Thanks to Maria Fernanda Gombi-Vaca in São Paulo for taking a photo of  Coca-Cola’s Christmas display.

Fortunately, Christmas tree ornaments have no sugar or calories…

Larry Cohen.  Prevention Diaries: The Practice and Pursuit of Health for All.  Oxford, 2016.

Larry Cohen is an old friend and I was happy to be asked to do a blurb for his terrific book:

Prevention Diaries is Larry Cohen’s intensely personal and introspective account of why stopping health problems before they start makes sense for individuals and for societies—and is possible.  His stories of how advocates have successfully intervened to prevent problems caused by unhealthy eating, cigarettes, automobiles, guns, violence, and system inequalities should inspire everyone interested in public health to get involved in prevention programs that will make a real difference in people’s lives.

Here’s a brief excerpt from his “food for thought” chapter:

The realities of our food system can feel overwhelming—too large and too entrenched to change all at once.  But, as with so many big problems, communities and businesses are taking valuable steps to create the system we want and need.  Indeed, it feels like the United States is at the beginning of a sea-change in its pproach to food—with a swell of interest in seemingly old approaches, like farmers’ markets, heirloom produce, and cooking from scratch, which benefit consumers and workers.  As the movement has been building, its momentum and innovation have increasingly started to reshape government policies and industry practices in ways that ensure all people can enjoy the fruits of a healthier food system (p. 93).

From his lips to God’s ear, as the saying goes.

The Associated Press reporter Candice Choi has a special interest in industry-funded research (as I do) and has been using emails obtained through FOIA requests to document connections between funders and researchers that otherwise would not come to light.

Yesterday, she reported some follow up on the article I was surprised to see published in the Annals of Internal Medicine—the one I wrote about in my last post.

Ms. Choi came up with these delicious tidbits:

• Mars Inc., which is one of the companies that funds ILSI (the International Life Sciences Institute, which funded the study in the Annals charging that dietary guidelines for sugar are based on weak evidence), is now denouncing the study on the grounds that “the paper undermines the work of public health officials and makes all industry-funded research look bad…[and] creates more doubt for consumers rather than helping them make better choices.”
• Mars is saying this even though emails show that two Mars executives knew about the study last year.
• Mars now said it will make clear to ILSI hat it does not support such work.
• ILSI’s executive director says ILSI devised the concept for the study, but the paper originally said that the authors wrote the protocol and conducted the study independently from the funder. Oops.  When confronted with the Associated Press emails “showing the group sent the authors ‘requested revisions’ on the proposal last year,” the journal corrected that statement to make clear that ILSI “reviewed and approved” the protocol.
• One of the authors did not fully disclose her consulting and research agreements with companies that make high-sugar foods.  The AP had emails demonstrating this author’s financial ties to Coca-Cola and to ILSI for a previous grant on the same topic.  The Annals now show a more complete disclosure statement.

The point of all this is that when food companies sponsor research, they sometimes are much more involved in it than they would like to let on.

Mars is right.  These kinds of incidents make all industry-funded research look bad.  Mars should know.  It funds research to make chocolate look like a health food.

I haven’t posted an industry-funded study for a while, but here’s a good one.  This is a systematic review published in the Annals of Internal Medicine attacking dietary advice to eat less sugar on the grounds that such advice is not scientifically justified.

This one doesn’t pass the laugh test.

What are dietary guidelines supposed to do?  Tell people to eat more sugar?

This review is particularly peculiar:

• It was funded by the International Life Sciences Institute (ILSI), a food-industry front group.
• Two of the four authors consult for ILSI, and one of the two is on the scientific advisory board of Tate & Lyle, the British sugar company.
• The authors admit that “given our funding source, our study team has a financial conflict of interest and readers should consider our results carefully.”  No kidding.
• It was published by a prestigious medical journal.  Why?
• It is accompanied by an editorial that thoroughly demolishes every single one of the authors’ arguments.

I can understand why ILSI wanted this review.  Many of its funders make sugary foods and drinks.  They would like to:

• Cast doubt on the vast amounts of research linking excessive sugar intake to poor health.
• Discredit dietary guidelines aimed at reducing sugar consumption.
• Head off regulatory attempts to tax or label added sugars.

In funding this study, ILSI is following the tobacco industry playbook to the letter.  Strategy #1 is to cast doubt on the science.

When the 2015 Dietary Guidelines came out with a recommendation to restrict sugar intake to 10% of calories or less, the Sugar Association called it“agenda-based, not science-based.”  The Annals review says international sugar guidelines do not “meet criteria for trustworthy recommendations and are based on low-quality evidence.”

I detect a theme here.

But I ask again: what are dietary guidelines supposed to do?  We cannot lock up large numbers of people and feed them controlled amounts of sugar for decades and see what happens.  Short of that, we have to do the best we can with observational and intervention studies, none of which can ever meet rigorous standards for proof.  So this review is stating the obvious.

Take a look at the accompanying editorial.  After destroying each of the flawed premises of this review, it concludes:

Industry documents show that the F&B [Food & Beverage] industry has manipulated research on sugars for public relations purposes….Accordingly, high quality journals could refrain from publishing studies on health effects of added sugars funded by entities with commercial interests in the outcome. In summary, our concerns about the funding source and methods of the current review preclude us from accepting its conclusion that recommendations to limit added sugar consumption to less than 10% of calories are not trustworthy. Policymakers, when confronted with claims that sugar guidelines are based on “junk science,” should consider whether “junk food” was the source.

I don’t ever remember seeing a paper accompanied by an invited editorial that trashes it, as this one did, but this incident suggests a useful caution.

Whenever you hear that something isn’t “science-based,” look carefully to see who is paying for it.

The press coverage

• The New York Times: A Food Industry Study Tries to Discredit Advice About Sugar (I’m quoted)
• NPR: How Much Is Too Much? New Study Casts Doubts On Sugar Guidelines (I’m quoted)
• EurekAlert: Dietary sugar guidelines are based on low quality evidence
• WTKR:The debate continues on how much sugar is OK
• Time: Should You Trust the New Research About Sugar?
• CSPI: Industry-funded Study Designed to Cast Doubt on Sugar Advice
• Daily Mail (Reuters): So we CAN eat more sugar? Controversy as top journal publishes Coca Cola-funded study claiming sweets are NOT as bad as feds claim (I’m quoted)

USDA has just released three sets of GIPSA rules governing poultry grower ranking (“tournament”) systems (GIPSA stands for Grain Inspection, Packers & Stockyards Administration).

These are draconian systems in which poultry growers working for giant, vertically integrated poultry companies compete with each other for payments.

The system works like this:

The vertically integrated live poultry dealer provides the chicks, feed, and medication to poultry growers who house and feed the birds under a contract. The poultry grower grows the birds to market size (preferred weight for slaughter) and then, after slaughter, receives a settlement check for that flock. The payment received depends on how efficiently the poultry grower converted feed to meat as compared to the other poultry growers in the settlement group.

It’s hard to begin to imagine how unfair this system can be.

The poultry companies control the following inputs and production variables: chick health, number of chicks placed, feed quality, medications, growout time, breed and type of bird, weighing of the birds, and weighing of the feed.

And on top of this, “company employees who are also poultry growers get preferential treatment and may get better birds or get to keep flocks longer.”

Or, as GIPSA’s Q and A puts it:

For example, if a chicken grower attempts to organize other chicken growers to bargain for better pay or publicly expresses unhappiness with the way they are being treated by a processor, they can suffer retaliation. Processors can require growers to make investments that are not economically justifiable for the grower, or can terminate contracts with little notice. And because in contract growing the processors own the birds and provide inputs like feed, they can choose to provide poultry growers with bad feed or sickly birds that have a higher mortality rate, which cuts deeply into a grower’s opportunity to earn income on those birds.

The USDA press release pointed out that

the four largest poultry processors control 51 percent of the broiler market and 57 percent of the turkey market.  In part due to this concentration, poultry growers often have limited options for processors available in their local communities: 52 percent of growers have only one or two processors in their state or region to whom they can sell.  That means processors can often wield market power over the growers, treating them unfairly, suppressing how much they are paid, or pitting them against each other.

GIPSA initially proposed rules in 2010 that would protect growers from some of these abuses by paying them more fairly, but the industry objected.  It doesn’t like the revised rules either.  As the National Chicken Council puts it, “Obama Administration Strangles Poultry and Livestock Producers with New, Controversial Regulations.”  And the pork producers say they will work with president Trump to get rid of the rule.

The current proposals are a compromise, but a reasonably good one.  The proposal establishes criteria that the USDA Secretary may use to determine:

whether a live poultry dealer has used a poultry grower ranking system to compensate poultry growers in an unfair, unjustly discriminatory, or deceptive manner, or in a way that gives an undue or unreasonable preference or advantage to any poultry grower or subjects any poultry grower to an undue or unreasonable prejudice or disadvantage.

The National Sustainable Agriculture Coalition says the rules

finally give the largely toothless act some bite. The “Farmer Fair Practices Rules” published today…will provide much-needed protections to contract farmers in the poultry and livestock industry.

Food and Water Watch says (via email)

These proposed and interim rules provide important, though modest, protections for farmers, but fall far short of the safeguards mandated by the 2008 Farm Bill. Hopefully, these rules can provide a foundation for strengthening farmer protections in the face of an increasingly consolidated poultry, hog and cattle slaughter and processing industry.

But I particularly love the tell-it-like-it-is statement from the Government Accountability Project’s Amanda Hitt (also via email):

It’s been a long time since we have been in a position to praise the Department of Agriculture, but today, Secretary Vilsack got it right…The GIPSA rules that came out today are not only a welcome attempt to right a series of wrongs that heretofore have gone unchecked, but are also simple common sense.

These farmers…were lied to and manipulated by a corporate machine that has been using its political influence to profit at the peril of the American farmer. This is not a partisan issue; this is about putting limits on corporate greed. I hope that all can agree that something needs to be done and that these rules are an important first step.

Here are the relevant documents:

• Poultry Grower Ranking Systems – Proposed Rule
• Scope of sections 202(a) and (b) PSA – Interim final rule
• Unfair Practices and Undue Preferences Violation PSA – Proposed Rule
• FAQs

I’m not sure how this happened, but I posted the title and cover of this book in October without saying a thing about it.  My apologies.  Here it is again.

Darryl Benjamin and Lyndon Virkler.  Farm to Table: The Essential Guide to Sustainable Food Systems for Students, Professionals, and Consumers.  Chelsea Green, 2016.

This is two books in one.

The first part, Farm, is about the real costs of industrial agriculture, environmental and human, and what can be and is being done about them.

The second part, Table, is a how-to for restaurants, schools, and institutions who want to source from local farms and for local farmers who want to supply those places.

The book gives specific examples illustrated with charts and photos and provides theory as well as practice suggestions.

The chapter on marketing gives the seven Ps–product, price, place, promotion, people, process, and physical evidence—along with things to consider and tips.

We have emphasized throughout this book that Farm-to-Table products sell themselves.  This is usually true once people have sampled their quality, understand their importance to the community and to the environment, and know where to find them.  The role of marketing is to facilitate those connections.

This is a great guide for beginners but there is plenty to learn hear for everyone.

The Urban Institute has just published The Pros and Cons of Taxing Sweetened Beverages Based on Sugar Content.

The report is funded by the American Heart Association and others.  The AHA issued a press release.

The sections of the report state its conclusions:

• Taxing Sugar Content Is the Least Costly Way to Reduce Sugar Consumption
• Taxing Based on Sugar Content Is Feasible at the National Level
• Taxing Based on Sugar Content Raises More Issues at the State and Local Level but Is Generally Feasible As Well

The report concludes:

We conclude that taxing based on the amount of added sugar a drink contains, either by taxing sugar content directly or by levying higher volume taxes on drinks with more sugar, is feasible in many jurisdictions and reduces sugar consumption more effectively than comparable taxes on drink volume.

Broad-based volume or sales taxes on all soft drinks, however, raise revenue more efficiently.

Federal, state, and local policymakers thus face trade-offs between using sweetened-beverage taxes to raise revenue and to discourage consumption of added sugars.

Keep this in mind when trying to do this in your community.

Attorneys in California Minnesota, Georgia, and North Carolina have filed a class action lawsuit in California against the leading manufacturers and sellers of pet food: Mars, Nestlé (no relation) Purina, Hills, Petsmart, and several veterinary hospital chains owned by one or another of these companies.

Why?  Prescription pet foods cost more but are no different than any other kind of pet food.

As the complain puts it:

• Defendents’ prescription pet food contains no drug or other ingredient not also common in non-prescription pet food.
• Defendents’ marketing, labeling, and/or sale of prescription pet food is deceptive, collusive, and in violation of federal antitrust law and California consumer-protection law.
• Defendents are engaged in an anticompetitive conspiracy to market and sell pet food as prescription pet food to consumers at above-market prices that would not otherwise prevail in the absence of their collusive prescription-authorization requirement.

As Malden Nesheim and I explained in our book Feed Your Pet Right (which is really an analysis of the pet food industry), all compete-and-balanced pet foods must meet identical nutritional standards.

The only difference between the most expensive and cheapest commercial pet foods is in where the ingredients come from.  When writing our book, we could not find any research demonstrating that pets eating the most expensive commercial brands were any healthier than those eating the cheapest.

No pet food company would want to do research like that.   Much more and better research is needed.

The lawsuit charges that the companies are using prescriptions to raise the price of the products.

The complaint is interesting to read.

• Item 46 points out that prescription pet food does not follow FDA requirements for manufacture, does not appear in the FDA’s “green book” listing approved animal drugs, and is made from the same ingredients found in common pet foods.
• Item 53 points out that nobody would purchase prescription pet food at higher prices, “if not for the misleading marketing described herein.”

I will be watching this one with riveted interest.  Stay tuned.