

Marketers must consider the totality of the science.

Example 30:  An advertiser wants to claim that a supplement will substantially reduce body fat.  The advertiser has two controlled, double-blind studies showing a modest but statistically significant loss of fat at the end of a six-week period.  However, there is an equally well-controlled, double-blind 12-week study showing no statistically significant difference between treatment and control groups.  Assuming other aspects of methodology are similar, the studies taken together suggest that, if the product has any effect on body fat, it would be very small and may not persist over time.  Given the totality of the evidence, the claim is unsubstantiated.

Here’s the press release. 

The bottom line:  The FTC is requiring evidence for health claims on supplements.

This will affect claims for thousands of supplement products.

Enforcement anyone?  This should be fun to watch.

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Jonathan Rees.  The Fulton Fish Market: A History. Columbia University Press, 2022.

I really wanted to read this book and was appy to do a blurb for it.

Rees’s history of Manhattan’s Fulton Fish Market is an elegy for a place that reached peak vibrancy in the 1920s, only to decline steadily as a result of overfishing, developers, the Mafia, unions, politics, refrigeration, real estate prices, and, eventually, more developers.  Rees’s thoughtful analysis of these themes has much to tell us about the clash between the natural and built worlds in American cities over the last couple of centuries.

Rees is a history professor at Colorado State-Pueblo, a food historian.  I’ve long wanted to understand the changes I’ve witnessed at Manhattan’s South Street Seaport and the reasons for moving the fish market to Hunt’s Point in the Bronx, a mile from the nearest subway station.

I remember my first visit—at 4:00 am on a cold winter’s day—to the fish market in the mid-1990s.  It was lit up like a stadium, crowded with people, tables covered with fish, and hand-trucks for moving them.  I thought it looked like a move set on which the director has just shouted, “Action.”  We had to move quickly to avoid being hit.

My guide was the chef-owner of a Chelsea fish restaurant who pulled thousands of dollars in cash out of his pockett o pay for the fish he was selecting carefully for the next few days.  His purchases went to a van that would take them to his restaurant within the next hour or so.

We went for coffee at a nearby café and were out of there by 6:00 a.m.

I picked four excerpts from Rees’ book that help explain the history of this place:

(1) Two developments very close to the Fulton Fish Market spurred the transformation of the entire neighborhood into something new by the end of the twentieth century and beyond: the founding of the South Street Seaport Museum in 1967 and the development of the neighborhood by the Rouse Corporation, a Baltimore firm best known for its successful revitalization of the Faneuil Hall area in Boston… More development increased rents. Businesses which made more money than dealing in wholesale fish then bought up properties that the dealers had moved into earlier in the century, thereby changing the character of the neighborhood. The city and the state never deemed the actual fish market worthy of protection. As a result, every new project that made the neighborhood more desirable made it harder for the fish market to stay a fish market.

(2) From a longterm perspective, the geographical advantage of the Fulton Fish Market disappeared when fish stopped arriving there by water….When they arrived in New York by train or truck it no longer mattered where in New York City the fish market happened to be. In fact, with the arrival of modern refrigeration and freezing, you could have moved the largest fish market in America to Connecticut, or South Carolina for that matter….

(3) The original Fulton Fish Market was obviously a market in the sense that it was a place to buy and sell fish, but the longterm historical significance of the place derives more from the other sense of the word “market,” namely the abstract idea that there is a set of dedicated buyers for the good that gets sold there. The wholesalers who ran the Fulton Fish Market expanded the scope of the abstract market in order to keep their physical market going…Nobody really cared about the public good as long as they were all still making money…the actions of the wholesalers who operated there spurred the general indifference of the wholesale fish industry to the problem of overfishing, despite the obvious cost of this behavior to the overall amount of fish in the sea.

(4) In ancient Greece, the marketplace was the center of daily life. The body politic congregated there to interact, make collective decisions and conduct commerce. Fulton Market bore some resemblance to this situation during its early history, but its operations became less public as it evolved into a wholesale market….Today, without a subway stop anywhere near it, average New Yorkers would have difficulty getting to any of the city’s wholesale markets in the South Bronx. Moreover, because of improvements in refrigeration and transportation, wholesale markets aren’t even necessary for restaurants or groceries to operate in the city anymore… These days, it is very easy to forget that Manhattan is an island.

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