This week’s sugar item #3

John Downs, the president of the National Confectioners Association has an editorial (note: sponsored) in Politico announcing the NCA’s new campaign to convince Americans of the benefits of eating candy.

Candy is a special treat that has played an important role in cultural traditions, seasonal celebrations and family occasions here in the U.S. and around the world. But some consumers might not know that there is much more that goes into this honest, affordable, fun and transparent treat.

What more?  The economic benefits, of course.  Here’s the Infographic:

The press release highlights the benefits.

The confectionery industry directly employs 55,000 people in the United States, and more than 400,000 jobs in agriculture, retail, transportation and other industries rely in part on the sale of confections for their livelihood.  For every job that is created in confectionery another seven are supported in related industries, which means that candy drives a multiplier effect of 1:7 or an impact of 700 percent.

Sugar?  Calories?  Tooth decay?  Obesity?

Never mind.

Sugars item #2 for this week (about half of the sugars in US diets come from sugar-sweetened beverages)

As promised in his op-ed in the Wall Street Journal in August, Muhtar Kent, the CEO of Coca-Cola, is making its funding transparent.  He said he “directed Sandy Douglas, president of Coca-Cola North America, to”

Publish on our website a list of our efforts to reduce calories and market responsibly, along with a list of health and well-being partnerships and research activities we have funded in the past five years, which we will continue to update every six months.

True to his word, here is Coca-Cola’s commitment to transparency:

• The company’s transparency website
• A list of the organizations it funds
• A list of the scientific experts and researchers it funds (but some declined to be listed)
• Answers to frequently asked questions

This makes interesting reading, to say the least.  Enjoy!

This week, I’m going to be posting items about sugar politics.

Item on sugars #1:

Funny thing.  I was not invited to this event, but someone who was invited passed along the invitation.  You too will be sad you weren’t invited.

I am contacting you at the request of Dr. Courtney Gaine, VP of Scientific Affairs from The Sugar Association, regarding an invitational roundtable on The Role of Sugars in Supporting a Nutrient-dense Diet for Toddlers, 12 to 24 Months.  It will be sponsored by the University of Colorado, Anschutz Medical Campus, Department of Pediatrics, chaired by Dr. Ronald Kleinman from Harvard Medical School, co-chaired by Dr. Frank Greer from the University of Wisconsin School of Medicine, and facilitated by Sylvia Rowe.  The roundtable is supported by an unrestricted educational grant from the Association….

Roundtable Objectives

• Provide a forum to discuss the science and research voids on the role of sugars as a strategy that may help parents successfully transition their older infants and toddlers (12 to 24 months) from complementary infant foods to consuming a variety of nutrient-dense foods from the family table.
• Generate potential research ideas and questions on this topic for future guidance on the feeding of young children, including birth to 24 months, which is scheduled for integration into the 2020 Dietary Guidelines for Americans.
• Create the impetus to extend this research to public-private partnerships with industry, academy and the government.

Proposed Topic Areas 

• The roundtable has been tentatively divided into these 5 topic areas: 1) transitional toddler feeding and nutrition policy; 2) physiology; 3) sugars in toddler feeding practices; 4) parent-feeding strategies: emerging science; and 5) the research path forward….

Honorarium 

The Sugar Association will reimburse you for all reasonable travel expenses, plus a $2,000 honorarium for your review of abstracts and presentations, which you will receive in mid-October, and your participation in the 1 ½ day roundtable.

This requires some translation.  I may be over-interpreting here, but as I see it, the Sugar Association is paying academics $2000 to implicitly endorse:

• Promoting the use of sugar as a way to get toddlers to eat healthier foods.
• Making sure the 2020 dietary guidelines say nothing about the need for kids to eat less sugar (we don’t even have the guidelines for 2015 yet).
• Making sure that government agencies don’t advise or set policies to encourage eating less sugar.

Sigh.

Lisa F. Clark. The Changing Politics of Organic Food in North America. Edward Elgar Publishing, 2015.

I did a blurb for this one.  It’s right up my alley.

Lisa Clark’s scholarly account of the development of the organic movement in the United States and Canada beautifully explains the decades-long transition from understanding organic production as inextricably tied to healthy soils, communities, and social justice (“process-based”) to views of organics as meeting certain standards for marketing purposes (“product-based”). Read this book and you will care deeply about the difference in these views as well as understand current debates about the future of organics.

In case you want to know why I favor organics, I do so from a process-based perspective.  I like what organics do for soils, communities, and social justice.  This book does a great job of explaining the basis of the debates over these issues.

Nutrition research studies funded by food companies are pouring in and here’s another set of five with expected results.  The first one is notable for its extensive revelations, a case of TMI (too much information) if I’ve ever seen one.  As usual, if you run across more of these—and especially industry-funded studies that do not favor the sponsor’s interest, please send.  The roundup since mid-March: 60 with favorable results, 3 without.

Effect of Fructose on Established Lipid Targets: A Systematic Review and Meta‐Analysis of Controlled Feeding Trials.  Laura Chiavaroli, Russell J. de Souza, Vanessa Ha, Adrian I. Cozma, Arash Mirrahimi, David D. Wang, Matthew Yu, Amanda J. Carleton, Marco Di Buono, Alexandra L. Jenkins, Lawrence A. Leiter, Thomas M. S. Wolever, Joseph Beyene, Cyril W. C. Kendall, David J. A. Jenkins, and John L. Sievenpiper.  J Am Heart Assoc. 2015;4: originally published September 10, 2015, doi:10.1161/JAHA.114.001700.

• Conclusion: Pooled analyses showed that fructose only had an adverse effect on established lipid targets when added to existing diets so as to provide excess calories (+21% to 35% energy). When isocalorically exchanged for other carbohydrates, fructose had no adverse effects on blood lipids.
• Conflicts:  The disclosures cover two full pages in the journal.  These authors report every source of income—honoraria, prizes, travel funds—including those of their spouses.  They apparently work for every food company imaginable, including any number with interests in minimizing a harmful role of fructose in health.
• Comment:  I do not know why the editors of this journal decided that the conflict-of-interest statement was worth two pages of journal space.  Perhaps they don’t think such statements necessary and were being ironic?  Or perhaps they wanted to make sure that these highly conflicted authors were fully exposed?  Yoni Freedhoff of Weighty Matters consulted an ethicist about this question but did not get a clear answer.  I wrote the journal editor and asked what this was about, but have not received a response.

Beneficial effects of oral chromium picolinate supplementation on glycemic control in patients with type 2 diabetes: A randomized clinical study. Ana N. Paiva, Josivan G. de Lima, Anna C.Q. de Medeiros, Heverton A.O. Figueiredo, Raiana L. de Andrade, Marcela A.G. Ururahye, Adriana A. Rezende, José Brandão-Neto, Maria das G. Almeida.   Journal of Trace Elements in Medicine and Biology 32 (2015) 66–72.

• Conclusions: CrPic supplementation had a beneficial effect on glycemic control in patients with poorly controlled T2DM, without affecting the lipid profile.
• Conflict: Manipulation Pharmacy Companhia da Fórmula donated the chromium picolinate supplement.
• Comment: Without knowing more about this situation, it’s not possible to say whether donation of a supplement is enough to raise concerns.  This study raises questions because most independently funded studies of chromium and diabetes have shown minimal or no benefits (see, for example this one).

Oat consumption reduced intestinal fat deposition and improved health span in Caenorhabditis elegans model. Chenfei Gao, Zhanguo Gao, Frank L. Greenway, Jeffrey H. Burton, William D. Johnson, Michael J. Keenan, Frederick M. Enright, Roy J. Martin, YiFang Chu, Jolene Zheng.  Nutrition Research September 2015 Volume 35, Issue 9, Pages 834–843.

• Conclusion: Oat consumption may be a beneficial dietary intervention for reducing fat accumulation, augmenting health span, and improving hyperglycemia-impaired lipid metabolism [in nematodes].
• Conflict: This research was supported by a nonrestricted donation from PepsiCo Inc. Oats used in this study were a gift of PepsiCo Inc. Y. Chu is an employee of PepsiCo, Inc, which manufactures oatmeal products under the brand name Quaker Oats.

A pilot study examining the effects of consuming a high-protein vs normal-protein breakfast on free-living glycemic control in overweight/obese ‘breakfast skipping’ adolescents. L B Bauer, L J Reynolds, S M Douglas, M L Kearney, H A Hoertel, R S Shafer, J P Thyfault and H J Leidy.  International Journal of Obesity (2015) 39, 1421–1424; doi:10.1038/ijo.2015.101; published online 7 July 2015

• Conclusion: These data suggest that the daily addition of a HP breakfast, containing 35 g of high-quality protein, has better efficacy at improving free-living glycemic control compared with a NP breakfast in overweight/obese, but otherwise healthy, ‘breakfast skipping’ adolescents.
• Disclosure: The authors declare no conflict of interest, but the study was funded by the Pork Checkoff.

Acute Cocoa Supplementation Increases Postprandial HDL Cholesterol and Insulin in Obese Adults with Type 2 Diabetes after Consumption of a High-Fat Breakfast.  Arpita Basu, Nancy M Betts, Misti J Leyva, Dongxu Fu, Christopher E Aston, and Timothy J Lyons.  J Nutr September 2, 2015, doi: 10.3945/​jn.115.215772

• Conclusions: Acute cocoa supplementation showed no clear overall benefit in T2D patients after a high-fat fast-food–style meal challenge. Although HDL cholesterol and insulin remained higher throughout the 6-h postprandial period, an overall decrease in large artery elasticity was found after cocoa consumption.
• Funding: Among other sources, the lead author receiveda grant from The Hershey Company.
• Comment: This is a negative study (no benefit) with a positive spin (higher HDL, decrease in large artery elasticity).

 

Dr. Thomas Schlenker, who directs San Antonio’s Metropolitan Health, asked the City Council to support a “drink less soda” campaign.

The City Council said no.  It fired Dr. Schlenker.

A representative of the Texas Beverage Association and Coca-Cola’s director of public affairs sit on the City Council and have veto power over its actions.

Schlenker says his firing is due to his outspoken critique of sugary drinks; the City Council says he’s just rude.

Maybe, but as Dr. Schlenker explains, Big Soda has donated millions to city government.

Says the Wall Street Journal,

One of the soft drink industry’s biggest challenges: constantly fighting the perception that soda is really bad for you. No matter how much money it spends on research or argues that exercise lowers obesity, the industry is playing a never-ending game of Whac-A-Mole. When it beats down critics in one place, they pop right back up in another.

Other cities, even in Texas, are looking for ways to slow down the rising prevalence of obesity.  Cutting out sugary drinks is a great first step.  Other cities should hire Dr. Schlenker.

There seems to be no end to such stories, many of which I cover in Soda Politics: Taking on Big Soda (and Winning)—officially out October 1 but being shipped right now.

Here’s one I didn’t cover.

2008: The U.S. Conference of Mayors (USCM) passed a resolution supporting “increased resources for cities to help combat obesity and fund obesity prevention, including consideration of revenues from the major leading contributors of the nation’s obesity epidemic, including calorically sweetened beverages, fast food, and high calorie snacks.”  Translation: taxes

2010: USCM posted an article in its online newspaper about mayors considering soda taxes.

2011: The American Beverage Association (ABA) became a member of the USCM’s Business Council, and partnered with the group to start a $3 million childhood obesity prevention program.  Would this aim to reduce intake of sugary beverages?  Nope.

Instead, the program focused on:

• Promoting physical activity
• Increasing fruit and vegetable consumption

2015:  The winning projects were:

• Jacksonville, FL, $150,000 for a youth initiative to make fresh fruits and vegetables available at a cheaper cost, and to promote physical activity.
• Seattle, WA, $25,000 to increase fruit and vegetable consumption among at-risk kids, through farm-to-table initiatives.

2015: Here’s what Scientific American says about all this (I’m quoted).

There is no mention in the application of decreasing consumption of calorically sweetened beverages, fast food, or high calorie snacks, which are all specifically cited in the 2008 USCM resolution as contributors to the nation’s obesity epidemic…The beverage industry seems to be obsessed with physical activity, as evident from the recent spate of stories about Coca-Cola funding studies that point the blame for obesity at caloric expenditure, rather than caloric intake. The science overwhelmingly does not support this.

Here’s the latest collection of 5 studies funded by food companies or trade associations, all with results that favor the sponsor’s interests.  I’ve just reviewed them and found a couple of duplicates, so this is a corrected score.  The correct score is 55 industry-funded studies with positive results vs. 3 with results unfavorable to industry—since mid-March.

I’m particularly interested in the unfavorable category.  If you run across any, please send.

Jejunal Casein Feeding Is Followed by More Rapid Protein Digestion and Amino Acid Absorption When Compared with Gastric Feeding in Healthy Young Men. Joanna Luttikhold, Klaske van Norren, Nikki Buijs, Marjolein Ankersmit, Annemieke C Heijboer, Jeannette Gootjes, Herman Rijna, Paul AM van Leeuwen, and Luc JC van Loon. J. Nutr. 2015; 145:2033-2038 doi:10.3945/jn.115.211615.

• Conclusions: Jejunal feeding of intact casein is followed by more rapid protein digestion and AA absorption when compared with gastric feeding in healthy young men. The greater postprandial increase in circulating EAA concentrations may allow a more robust increase in muscle protein synthesis rate after jejunal vs. gastric casein feeding.
• Funding: Supported by Nutricia Research, Utrecht, Netherlands. J Luttikhold was employed by Nutricia Research; K van Norren is a guest employee of Nutricia Research; and LJC van Loon has served as a consultant for Nutricia Research.  [Note: Nutricia Research is a subsidiary of Danone].

Higher Total Protein Intake and Change in Total Protein Intake Affect Body Composition but Not Metabolic Syndrome Indexes in Middle-Aged Overweight and Obese Adults Who Perform Resistance and Aerobic Exercise for 36 Weeks. Wayne W Campbell, Jung Eun Kim, Akua F Amankwaah, Susannah L Gordon, and Eileen M Weinheimer-Haus. J. Nutr. 2015; 145:2076-2083 doi:10.3945/jn.115.213595.

• Conclusions: In conjunction with exercise training, higher TPro [total protein] promoted positive changes in BC [body composition] but not in MetS [metabolic syndrome] indexes in overweight and obese middle-aged adults. Changes in TPro from before to during the intervention also influenced BC responses and should be considered in future research when different TPro is achieved via diet or supplements.
• Funding:  Supported by the US Whey Protein Research Consortium (to WWC) among others.  WW Campbell was a member of the National Dairy Council Whey Protein Advisory Panel while the research was being conducted.

Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management.  France Bellisle.  Current Obesity Reports March 2015, Volume 4, Issue 1, pp 106-110 10.1007/s13679-014-0133-8

• Conclusion: While many of the existing studies cannot identify any causal links between use of LES [artificial, low-energy sweeteners] and appetite for sweetness, randomized trials in children and adults suggest that use of LES tends to reduce rather than increase the intake of sugar-containing foods and to facilitate, rather than impair, weight loss.
• Conflict: Parts of [this study] are extracted from a non-published document for which the author received an honorarium from the International Sweeteners Association (ISA).  France Bellisle is a member of the Scientific Advisory Board for General Mills and has received travel reimbursement and honoraria for contributions in scientific congresses from Mondelez, ISA, and General Mills.

Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Christian Heiss & Roberto Sansone & Hakima Karimi & Moritz Krabbe & Dominik Schuler & Ana Rodriguez-Mateos & Thomas Kraemer & Miriam Margherita Cortese-Krott & Gunter G. C. Kuhnle & Jeremy P. E. Spencer & Hagen Schroeter & Marc W. Merx & Malte Kelm & for the FLAVIOLA Consortium, European Union 7th Framework Program.  AGE (2015) 37: 56 DOI 10.1007/s11357-015-9794-9

• Conclusion: CF [cocoa flavanol] intake reverses age-related burden of cardiovascular risk in healthy elderly, highlighting the potential of dietary flavanols to maintain cardiovascular health.
• Funding: …Additional funding was provided by an unrestricted grant by MARS, Inc…MARS, Inc. provided the standardized test drinks used in this investigation. HS is employed by MARS, Inc., a member of the FLAVIOLA research consortium and a company engaged in flavanol research and flavanol-related commercial activities.

Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Roberto Sansone, Ana Rodriguez-Mateos , Jan Heuel, David Falk, Dominik Schuler, Rabea Wagstaff, Gunter G. C. Kuhnle, Jeremy P. E. Spencer, Hagen Schroeter, Marc W. Merx, Malte Kelm and Christian Heiss for the Flaviola Consortium, European Union 7th Framework Program.  British Journal of Nutrition, September 9, 2015. doi:10.1017/S0007114515002822.

• Conclusion: In healthy individuals, regular CF [cocoa flavanol] intake improved accredited cardiovascular surrogates of cardiovascular risk, demonstrating that dietary flavanols have the potential to maintain cardiovascular health even in low-risk subjects.
• Funding: Additional funding was provided…through an unrestricted grant by MARS Inc. MARS Inc. also provided the standardised test drinks used in this investigation… H. S. provided test drinks on behalf of Mars Inc… H. S. is employed by MARS Inc., a member of the Flaviola research consortium and a company engaged in flavanol research and flavanol-related commercial activities. [The conflict statement also discloses that MARS employee H.S. shared responsibility for designing the study, writing the paper, and approving the final content].
• Comment: Lest the implicit (but never stated directly) “eat more chocolate” message of these studies be missed, Mars sent out a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”