The FDA is extending the comment period for the meaning of “natural” on food labels until May 10, 2016.  This, it says, is

In direct response to requests from the public…Due to the complexity of this issue, the FDA is committed to providing the public with more time to submit comments. The FDA will thoroughly review all public comments and information submitted before determining its next steps.

The “complexity of this issue?”  Isn’t it obvious what “natural” means when applied to food—minimally processed with no junk added?

Not a chance.  “Natural” is too valuable a marketing term to forbid its use on highly processed foods.  To wit:

Here, as the agency explains, is what complicates the meaning of “natural”:

The FDA is taking this action in part because it received three Citizen Petitions asking that the agency define the term “natural” for use in food labeling and one Citizen Petition asking that the agency prohibit the term “natural” on food labels.  We also note that some Federal courts, as a result of litigation between private parties, have requested administrative determinations from the FDA regarding whether food products containing ingredients produced using genetic engineering or foods containing high fructose corn syrup may be labeled as “natural.”

Are foods containing genetically modified ingredients or HFCS “natural?”

The FDA says

It has long “considered the term “natural” to mean that nothing artificial or synthetic  (including all color additives regardless of source) has been included in, or has been added to, a food that would not normally be expected to be in that food.

However, this policy was not intended to address food production methods, such as the use of pesticides, nor did it explicitly address food processing or manufacturing methods, such as thermal technologies, pasteurization, or irradiation. The FDA also did not consider whether the term “natural” should describe any nutritional or other health benefit.

Specifically, the FDA asks for information and public comment on questions such as:

• Whether it is appropriate to define the term “natural,”
• If so, how the agency should define “natural,” and
• How the agency should determine appropriate use of the term on food labels.

If you want to weigh in on this, you now have until May 10 to do so.  Go to http://www.regulations.gov and type FDA-2014-N-1207 in the search box.

Here are the background documents:

• Federal Register Notice: Use of the Term “Natural” in the Labeling of Human Food Products; Request for Information and Comments; Extension of the Comment Period.
• “Natural” on Food Labeling

May your holidays be happy, healthy, and natural, of course.

Systematic Review of Pears and Health. Holly Reiland, BS Joanne Slavin, PhD, RD.  Nutrition Today November/December 2015 – Volume 50 – Issue 6 – p 301–305.  doi: 10.1097/NT.0000000000000112.  

• Conclusions: Animal studies with pears suggest that pears may regulate alcohol metabolism, protect against ulcers, and lower plasma lipids. Human feeding studies with pears have not been conducted. In epidemiological studies, pears are combined with all fresh fruits or with apples, because they are most similar in composition. The high content of dietary fiber in pears and their effects on gut health set pears apart from other fruit and deserves study.
• Funding: The authors received a grant from USA Pears in the past. The authors provided their own funding to allow this article to publish as Open Access.
• Comment: Pears are a great fruit but the marketing purpose of this study is evident from this press release from the Pear Bureau Northwest: “While the body of evidence connecting pear intake and health outcomes is still limited, USA Pears has been contributing to research efforts by commissioning independent studies to learn and affirm the heath attributes of pears. Visit www.usapears.org for additional pear research, nutrition resources and recipes.”

Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents – Findings from the MyBreakfast Study.  Norimah AK , H. C. Koo, Hamid Jan JM, Mohd Nasir MT, S. Y. Tan, Mahendran Appukutty, Nurliyana AR, Frank Thielecke, Sinead Hopkins, M. K. Ong, C. Ning, E. S. Tee.  PLoS ONE 10(10): e0138247. doi:10.1371/journal.pone.0138247

• Conclusion: Whole grain is consumed by only a minority of Malaysian children and adolescents and even among consumers, intakes are well below recommendations. Efforts are needed to firstly understand the barriers to whole grain consumption among Malaysian children in order to design effective health promotion initiatives to promote an increase in whole grain consumption.
• Funding: The Nutrition Society of Malaysia received an unrestricted research grant from Cereal Partners Worldwide, Switzerland and Nestleé R&D Center, Singapore. This financial support was provided in the form of salaries for authors but the funders did not have any additional role in the study design, data collection and analysis or decision to publish. Frank Thielecke was an employee of Cereal Partners Worldwide at the time this study was conducted. He now works for Nestec SA. Sinead Hopkins is employed by Cereal Partners Worldwide (CPW), Switzerland and Moi Kim Ong and Celila Ning are employed by Nestleé R&D Center, Singapore….Nestlé and Cereal Partners Worldwide have a commercial interest in breakfast cereals.
• Comment: I learned about this study from a comment on Retraction Watch, which reported that PLoS One had filed a correction to the funding section.  The correction says that the salaries were for research assistants, not authors.

Walnuts Consumed by Healthy Adults Provide Less Available Energy than Predicted by the Atwater Factors.  David J Baer*, Sarah K Gebauer, and Janet A Novotny. J Nutrition First published November 18, 2015, doi: 10.3945/​jn.115.217372.

• Conclusion: Consistent with other tree nuts, Atwater factors overestimate the metabolizable energy value of walnuts. These results could help explain the observations that consumers of nuts do not gain excessive weight and could improve the accuracy of food labeling.
• Funding: This research was funded by the USDA and the California Walnut Commission… DJ Baer was funded by the USDA and the California Walnut Commission.

Cardiorespiratory Fitness, Body Fatness, and Submaximal Systolic Blood Pressure Among Young Adult Women.  Prasad Vivek Kumar, Drenowatz Clemens, Hand Gregory A., Lavie Carl J., Sui Xuemei, Demello Madison, and Blair Steven N.  Journal of Women’s Health, 2015 ahead of print. doi:10.1089/jwh.2015.5307.

• Conclusion: CRF, BF%, and BMI seem to have critical roles in determining SSBP with CRF and BF% being more potent at lower intensity exercise, whereas BMI was more strongly associated at higher intensity exercise.
• Funding for this project was provided through an unrestricted grant from The Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis, and interpretation, or preparation and submission of this article. The authors thank the Energy Balance staff and study participants for their contributions. No competing financial interests exist. 
• Comment: This is one of the papers produced by participants in the now defunct Global Energy Balance Network formerly sponsored by Coca-Cola.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including metaanalyses, of the evidence from human and animal studies. PJ Rogers, PS Hogenkamp, C de Graaf , S Higgs , A Lluch , AR Ness , C Penfold , R Perry , P Putz , MR Yeomans and DJ Mela.  International Journal of Obesity advance online publication, 10 November 2015; doi:10.1038/ijo.2015.177

• Conclusion¨The preponderance of evidence from all human randomized controlled trials indicates that LES [low-energy sweeteners] do not increase EI [energy intake] or BW [body weight], whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.
• Conflict: This work was conducted by an expert group of the European branch of the International Life Science Institute (ILSI Europe). The expert group received funding from the ILSI Europe Eating Behaviour and Energy Balance Task Force. Industry members of this task force are listed on the ILSI Europe website at www.ilsi.eu.
• Comment: ILSI is funded by food companies.

Last Friday, Coca-Cola UK joined its US counterpart in revealing the names of the organizations, researchers, and individuals it funds and the amounts it pays for these services.

As Jon Woods, General Manager of Coca-Cola Great Britain and Ireland, explains:

Earlier this year, my colleagues in the US published a list of the health and wellbeing partnerships, research and individuals funded there, dating back to 2010. In October, I committed to do the same and today we have published the details of what we have funded in Great Britain.  I believe this is the right thing to do…The total amount of funding we have provided in GB since 2010 is £9,328,095.

Like the US list, which has been analyzed extensively by Ninjas for Health, this one is interesting to read.

Here is a small sample from the list of organizations:

• Biotechnology and Biological Sciences Research Council — £20,000
• British Dietetic Association — £5,600
• British Feeding & Drinking Group Annual Meeting — £1,200
• British Nutrition Foundation — £33,000

A sample from the list of scientists and other individuals (not otherwise identified, alas):

• Fiona Hunter
• Prof. Ken Fox
• Lynne Garton
• Dr. Geoffrey Livesey
• Dr. Sigrid Gibson
• Dr. David Haslam
• Prof. Marion Hetherington
• Penny Hunking
• Angie Jefferson
• Prof. Ian Macdonald

I’m sure British public health advocates will have fun looking up what these people have said about sugary drinks and obesity.

The Times of London explained who some of them are:

The advisers include Stuart Biddle, of Loughborough University, who was chairman of a health department group on obesity in 2010; Alan Boobis, a director at Public Health England, who stopped receiving funding in 2013; Ken Fox, who advised the government on obesity in 2009; and Carrie Ruxton, now on the board of Food Standards Scotland. In 2010 Dr Ruxton co-wrote a study sponsored by the UK Sugar Bureau, an industry group, that found no proven association between sugar intake and obesity.

According to Der Spiegel, Coca-Cola plans to reveal everyone it sponsors in Europe.  All of this is further fallout from August’s New York Times’ revelations of Coca-Cola sponsorship of the now defunct Global Energy Balance Network.

More to come, no doubt.  Stay tuned.

Mark Pendergrast: Beyond Fair Trade: How One Small Coffee Company Helped Transform a Hillside Village in Thailand.  Greystone Books, 2015.

Mark Pendergrast is the author of the definitive history of Coca-Cola, For God, Love, and Coca-Cola, about which I have warmly appreciative things to say in my own contribution to that genre, Soda Politics.  

He writes a “semi regular”column on coffee for the Wine Spectator, and this is his second book on coffee.  The first was Uncommon Grounds: The History of Coffee and How it Transformed the World.

Here, he focuses on the Doi Chaang Coffee Company, the result of a business partnership between a Canadian coffee company and a coffee-growing hill tribe in Thailand.  This is an inspiring story of social entrepreneurship at its best. Sometimes these things work.  It’s worth reading about how this one did.

Thanks to Helena Bottemiller Evich of Politico Pro for doing the homework on food issues covered by the omnibus spending deal just agreed to by the House.  Here’s my quick summary of her summary.

• GMO labels: the effort to preempt local and state GMO labeling initiatives failed as a result of the efforts of 30 representatives who opposed the measure.
• Country of origin labels repealed: the meat industry scores a win in the House vote to repeal the measure.
• Dietary guidelines: I discussed this one in yesterday’s post.  The House wants to block their release on the grounds that they are not sufficiently scientific (translation: the meat industry doesn’t like advice to eat less meat).
• The Clean Water Act: it survives.
• GMO salmon: it will have to be labeled.
• Food safety funding: up more than $132 million to $2.72 billion in discretionary funding. This is a big win for the FDA. It also proposes $1 billion for the USDA’s Food Safety and Inspection Service, also above the president’s request.
• Trans fat ban”: delayed until FDA’s formal rules go into effect in June 2018.
• School lunch flexibility: Riders allow schools to ignore whole grain requirements and block sodium restrictions pending further research.
• Chinese chicken out of schools: Prohibits purchasing chicken that was processed in China for school meals or other federal nutrition programs.
• More kitchen equipment: Schools get another $30 million for school equipment grants.
• Horse slaughter: Banned.

Caveat: this is the House deal only.  The House has to vote on the actual bill, then the Senate.  Then the two bills need to be reconciled and the President needs to sign.  Until then, everything is up for grabs.

The bill just passed by the House contains this language:

SEC. 734. None of the funds made available by this or any other Act may be used to release or implement the final version of the eighth edition of the Dietary Guidelines for Americans, revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341), unless the Secretary of Agriculture and the Secretary of Health and Human Services ensure that each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and each new nutritional or dietary information or guideline to be included in the eighth edition of the Dietary Guidelines for Americans.

(1) is based on significant scientific agreement; and

(2) is limited in scope to nutritional and dietary information.

SEC. 735.

(a) Not later than 30 days after the date of the enactment of this Act, the Secretary of Agriculture shall engage the National Academy of Medicine to conduct a comprehensive study of the entire process used to establish the Advisory Committee for the Dietary Guidelines for Americans and the subsequent development of the Dietary Guidelines for Americans, most recently revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341). The panel of the National Academy of Medicine selected to conduct the study shall include a balanced representation of individuals with broad experiences and viewpoints regarding nutritional and dietary information.

(b) The study required by subsection (a) shall include the following:

(1) An analysis of each of the following:

(A) How the Dietary Guidelines for Americans can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.

(B) How the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints.

(C) How the Nutrition Evidence Library is compiled and utilized, including whether Nutrition Evidence Library reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards.

(D) How systematic reviews are conducted on longstanding Dietary Guidelines for Americans recommendations, including whether scientific studies are included from scientists with a range of viewpoints.

(2) Recommendations to improve the process used to establish the Dietary Guidelines for Americans and to ensure the Dietary Guidelines for Americans reflect balanced sound science.

(c) There is hereby appropriated $1,000,000 to conduct the study required by subsection (a).

Comment:  I continue to be astonished that the House of Representatives would take such an intense interest in the science of nutrition when it is so uninterested in the science of climate change.  And I am puzzled as to why the House thinks that nutrition scientists appointed by the Academy of Medicine (formerly Institute of Medicine) would have views any different from those of the current Dietary Guidelines Advisory Committee.

Will the USDA and HHS release the 2015 Dietary Guidelines before the Senate passes its version of the Appropriations bill?

I’m in Geneva this week and am hoping they wait until I get back.

I’ve been asked to comment on the Associated Press investigation of slave-like working conditions in the Asian shrimp-processing industry.  It’s an ugly story, with seemingly everyone turning a blind eye to horrendous working conditions, child labor, and forced labor in order to keep the cost of shrimp—our number one seafood import—dirt cheap.

The AP quotes Susan Coppedge, the U.S. State Department’s new anti-trafficking ambassador.  Who knew that we even had an anti-trafficking ambassador?  But here’s the 2015 Trafficking report.

Ciooedge said

problems persist because brokers, boat captains and seafood firms aren’t held accountable and victims have no recourse.

Here are another five industry-sponsored studies with results that can be used for marketing purposes (otherwise, what’s the point?).

Effects on childhood body habitus of feeding large volumes of cow or formula milk compared with breastfeeding in the latter part of infancy David Hopkins, Colin D Steer, Kate Northstone, and Pauline M Emmett.  Am J Clin Nutr 2015;102:1096–103.

• Conclusion: “The feeding of high volumes of cow milk in late infancy is associated with faster weight and height gain than is BM feeding. The feeding of bottle-fed infants with high volumes of cow milk in late infancy may have a persisting effect on body habitus through childhood.”  The authors point out “Our findings strengthen the current American Academy of Pediatrics and United Kingdom Department of Health guidelines, which stress the need to not introduce cow milk as a main drink before 12 mo of age. Parents should be advised about the appropriate volume of milk to offer their children once complementary feeding is established.”
• Funding: The research, although specifically funded by Wyeth Nutrition, was carried out independently. DH previously received funding from Pfizer Nutrition Ltd. KN and PME have, from time to time, received research funding, and PME has received consultancy funding from Pfizer Nutrition Ltd., Plum Baby, and Danone Baby Nutrition (Nutricia Ltd.). PME currently receives research funding from Nestlé Nutrition.
• Comment: The study finds that differences between the growth of children fed breast milk or formula disappear by age two.  Infants fed cow milk grew significantly faster than both of the other groups.

Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Liana C Del Gobbo, Michael C Falk, Robin Feldman, Kara Lewis, and Dariush Mozaffarian. Am J Clin Nutr December 2015, vol. 102 no. 6 1347-1356.

• Conclusions: Tree nut intake lowers total cholesterol, LDL cholesterol, ApoB, and triglycerides.
• Funding: LCDG and DM received modest ad hoc consulting fees from the Life Sciences Research Organization (LSRO) in Bethesda, MD, to support this study. MCF, RF, and KL received payment through LSRO (<5% of gross income) to conduct a review of nuts and cardiovascular health outcomes, which was funded through a contract with the International Tree Nut Council (ITNC).

Safety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trial Javier I Ottaviani, Marion Balz, Jennifer Kimball, Jodi L Ensunsa, Reedmond Fong, Tony Y Momma, Catherine Kwik-Uribe, Hagen Schroeter, and Carl L Keen. Am J Clin Nutr December 2015, vol. 102 no. 6 1425-1435

• Conclusion: The consumption of CFs [cocoa flavanols] in amounts up to 2000 mg/d for 12 wk was well tolerated in healthy men and women.
• Funding: Supported in part by an unrestricted gift from Mars Inc. The company also provided the food-grade, standardized test materials and authentic analytical standards as gifts…. JIO, MB, CK-U, and HS are employed by Mars Inc., a company with long-term research and commercial interests in flavanols and procyanidins. CLK has received an unrestricted research grant from Mars Inc. and is the current holder of the Mars Chair in Developmental Nutrition. In addition, CLK has consulted for other food companies and government agencies with an interest in health and nutrition, as well as in phytonutrients, including flavanols and procyanidins.

Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Roger D Gibb,*, Johnson W McRorie Jr., Darrell A Russell, Vic Hasselblad, and David A D’Alessio. Am J Clin Nutr December 2015 , vol. 102 no. 6 1604-1614.

• Conclusion: These data indicate that psyllium would be an effective addition to a lifestyle-intervention program.
• Funding: RDG, JWM, and DAR are full-time employees of P&G, which markets a psyllium product. DAD has received an unrestricted research grant from P&G. VH has received research funding from P&G.

Fresh Pear Consumption is Associated with Better Nutrient Intake, Diet Quality, and Weight Parameters in Adults: National Health and Nutrition Examination Survey 2001-2010.  O’Neil CE, Nicklas TA, Fulgoni VL (2015) J Nutr Food Sci 5: 377. doi:10.4172/2155-9600.1000377

• Conclusion:  Compared to non-consumers [of pears], consumers were 35% less likely to be obese (p<0.05). Fresh pears should be encouraged as a component of an overall healthy diet.
• Funding: Partial support was received from the United States Department of Agriculture/ Agricultural Research Service (USDA/ARS)…Partial support was also received from Pears Bureau Northwest.
• Comment: I’m guessing the same result could be obtained by looking at consumption of any other fruit.  And to prove my point that this is about marketing, here’s the press release.