My book, Soda Politics, came out not quite a year ago but so much has happened since then that it’s been hard to keep up with everything that’s happening in campaigns to discourage consumption of sugar-sweetened beverages.

Fortunately, Healthy Food America’s Casey Hinds puts out a daily roundup of sugar and soda news (you can sign up for it and HFA’s other materials here).

A few recent items of particular interest:

USA Today’s editorial, “soda taxes fall flat“

More effective ways already are being used to change people’s diets. The best use of government authority is to empower people with the information they need to make healthier choices.

The editorial comes with a poll, still up.  You can vote on it here.  At this moment only 183 votes have come in, 51% strongly in favor of the editorial opinion.

Jim Krieger of Healthy Food America did a counterpoint

The time has come to tax sugary drinks like we tax tobacco. The analogy is powerful: As with tobacco, rock-solid evidence shows habitual use harms health. Sugary drinks are a prime culprit in rampant health problems — diabetes, obesity, and heart, dental and liver disease – that cut lives short and drive up health care costs.  Tobacco taxes have reduced smoking, while raising money to make lives better. Taxing sugary drinks would do the same

This too has a poll on which you can still vote.  Only 92 votes have come in, and only 38% strongly agree.

Americans don’t like taxes.  Even so, either this issue doesn’t generate much interest or it’s just August and too hot to think about such things.

The beverage industry spent $10.6 million to oppose Philadelphia’s soda tax initiative

The soft drink industry does not like taxes and seems willing to put fortunes into opposing them.

The Philadelphia City Council passed the tax anyway.  I keep thinking of all the good things nearly $11 million could do for public health.

Melbourne’s The Alfred Hospital reduces sugary drink consumption

The hospital did an experiment to see if they could shift the mix of drinks purchased from sugary to less sugary.  They did this by increasing the price of sugary drinks and hiding them under counters.  Sales of sugar-sweetened beverages sales fell by 36,500 drinks in a year.

I don’t get it.  Why not just stop selling them altogether?

That’s it for this August Monday.  Stay cool.  More to come.

Addition, August 23

A reader from New Zealand writes to say that “all of its hospitals no longer sell sugary sodas and some are also beginning to remove juice and artificially sweetened beverages due to their acidic nature and detrimental impact on oral health.”

Michaela DeSoucey.  Contested Tastes: Foie Gras and the Politics of Food.  Princeton University Press, 2016. 

I thought this book was exceptionally interesting and did a blurb for it:

Contested Tastes takes a deep dive into the gastropolitics of foie gras, the fatty duck liver commonly consumed in France but much less so in America.  Whether or not you approve of eating this food, you will want to read this riveting case study of how fights among stakeholders—producers and eaters of fatty duck liver, of course, but also animal welfare advocates, chefs, and government officials—reflect much larger issues of national identity, class, economic markets, and who gets to decide what we have for dinner.

Here’s a brief excerpt from her chapter on Chicago’s decision in 2006 to ban the sale of foie gras in restaurants, rescinded two years later and considered a fiasco by the Chicago Tribune.

Personal and social identities, as well as consumer movements, are realized through commodities and solidified through consumer behavior.  This lends a political dimension to the act of choosing, or refusing, certain foods…But yet, one can only “vote” as an eater among the choices made available by the business and regulatory communities…who has the ability and resources to “vote with their forks” remains a salient issue of social class.  This analogy casually affirms the liberal rhetoric of personal choice, bypassing the myriad ways in which one’s choices are influenced by others and their life circumstances.  This is the gastropolitical model that surrounded events in Chicago, meshing the language of taste and of choice with that of overt stakeholder politics.

This is an example of food studies in action—using food to explore the deeper cultural implications of important issues in our society.

I breathed a long sigh when I read Gina Kolata’s We’re So Confused: The Problems With Food and Exercise Studies in the New York Times on August 11.

Nearly everything you have been told about the food you eat and the exercise you do and their effects on your health should be met with a raised eyebrow… The problem is one of signal to noise. You can’t discern the signal — a lower risk of dementia, or a longer life, or less obesity, or less cancer — because the noise, the enormous uncertainty in the measurement of such things as how much you exercise or what exactly you eat, is overwhelming. The signal is often weak, meaning if there is an effect of lifestyle it is minuscule, nothing like the link between smoking and lung cancer, for example.

This is a pessimist’s view.  I, however, am an optimist.

Nutrition advice could not be easier to understand.  Eat plenty of vegetables and fruits; balance calories; don’t eat too much junk food.

David Katz must agree.  He asks: Diets, Doubts, and Doughnuts: Are We TRULY Clueless?

No, we are not, absolutely not, emphatically NOT clueless about the basic care and feeding of Homo sapiens…In the New York Times this past week, Gina Kolata made the case that almost all studies about diet, exercise, and health are suspect in one way or another, and that therefore we are confused about lifestyle practices for health, and justifiably so. The first point is valid; the second is utter nonsense…A global consensus of expert judgment concurs… Routine physical activity and a diet of mostly minimally processed vegetables, fruits, whole grains, beans, lentils, nuts, seeds and water when thirsty redounds consistently to the advantage of human health. It offers benefits to the planet as well.

Or, as Michael Pollan famously put it:

Eat food, not too much, mostly plants.

Articles like that one add to the confusion; they don’t help clear it up.

The FDA has announced its Final Rule on Substances Generally Recognized as Safe (GRAS).

The FDA explains:

Unlike food additives, GRAS substances are not subject to FDA pre-market approval; however, they must meet the same safety standards as approved food additives…The GRAS criteria require that the safe use of ingredients in human and animal food be widely recognized by the appropriate qualified experts.

Uh oh.  “Appropriate qualified experts?”  Like those selected by the companies themselves?  The FDA has failed the public on this one.

Consumers Union (CU) says

FDA missed a major opportunity to clean up the food system… Companies will still be able to introduce novel substances into food in secret, without having to show they are safe.  The agency also failed to fix the rampant conflicts of interest that affect the review process for ingredients. That is unacceptable and deeply disappointing [CU should know.  It filed comments on the FDA’s proposed GRAS rules in 2011].

Senator Ed Markey (Dem-MA) says

FDA’s Final Rule On Food Safety Process Is A Missed Opportunity…The health and well-being of the American people depend on a meaningful food safety regulatory policy, not a self-graded take home exam that industry doesn’t even have to hand in…I plan to explore whether a legislative remedy is needed to ensure the safety of our food supply [Sen. Markey sent FDA a letter in April asking if the agency needs statutory authority to ensure the safety of GRAS substances and encouraging the FDA to issue guidance on how to prevent conflicts of interest for outside experts evaluating GRAS substances.

The backstory

The FDA’s final GRAS rule is the result of a settlement agreement following a 2014 lawsuit filed by the Center for Food Safety. The basic issue: GRAS substances are not subject to FDA premarket approvals required for food additives.  Manufacturers are allowed to decide for themselves whether their additives are GRAS without informing the FDA. The new rules confirm this self-managed GRAS notification procedure.

I wrote about this issue in an editorial for JAMA Internal Medicine in 2013 when I commented on a study by Tom Neltner and his colleagues on the blatant conflicts of interest in FDA approval of GRAS substances.

Their study examined conflicts of interest among scientific experts serving on panels deciding whether food additives–substances that preserve, flavor, blend, and thicken food—should be deemed generally recognized as safe (GRAS) and exempt from Food and Drug Administration (FDA) premarket approval requirements.  Their findings are alarming. An astonishing 100 percent of the members of 290 expert panels included in their review worked directly or indirectly for the companies that manufactured the additive in question.  Even more alarming, the experts on these panels form a tight professional cadre.  Although 850 people served on the panels, 10 experts served on 27 panels or more, and one of these ten participated in three-quarters of the panels.

My editorial reviewed the lengthy history of FDA’s dithering about the GRAS process.  None of this would matter if all food additives were safe.  But some are not.  I also pointed out:

The problems created by conflicts of interest for the FDA go well beyond those related to food additives and GRAS exemptions.  A recent analysis of requests for waivers by people serving on FDA advisory committees views conflicts of interest as a severe threat to scientific integrity.  As Neltner et al. argue, the lack of independent review in GRAS determinations raises serious questions about the public health implications of unregulated additives in the food supply, particularly the additives that the FDA does not even know about. It also raises questions about conflicts of interest in other regulatory matters.

The FDA’s decision is a loss for public health.

It constitutes yet another reason not to eat products with long lists of additive ingredients.

Addition, August 16

The Environmental Working Group also issued a statement.

EWG is disappointed the FDA has decided to once again ignore its legal obligation to ensure the safety of our nation’s food supply…The so-called “GRAS loophole” – originally intended to only allow known ingredients proven safe to skip regulatory approval – has swallowed the law, permitting novel chemicals to be added to food without government oversight.

I can hardly keep up with news about sugar these days.  Here are a bunch of items that I thought worth notice.

Healthy Food America has produced a Sugar Advocacy Toolkit

Now is the time to act. Scientific evidence of the harm caused by added sugars is strong and growing. News stories have begun sounding the alarm. Some Americans are getting the message that sugar is unhealthy and are cutting back, but consumption remains high along with health impacts associated with overconsumption.

Corporate Europe Observatory has produced a report, A Spoonful of Sugar: How the food lobby fights sugar regulation in the EU.  Here’s how:

• Lobbies for trade treaties that help undermine or overturn food regulations
• Challenges regulation through legal threats, complaints, and deregulation drives
• Works towards corporate capture of regulatory bodies
• Emphasizes physical activity to avoid legislative action
• Sponsors scientific research
• Champions weak voluntary schemes
• Lobbies aggressively and spends huge sums to combat effective regulation

Good news: A textual analysis of sugar industry influence on the World Health Organization’s 2015 sugars intake guideline shows that WHO mostly resisted the lobbying (here’s the entire paper).

There was little change between draft and final versions of the WHO sugars intake guideline 2015, following industry consultation. The main change was linked to emphasizing the low quality of the evidence on sugar’s adverse effects. Guideline development appeared relatively resistant to industry influence at the stakeholder consultation stage.

Britain’s Food and Drink Federation issued reformulation guidelines for small- and medium-sized businesses on how to reduce sugar and label sugars.

How’s this for a headline: Food lobby rigs EU sugar laws while obesity and diabetes spiral out of control.

Another headline: Big Sugar’s Fanjul Family Hosting Miami Fundraisers for Both Clinton and Trump This Year [The Fanjuls have long been equal opportunity funders]

From The Hagstrom Report: 

House Agriculture Committee Chairman Michael Conaway, R-Texas, Senate Agriculture Committee ranking member Debbie Stabenow, D-Mich., and Alexis Taylor, a high ranking Agriculture Department official, all committed themselves to the future of the U.S. sugar program today as industry officials and analysts talked about the struggles that beet producers and cane refiners are experiencing in the midst of imports from Mexico and the controversy surrounding genetically modified foods [Comment: recall that US sugar prices are higher than world market prices because of tariffs and quotas, and that every attempt to drop these measures has failed under lobbying pressures].

KIND bars are the first to label added sugars.  

As Grub Street puts it, all food companies are scrambling to reduce their sugars.

It will still be two years before nutrition labels have to get seriously transparent about their sugar content, yet it looks like the countdown is already starting to make Big Food squirm. Added sugar is both omnipresent in Americans’ diets and actively loathed for that very reason. So in May, when the FDA announced new labels had to disclose the number of grams, experts’ hunch was that many products were about to suddenly become a lot less sweet. This prediction was pretty spot-on, if Bloomberg’s new report on Kind is any indication: The snack-bar-maker just became the first company to start voluntarily labeling sugar content, and — surprise, surprise — there’s a lot less sugar in there.

Enough for now.  More to come.  Have a sweet weekend.

In Great Britain, at least, supermarkets promote junk foods more than they promote healthy foods.

No surprise.  Junk foods are more profitable!

A recent study did something useful.  It examined the nutritional quality of more than 2000 foods with or without health-related claims.

As compared with food products without health claims, foods with health claims had, on average, per serving:

• 29 fewer calories
• 3 grams less sugar
• 2 grams less saturated fat
• 842 mg less sodium
• 0.8 grams more fiber

The authors conclude:

Foods carrying health-related claims have marginally better nutrition profiles than those that do not carry claims…It is unclear whether these relatively small differences have significant impacts on health.

Unclear?  Most of these are barely measurable.  Only the sodium reduction might help.

This study confirms the following:

• Health claims on food packages are not about health; they are about marketing.
• Just because a food product is slightly better for you does not necessarily mean that it is a good choice.

JAMA Pediatrics has just published a report that cases of marijuana intoxication in young children has increased since the drug was legalized in Colorado.  The authors are careful to note that the number of cases is small relative to those that occur in kids consuming pharmaceutical drugs or household cleaning products, but the trend is not good.

Nearly half the cases occurred in kids eating foods in which THC (tetrahydrocannibinaol) is a prominent ingredient:

Known marijuana products involved in the exposure included 30 infused edible products (48%): 17 baked goods (cookies, brownies, and cake), 10 candies, and 2 popcorn products…. Ingestion of edible products continues to be a major source of marijuana exposures in children and poses a unique problem because no other drug is infused into a palatable and appetizing form. These palatable products are often indistinguishable from the noninfused products.

Dosing a drug in a “serving size” less than typically recommended for an equivalent food product also can be a source of confusion. For example, a marijuana chocolate bar can contain multiple 10-mg THC single-dose units. In adults, overconsumption of edible projects is associated with an increase in ED visits resulting from dysphoric reactions, panic attacks, and anxiety. Edibles have also been blamed for 3 adult deaths in Colorado.

Pot-laced popcorn?

One concern is that the infused edibles look like normal foods.  You have to read the fine print to see the THC label.

And they are not likely to go away.  THC-edibles are big business.  They accounted for 45% of marijuana sales last year, according to the Denver Post.

Dr. Christopher Colwell, chief of emergency medicine at Denver Health Medical Center…estimated there was a fivefold to tenfold increase in the number of patients — including a sharp rise in the number of adolescents and teenagers — arriving at the hospital after consuming part or all of a marijuana edible.

Colwell said he expected an increase in the number of marijuana cases. But he said he was surprised and concerned with the higher potency of THC in the edibles and the more severe symptoms it can cause.

Users: be careful.

Parents: keep the brownies away from kids.

I’m guessing we will be hearing  a lot more about this issue.