Let’s start the new year with some good news.

I was excited to read in The Lancet that Colombia has enacted a tax on junk foods.

The new tax was included in a wider reform that passed into law in December, 2022, seeking to reduce the
burden of obesity and other diseases on Colombia’s health system, while also bringing in revenue in a country that manages a fiscal deficit.

This is a tax on ultra-processed foods!

The tax is being implemented gradually, beginning at 10%, before rising to 15% in 2024 and 20% in 2025, and targets foods are high in salt and saturated fat, as well as industrially manufactured prepackaged foods.

Colombia already has warning labels.  Here’s who else has them.

The warning label movement!

Now, if we only could get these in the U.S….

But note: not everyone loves the tax.  The Guardian reports charges that it is unfair to the poor.  But so is type 2 diabetes.

The FDA issued its most recent report on antibiotics late last year: 2022 Summary Report On Antimicrobials Sold or Distributed for Use in Food-Producing Animals, along with Antimicrobial Sales and Distribution Data 2013-2022.

It did this in response to public concerns about antibiotic use in food animals: if antibiotics are used at subtherapeutic doses, they might induce microbial resistance to drugs used to treat diseases in humans.

This is not a theoretical concern.  It’s a real problem.

It’s also a problem because the vast majority of antibiotics were used as growth promoters or to prevent infections in animals crowded together—not to treat disease.

In 2014 or so, the FDA ruled that medically important antibiotics could no longer be used as growth promoters in farm animals.  That rule went into effect in 2017.

The FDA’s good news: the amounts of antibiotics used in farm animals has declined since then.

Are medically important antibiotics still used for non-therapeutic purposes?

The report says that since 2017, zero antibiotics are administered for growth promotion.

If you wonder whether this is really true (as I do), consider that $11.2 million kilograms of antibiotics were used in food animals in 2022.  This is a decrease from the 15.6 million kg used in 2015, but still a lot.

Of these drugs, 63% are administered in feed, and 31% in water.

All antibiotics still used as growth promoters are supposed to be drugs not used in human medicine.

I’m not the only skeptic on this one.  See:

I.  The Bureau of Investigative Journalism’s Antibiotics in agriculture: The blurred line between growth promotion and disease prevention.

In an investigation published today, the Bureau revealed how US farm animals are still being dosed with antibiotics vital to human health, despite efforts to curtail such usage and combat the spread of deadly superbugs. We also found that a regulatory loophole means that using antibiotics to make animals fatter – a process known as growth promotion – is technically still possible, despite this practice being banned in January 2017.

II.  Nature: Antibiotic use in farming set to soar despite drug-resistance fears. Analysis finds antimicrobial drug use in agriculture is much higher than reported.

III.  Vox: Big Meat just can’t quit antibiotics: Meat production is making lifesaving drugs less effective. Where’s the FDA?

According to an analysis published in September by the Natural Resources Defense Council and One Health Trust, medically important antibiotics are increasingly going to livestock instead of humans. In 2017, the meat industry purchased 62 percent of the US supply. By 2020, it rose to 69 percent.

Does the FDA check?  It has guidance for industry on The Judicious Use of Medically Important Antimicrobial Drugs in Food-Producing Animals, but this guidance is non-binding.

Obviously, the FDA needs to do more.  Its officials told Vox:

Lots of people are uncomfortable about the concept of ultra-processed foods, the category of processed foods made mainly of industrially extracted ingredients, containing little or no recognizable food, and able to reproduced in home kitchens only if you have the ingredeients and the equipment.

Here is an example: The Guardian headline: “Ultra-processed foods are not more appealing, study finds”

The Study: Evidence that carbohydrate-to-fat ratio and taste, but not energy density or NOVA level of processing, are determinants of food liking and food reward.  Appetite, Volume 193, 2024, 107124, https://doi.org/10.1016/j.appet.2023.107124.

• Purpose: “This virtual (online) study [highlighted so you won’t miss this point] tested the common but largely untested assumptions that food energy density, level of processing (NOVA categories), and carbohydrate-to-fat (CF) ratio are key determinants of food reward.”
• Method: “Individual participants (224 women and men, mean age 35 y, 53% with healthy weight, 43% with overweight or obesity) were randomised to one of three, within-subjects, study arms: energy density (32 foods), or level of processing (24 foods), or CF ratio (24 foods). They rated the foods for taste pleasantness (liking), desire to eat (food reward), and sweetness, saltiness, and flavour intensity (for analysis averaged as taste intensity).”
• Results: Against our hypotheses, there was not a positive relationship between liking or food reward and either energy density or level of processing. As hypothesised, foods combining more equal energy amounts of carbohydrate and fat (combo foods), and foods tasting more intense, scored higher on both liking and food reward. Further results were that CF ratio, taste intensity, and food fibre content (negatively), independent of energy density, accounted for 56% and 43% of the variance in liking and food reward, respectively. We interpret the results for CF ratio and fibre in terms of food energy-to-satiety ratio (ESR), where ESR for combo foods is high, and ESR for high-fibre foods is low.”
• Conclusion: “We suggest that the metric of ESR should be considered when designing future studies of effects of food composition on food reward, preference, and intake.”I ca

Comment

I can’t say this any better than Stuart Gillespie, who posted:

https://twitter.com/stuartgillesp16/status/1729061409202618512?s=51&t=BTlnSTTeO7_vUXAOw5KNXg

Or Tamar Haspel (@Tamar Haspel) who points out:

Want to find out what properties of food drive consumption?

Is it fat/carb ratio, degree of processing, sweetness?

I’m gonna say asking a self-selected group of internet randos to rate a bunch of really unappetizing photographs isn’t the way.

If nutrition and food scientists want to shoot down the concept of ultra-processed foods, they are going to have to refute hundreds of studies linking such foods to poor health outcome, as well as the carefully controlled clinical trial demonstrating that ultra-processed foods encourage overeating.

If

I was guest editor for a supplement to the American Journal of Public Health: Policies and Strategies to Increase Equitable Access to Family Nutrition.

It is open access so you can access it here.

I wrote the lead editorial: Equitable Access to the USDA’s Food Assistance Programs: Policies Needed to Reduce Barriers and Increase Accessibility.  113(S3), pp. S167–S170.  

This special supplement to AJPH deals with a critically important topic: enabling and increasing access to federal nutrition assistance programs among low-income Americans who are eligible for these programs but unaware, unable, or unwilling to participate in them. To help identify the barriers to nonparticipation and to recommend policies to reduce them, the Robert Wood Johnson Foundation funded research projects aimed at these goals, especially as they pertain to families with young children.  PDF/EPUB

Editor’s choice

One of the big issues in food advocacy is how to develop coalitions broad and strong enough to demand—and achieve—real change.  Thousands of organiations are working on food issues, local, regional, and national.  But for the most part, each works on its own thing, with its own leadership and staff, competing with all the others for limited funding.

This is why the work that the Union of Concerned Scientists (UCS) is doing to organize support for Farm Bill change is so important and so exciting—the cheeriest food news possible.

Here’s the headline:  Nonprofit Groups Award $2.2 Million to Equip Frontline and BIPOC-led Organizations to Engage in Food and Farm Bill Debates:  With 15 Organizations Collaborating to Select 28 Grantees Across the Country, the Effort is Among Largest Participatory Grantmaking in Food and Farming to Date.

As Congress continues to negotiate the next food and farm bill, a group of organizations with expertise in agriculture, labor, climate change, food security, and nutrition have announced a first of its kind effort to uplift the voices of food and farmworkers, marginalized farmers, and frontline communities in the farm bill process. Through a participatory grantmaking process, the groups awarded $2.235 million in grants to support 28 grassroots groups. The grants will support capacity building, organizing and advocacy efforts around the food and farm bill.

I had not heard about this and wrote Dr. Ricardo Salvador, director of the Food and Environment Program at UCS, the group behind this initiative.

He explained:

This got started (publicly, at least) with this note last summer to Biden (we continue to work with his team at EEOP, with whom we have regular meetings.) In that opening salvo you’ll see the broad categories on which our initial 170 members were able to agree. An example of how we’ve put this to use are our wedging labor issues into the farm bill debate, which as you know has steadfastly been resisted until now on grounds of jurisdiction. The pandemic’s meat processing horrors gave us traction. Just before the recess, we started to press collectively for the coherent set of reforms embodied in over 30 marker bills that would update the farm bill to more accurately reflect 21st century priorities. The farm bill extension is giving us extra time to work on this.

The history of farmer coalitions goes back a couple of hundred years in the United States to agrarian and grange movements.  But real farmers (as opposed to corporate) have been too small and too dispersed to gain enough political power to change the system.

The UCS project wants to work with farmers who have a real stake in federal policy and want to do something about it.

This is ambitious.  But UCS is going about this in an especially thoughtful way, which makes me think it has a change of succeeding where other attempts could not.

This effort deserves enthusiastic applause and support.

I will be watching what UCS and its grantees do with great interest.  Stay tuned.

Just before the Christmas holidays, Senator Bernie Sanders (Ind-VT), who chairs the Senate Health, Education, Labor & Pensions Committee , held a hearing: What is Fueling the Diabetes Epidemic? 

The Senator’s Tweet:

Some of the quotes from the Senator’s remarks are amazing.  They need to be said, loud and clear:

• Why is the number of children in America today who have Type 2 diabetes estimated to skyrocket by nearly 700% over the next four decades?
• For decades, in my view, we have allowed large corporations in the food and beverage industry to entice children to eat foods and beverages loaded up with sugar, salt, and saturated fat, purposely designed to be over-eaten,
• The situation has gotten so bad that most of what children in America eat today consists of unhealthy, ultra-processed foods that doctors have told us lead to a higher risk of type 2 diabetes.
• While diabetes and obesity rates in America soar, the food and beverage industry spends billions on advertising to get consumers, including young children, hooked on their unhealthy products.
• This has got to stop. A good place to start? Banning junk food ads targeted at kids.
• This is not a radical idea.
• We must have the courage to take on the greed of the food and beverage industry which, every day, is undermining the health and well-being of our children by pushing extremely unhealthy products which far too often cause obesity and type-2 diabetes.

The hearing began with:

• Chairman Bernie Sanders, I-Vt., prepared remarks  
• Ranking member Sen. Bill Cassidy, R-La., prepared remarks

Witness testimony

• Ashley Gearhardt — Professor of psychology, University of Michigan, Ann Arbor, Mich.
• Lindsey Smith Taillie — Associate professor, Department of Nutrition, University of North Carolina, Chapel Hill, N.C.
• Kasia Lipska — Associate professor of medicine, Yale School of Medicine, New Haven, Conn. 
• Natalie Stanback — Volunteer and parent of a child with type 1 diabetes, JDRF, Lewisville, Texas   
• Aaron Kowalski — CEO, JDRF, New York

Senator Sanders also wrote an op-ed in USA Today: “We can’t allow the food and beverage industry to destroy our kids’ health.

Helena Bottemiller Evich, writing in Food Fix “Bernie Sanders vs. Big Food,” asks why Sanders is doing this now?  She has no answer, but I think its fabulous that he is taking this on and joining Senator Cory Booker in this endeavor.

Diet-related chronic diseases are a big problem for kids as well as adults.

It’s way past time to take on the food industry’s manipulative marketing practices.

Cheers to Senators Sanders and Booker.  We need more of you in Congress.

Conclusions and Relevance  In this randomized clinical trial, we observed cardiometabolic advantages for the healthy vegan vs the healthy omnivorous diet among healthy, adult identical twins. Clinicians may consider recommending plant-based diets to reduce cardiometabolic risk factors, as well as aligning with environmental benefits.

The study has its share of detractors, American Council on Science and Health (ACSH), for example: Stanford Medicine Releases Confirmation Bias Study; Media Takes The Bait.  Its chief criticisms

• The improvements were in biomarkers, not health.
• Both diets were healthy,
• Obviously, diets without cholesterol will reduce cholesterol.
• Vitamin B12 levels were ldeficient on the vegan diet.

Comment: The ACSH is an industry-funded front group.  Low B12 is an easy problem to solve, and vegans, who by definition eat no foods of animal origin, have to make sure they complensate for its absence.

The twin idea is clever and adorable—and the reason for the press attention and for the Netflix documentary.  The study shows that vegan diets improve cardiovascular risk biomarkers in healthy people.  Why not?  This is further evidence for the benefits of largely plant-based diets.

I want to start off the new year with a week of cheery postings.  IHow’s this for an irresistable beginning!

The study:  Could sharing chocolate cake increase engagement with research on intermittent fasting?   BMJ2023; 383 doi: https://doi.org/10.1136/bmj.p2585 (Published 20 December 2023).

Rationale: “Food and the festive season are heavily intertwined, and for us one sweet treat stands out: the chocolate brownie. Whether it’s the fudgy centre or the crinkled crust, brownies’ irresistibly rich deliciousness evokes comfort and delight. And isn’t chocolate good for you?…We wanted to know whether offering brownies affects how recipients respond to research findings on intermittent or short-term fasting.”

Method: “We completed two multicentre studies—a randomised controlled trial and a cross-sectional study—to seek understanding of the effects of offering brownies on healthcare professionals’ engagement with, and perception of, research findings on fasting.”

Results: “Preliminary results indicate that brownies did not influence their views—but many saw value in short term fasting to improve wellbeing.”

Conclusion: “Sharing brownies may not affect perceptions of presented evidence, but we remain convinced that they are the best treat to offer while discussing calorie restriction.”

Conflicts of interest:  “We have,,,no relevant interests to declare.”

Comment: This study produced a negative result, but who cares?  I’ll bet participants had a great time.  Check out the recipe; it is designed to produce enough brownies for one research meeting.

No, I am not making this up.

Happy new year!