Here in Australia, yesterday was Australia Day (somewhat equivalent to the American Fourth of July) although many prefer to call it Invasion Day, Survival Day, or Day of Mourning and to make it an occasion for protest.  Hence: the fuss over the what Google Australia posted as the day’s Google Doodle.

Newcomer that I am, I celebrated with some Glebe Street gelato:

Can’t read the sign?

“Celebrate Australia Day with Vegemite Gelato on toast!”

Yum.

I’m in residence at the Charles Perkins Centre at the University of Sydney for a bit and am getting the chance to learn the Australian version of food politics.

I like milk with my coffee.  Here’s all they had at a local corner store.

The banner on the label says that it “NATURALLY contains A2 protein.*”

A2 protein?  What’s that?

The label, alas, is not much help.

*Dairy Farmers milk naturally contains A2 protein as well as A1 protein.  Of those proteins, our tests to date confirm that 50-7-% is A2.

So?  Should we care?  YES, according to the A2 Milk Company:

The two main types of milk proteins are the casein and the whey proteins. These make up to 80% and 20% of the protein content of cows’ milk respectively. Other proteins present at low levels in milk include antibodies and iron carrying proteins.

Beta-casein makes up about one third of the total protein content in milk. All cows make beta-casein but it is the type of beta-casein that matters. There are two types of beta-casein: A1 and A2. They differ by only one amino acid. Such small differences in the amino acid composition of proteins can result in the different protein forms having different properties.

According to a press account,

For nearly 20 years, there have been claims that the A2 beta-casein protein is easier to digest than A1, but it’s been dismissed as unscientific.  This pilot study at Curtin University…found subjects on an A2 milk diet reported less bloating abdominal pain, and firmer stools, by staying off A1 beta-casein.

But this milk contains both A1 and A2 proteins.

In any case, guess who funded this research!

Comparative effects of A1 versus A2 beta-casein on gastrointestinal measures: a blinded randomised cross-over pilot study.  Ho S, Woodford K, Kukuljan S, Pal S.  Eur J Clin Nutr. 2014 Sep;68(9):994-1000. doi: 10.1038/ejcn.2014.127. Epub 2014 Jul 2.

• Conclusions: These preliminary results suggest differences in gastrointestinal responses in some adult humans consuming milk containing beta-casein of either the A1 or the A2 beta-casein type, but require confirmation in a larger study of participants with perceived intolerance to ordinary A1 beta-casein-containing milk.
• Funding: This study was supported by a grant from A2 Dairy Products Australia, who also supplied the milk.  A2 Dairy Products Australia had no role in the data analysis of this study.

The label has more to say:

Of course, it’s made here in New South Wales and it’s Permeate Free—so it’s less processed and simply delicious.

Permeate Free?   What’s that?  A local website explains:

Permeate is simply a collective term for the natural lactose, vitamin and mineral components which are separated from fresh milk by a process called ultrafiltration. Because milk is a natural food (and tastes different from cow to cow) filtering the permeate out (before putting it back in) allows processors to regulate their milk so they can control the taste, protein and fat content.

Apparently, Australian labeling authorities allow this process to qualify as “natural?”

The label lists these ingredients: Skim milk, milk, milk solids [the source of the extra A2 proteins and the Permeate?].

Next time, I’ll look for a product with precisely one ingredient: milk.

Dwight Eschliman, Text by Steve Ettlinger.  Ingredients: A Visual Exploration of 75 Additives & 25 Food Products.  Regan Arts, 2015.

The photographer and writer went through the grocery store and jotted down every food ingredient they could find—from Acesulfame potassium to xanthan gum.  Dwight Eschliman acquired samples of each ingredient in its pure form, arranged them in piles, and took photographs.  Steve Ettlinger provided their Code of Federal Regulations numbers, chemical structures, and brief descriptions of how they are used. The photographs are gorgeous.  Even though all the ingredients look like piles of salt, their textures and colors are sufficiently different to make this book weirdly fascinating.

I’ve collected five more studies funded directly or indirectly by food companies or trade associations, with results useful for marketing purposes.  This brings the total to 105 that I’ve noticed since last March versus only 9 with results that must have disappointed the sponsors.

Canned Vegetable and Fruit Consumption Is Associated with Changes in Nutrient Intake and Higher Diet Quality in Children and Adults: National Health and Nutrition Examination Survey 2001-2010.  Marjorie R. Freedman, PhD; Victor L. Fulgoni III, PhD.  J Acad Nutr Diet. 2015  http://dx.doi.org/10.1016/j.jand.2015.10.013.

• Conclusions: Results suggest CVþCF consumption was associated with higher intake of select nutrients, a higher-quality diet, and comparable adiposity measures and blood pressure.
• Funding for this project was received from the Canned Food Alliance.  As senior vice president at Nutrition Impact, LLC, V. L. Fulgoni III provides food and nutrition consulting and database analyses for various members of the food and beverage industry.  No potential conflict of interest was reported by M. R. Freedman.

Regular Fat and Reduced Fat Dairy Products Show Similar Associations with Markers of Adolescent Cardiometabolic Health.   O’Sullivan, T.A.; Bremner, A.P.; Mori, T.A., Beilin, L.J., Wilson, C., Hafekost, K., Ambrosini, G.L., Huang, R.C., Oddy, W.H..Nutrients 2016, 8, 22.

• Conclusion: Although regular fat dairy was associated with a slightly better cholesterol profile in boys, overall, intakes of both regular fat and reduced fat dairy products were associated with similar cardiometabolic associations in adolescents.
• Conflicts of Interest: Therese A. O’Sullivan received a grant from The Dairy Health and Nutrition Consortium Australia…which provided funding for the analysis and write up of this study. No other authors declare a conflict of interest.

Suboptimal Plasma Long Chain n-3 Concentrations are Common among Adults in the United States, NHANES 2003–2004. Rachel A. Murphy, Elaine A. Yu, Eric D. Ciappio, Saurabh Mehta and Michael I. McBurney   Nutrients 2015, 7, 10282–10289; doi:10.3390/nu7125534.

• Conclusion: Suboptimal LCn-3 [omega-3] concentrations are common among U.S. adults. These findings highlight the need to increase LCn-3 intake among Americans.
• Conflicts of Interest: M.I.M., E.D.C. and R.A.M. are employees of D.S.M. Nutritional Products, L.L.C., manufacturers and suppliers of omega-3 nutritional lipids. E.Y. and S.M. have no conflicts of interest to disclose.

Red Raspberries and Their Bioactive Polyphenols: Cardiometabolic and Neuronal Health Links.  Britt M Burton-Freeman, Amandeep K Sandhu, and  Indika Edirisinghe.  Adv Nutr January 2016 Adv Nutr vol. 7: 44-65, 2016. doi: 10.3945/​an.115.009639

• Conclusion: The body of research is growing and supports a potential role for red raspberries in reducing the risk of metabolically based chronic diseases.
• Funding: Supported in part by various donors and the National Processed Raspberry Council.

Dietary flavonoid intake and incidence of erectile dysfunction. Aedín Cassidy, Mary Franz, and Eric B Rimm.  American Journal of Clinical Nutrition. First published ahead of print January 13, 2016 as doi: 10.3945/ajcn.115.122010.

• Conclusions: These data suggest that a higher habitual intake of specific flavonoid-rich foods is associated with reduced ED incidence. Intervention trials are needed to further examine the impact of increasing intakes of commonly consumed flavonoid-rich foods on men’s health.
• Authors’ disclosure: AC and EBR received funding from the US Blueberry Highbush Council for a separate project unrelated to this publication.
• Comment: The University of East Anglia, where the lead author works, sent out a press release “Blueberries associated with reduced risk of erectile dysfunction.”

Several members of the Academy of Nutrition and Dietetics (AND–formerly the American Dietetic Association) sent me a letter from the Academy’s president, Evelyn Crayton, announcing its new policy on sponsorship.

AND’s previous policy, which encouraged sponsorship by food companies selling fast food, salty snacks, and sugary drinks, has been the subject of a critical investigative report and induced members of the Academy to create Dietitians for Professional Integrity to get the policy changed.

This advocacy worked.  It induced AND’s leadership to appoint a Sponsorship Advisory Task Force (SATF) to recommend a less conflicted policy to AND’s Board of Directors.

The SATF delivered its report to the Board on January 13.  As Evelyn Crayton explains,

The Board voted to implement a pilot program encompassing many of the SATF’s recommendations. The one-year pilot program includes appointing a Sponsorship Committee to review national-level sponsor opportunities and to develop assessment tools that will support the sponsorship process.

The Board of Directors approved the following newly revised sponsorship guidelines, which take effect immediately for all Academy organizational units. Dietetic Practice Groups and Member Interest Groups will be required to adhere to these guidelines and Affiliates are encouraged to adopt them.

Sponsorship approval requires that:

• The sponsor’s vision and mission align with the Academy’s Vision, Mission and Strategic Goals.
• The sponsor’s product portfolio is broadly aligned with the Academy’s Vision: Optimizing health through food and nutrition.
• The sponsor relationship and sponsor product portfolio are broadly aligned with official Academy positions.
• All aspects of the sponsorship (such as research, consumer messaging or professional education for members) align with the Academy’s Scientific Integrity Principles.
• The Academy does not endorse any company, brand or company products, nor does the Academy’s name or logo appear on any product. Such endorsement is neither actual nor implied.
• The Academy maintains final editorial control and approval of all content in materials bearing the Academy name or logo.
• There is clear separation of Academy messages and content from brand information or promotion.
• Relevant facts and important information are included.
• The Board is confident that these revised guidelines and the new Sponsorship Committee pilot program will enable the Academy to better serve the organization and our members.

This looks impressive and deserves congratulations.  The policy calls for transparency, separation, and alignment—all laudable goals.

I have only two concerns:

• What did the SATF report actually say?  How about making it available?  [If anyone has a copy and can send, please do.]
• What is the definition of “alignment with the Academy’s goals and principles?”

As always, the devil is in the details.  As Andy Bellatti explains,

Some of these guidelines (i.e.: “the sponsor’s mission and vision align with AND’s”) already exist in the current policy — the same policy that considered PepsiCo (and former sponsors Coca-Cola, Kellogg’s, and General Mills) an appropriate sponsor.

The Academy’s Board can start the process by making the SATF report public (at least to members) and then explaining its process for setting the policy.*

It also needs to explain how “alignment” will be defined.  What are the actual criteria for deciding whether AND will accept food-industry sponsorship.

But this is a great first step and deserves much praise.

*Update: the Academy released the report.

What is the role of the food industry in helping to address world malnutrition?  This collection of articles from Nutra-Ingredients.com begins with a viewpoint from Nestlé (no relation), the world’s largest food company.

Nestlé: Profit is not a dirty word in the race against global malnutrition

Big food companies like Nestlé are oft-criticised for being a factor in the spread of non-communicable diseases like obesity and diabetes with less healthy food offerings but all are engaged in shifting their portfolios to the healthier end of the spectrum, and their capacity to deliver benefits with fortified offerings to malnourished populations can be overlooked.“The food industry is a commercial enterprise – that won’t change – but it has immense power to bring nutrients to the populations that needs them the most.

Here are the other articles in this series.

Sarah Bowen.  Divided Spirits: Tequila, Mezcal, and the Politics of Production.  University of California Press, 2015

This remarkable book, a recent addition to UC Press’s series on California Studies in Food and Culture, uses drinks distilled from roasted, fermented agave as a basis for entering into debates about production and protection of indigenous food products in the face of globalization.

In recent years, traditional foods and drinks have emerged as profitable and politically salient alternatives to the perceived homogenizing effects of globalization.  Initiatives like the Slow Food movement and DOs [denomination of origin] attempt to rescue eating establishments, dishes, and products from the flood of standardization engendered by the industrial food system.  In doing so, they strive to support the rural communities, farmers, and processors involved in the production of traditional products.  And yet, as my research shows, efforts to regulate Mexico’s iconic spirits illustrate the limitations of relying on alternative markets to protect food cultures and the livelihoods of those who produce them.  My work demonstrates how cultural symbolism can be manipulated to perpetuate and deepen long-standing inequalities along global commodity chains.

Or, as she explains much later, “the right to define what constitutes ‘tequila’ and ‘mezcal’ extends as much from market power and it does from a sense of tradition or justice.”

Consider this book with your next Margarita.

If you have been following this saga, you will know that since mid-March 2015 I’ve been collecting examples of published research supported wholly or in part by food companies.  As of today, the collection includes 95 studies with results favorable to the sponsor’s marketing interests as opposed to just 9 with unfavorable results.

Here are the most recent five.  These bring up general and specific questions that I’m pondering these days and I’ve indicated them in red.

The Effects of Water and Non-Nutritive Sweetened Beverages on Weight Loss and Weight Maintenance: A Randomized Clinical Trial.  John C. Peters, Jimikaye Beck, Michelle Cardel, Holly R. Wyatt, Gary D. Foster, Zhaoxing Pan, Alexis C. Wojtanowski, Stephanie S. Vander Veur, Sharon J. Herring, Carrie Brill, and James O. Hill. Obesity (2015) 00, 00–00. doi:10.1002/oby.21327.

• Conclusions: Water and NNS [non-nutritive sweetened] beverages were not equivalent for weight loss and maintenance during a 1-year behavioral treatment program. NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program. These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program.
• Funding agencies: The study was fully funded by The American Beverage Association. The American Beverage Association was not involved in the design, conduct, interpretation, or manuscript preparation of this study. Furthermore, a third-party organization (Biofortis-Provident) was hired at the PIs’ request. Biofortis-Provident audited data at both clinical sites to check for the accuracy and integrity of the data…Disclosure: J.C.P. and J.O.H. received consulting fees from The Coca-Cola Company outside of the submitted work.
• Questions: Does recruiting a third party to audit data increase confidence in the credibility of this study?  Isn’t it more relevant to ask about how the research question is framed? 

Nutrition and Health Disparities: The Role of Dairy in Improving Minority Health Outcomes.  Constance Brown-Riggs.  Int. J. Environ. Res. Public Health 2016, 13(1), 28; doi:10.3390/ijerph13010028.

• Conclusion: Because of the presence of lactase-producing cultures, yogurt is often a more easily digestible alternative to milk, and thus more palatable to people who experience symptoms of lactose intolerance. This was a key factor cited in the final rule to include yogurt in the Special Supplemental Nutrition Program for Women, Infants, and Children.
• Funding: This work was supported by The Dannon Company Inc. (White Plains, NY). The Dannon Company Inc. provided information for this article but did not have final approval for its content.
• Conflicts of Interest: Nutrition advisor for Dannon’s One Yogurt Everyday Initiative, providing consultation services on the health issues affecting African Americans.

Protein Supplementation at Breakfast and Lunch for 24 Weeks beyond Habitual Intakes Increases Whole-Body Lean Tissue Mass in Healthy Older Adults.  Catherine Norton, Clodagh Toomey, William G McCormack, Peter Francis, Jean Saunders, Emmet Kerin, and Philip Jakeman.  Nutr. 2016; 146:65-69 doi:10.3945/jn.115.219022.

• Conclusions: Protein supplementation at breakfast and lunch for 24 wk in healthy older adults resulted in a positive (+0.6 kg) difference in LTM compared with an isoenergetic, nonnitrogenous maltodextrin control. These observations suggest that an optimized and balanced distribution of meal protein intakes could be beneficial in the preservation of lean tissue mass in the elderly.
• Funding: Supported by Food for Health Ireland and Enterprise Ireland grant CC20080001.  Author disclosures: C Norton, C Toomey, P Francis, J Saunders, E Kerin, and P Jakeman, no conflicts of interest. WG McCormack was an employee of Carbery Ingredients on secondment to Food for Health Ireland during the in vivo data collection and analysis.
• Comment: The Carbery Group advertises itself as “a global leader in food ingredients, flavours and cheese.”
• Question: Why would Carbery put one of its employees to work on this study?

Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.  Neil R Brett, Paula Lavery, Sherry Agellon, Catherine A Vanstone, Jonathon L Maguire, Frank Rauch, and Hope A Weiler.  Am J Clin Nutr 2016; 103:144-152 doi:10.3945/ajcn.115.115956.

• Conclusion: Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D $50 nmol/L during periods of minimal ultraviolet B radiation exposure.
• Supported by funding from Dairy Farmers of Canada, the Canadian Foundation for Innovation and Canada Research Chairs, and in-kind support from Agropur and Ultima Foods for the study products.
• Question: Does providing study products introduce conflicts of interest?

Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: a randomized controlled trial.  Sally Chiu, Nathalie Bergeron, Paul T Williams, George A Bray, Barbara Sutherland, and Ronald M Krauss.

• Conclusions: The HF-DASH diet lowered blood pressure to the same extent as the DASH diet but also reduced plasma triglyceride and VLDL concentrations without significantly increasing LDL cholesterol
• Supported by Dairy Management Inc. and by the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, through University of California, San Francisco Clinical & Translational Science Institute grant UL1 RR024131.  RMK has previously received and is currently receiving research funding from Dairy Management Inc. for this and other projects. None of the other authors reported a conflict of interest. This was an investigator-initiated study, and its financial supporters had no role in the study design, implementation, data analysis, or data interpretation.
• Question: Does this mean that the investigators decided what they wanted to study and then asked Dairy Management Inc for funding, knowing that Dairy Management would have congruent interests?  Does something like this increase confidence in the results?

I don’t have clear, unambiguous answers to such questions and am collecting opinions in preparation for my next book project.  If you have thoughts about these matters, do share.