Search results: dietary guidelines

Jim Krieger of Healthy Food America sent me this Food Navigator article titled “Can ultra-processed packaged food play a role in healthy, sustainable diets of the future.”

Uh oh.  Another attack on the concept of ultra-processed foods.  These, you will recall, are strongly associated in observational studies with poor health outcome, and one clinical trial demonstrates them to cause people to eat more calories.

The makers of highly processed foods are understandably worried that the word will get out and people will stop eating them.

Clif Bar to the rescue.

It sponsored a small session to establish guidelines for making highly processed foods healthier: “Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods”

The publication emphasizes flaws in the concept of “ultra-processed,” an approach it says

lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health.

Acknowledgments: “Staff at Clif Bar & Company developed the meeting agenda, synthesized all prework inputs, participated as observers in the workshop, and assisted in the gathering of the materials used to prepare this manuscript.”

Here is an ingredient list for an oatmeal raisin walnut Clif Bar:

ORGANIC ROLLED OATS, ORGANIC BROWN RICE SYRUP, SOY RICE CRISPS (SOY PROTEIN ISOLATE, RICE FLOUR, BARLEY MALT EXTRACT), ORGANIC ROASTED SOYBEANS, ORGANIC TAPIOCA SYRUP, ORGANIC CANE SYRUP, ORGANIC RAISINS, CHICORY FIBER, ORGANIC SOY FLOUR, WALNUTS, SUNFLOWER AND/OR SOYBEAN OIL, NATURAL FLAVORS, SALT, ORGANIC CINNAMON, MIXED TOCOPHEROLS (ANTIOXIDANT).

My definition of ultra-processed is that you can’t make it in your home kitchen because the ingredients are industrially produced and not available in supermarkets.  By this definition, the soy rice crisps are ultra-processed and maybe chicory fiber, but that’s about it.

The Clif people must be worried that they will be viewed in the same category as seriously ultra-processed snack foods.

Let’s give them and their parent company, Mondelez, credit for full disclosure.

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For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

If you are plenty old, or up on your history of US nutrition policy, you might remember the 1969 White House Conference on Food, Nutrition, and Health.

Tufts held a 50th anniversary conference at which I spoke (videos of the talks are here–I was on Panel 3 starting at about 17 minutes in).

In early December 1969, President Richard M. Nixon convened the first and only White House Conference on Food, Nutrition and Health to “put an end to hunger in America for all time” and improve the nutritional well-being of all Americans at a time when malnutrition was of urgent national concern. The agenda of the Conference was to draft recommendations that could be implemented by a bipartisan coalition into national nutrition policy.

The conference was notable for Nixon’s amazing speech kicking off the conference.

We see, then, that the problem of hunger and malnutrition is, really, two separate problems. One is to insure that everyone is able to obtain an adequate diet. The second is to insure that people actually are properly fed, where they have the ability to obtain the adequate diet.

On the one hand, we are dealing with problems of income distribution. On the other hand, with problems of education, habit, taste, behavior, personal preferences-the whole complex of things that lead people to act the way they do, to make the choices they do.

Look at what Nixon was proposing:

For the first time–Mr. Moynihan [Counsellor to the President] please notice–for the first time, this new family assistance plan would give every American family a basic income, wherever in America that family may live. For the first time, it would put cash into the hands of families because they are poor, rather than because they fit certain categories. When enacted, this measure alone will either supplement the incomes or provide the basis for the incomes of 25 million American men, women, and children.

The conference was also notable for its hundreds of recommendations—among them, free food stamps, cash income supports, transfer of food assistance out of the USDA.  We didn’t get the Universal Basic Income but we did get food stamps (now SNAP), school meals,and other useful policies.

The Tufts program kicked off demands for another White House Conference, and it looks like we may actually get that.

Congress allotted $2.5 million for a White House Conference on Food, Nutrition, Health, and Hunger in the FY22 omnibus spending package (see page 112), as part of efforts to end hunger.

The conference should be developed using a whole-of-government approach- in partnership with the Executive Office of the President, the Department of Agriculture, and other Federal agencies-and in consultation with State, territories, local, and Tribal officials, and a diverse group of interested parties from across the country, including anti-hunger, nutrition, and health experts; the private sector; and people with lived experience of hunger and nutrition insecurity. The conference should examine why hunger and nutrition insecurity persist and how they affect health, including their role in the high prevalence of chronic disease. It should also review existing and crossdepartmental strategies and consider new approaches to improve health by eliminating hunger, reducing the prevalence of chronic disease, and improving access to and consumption of nutritious foods in accordance with Dietary
Guidelines for Americans.

The conference was called for in bills S. 3064 sponsored by Senator Cory Booker (D, NJ) and Mike Braun (R, IN) and H.R. 5724 sponsored by House Rules Chair Jim McGovern (D, MA) and Jackie Walorski (R, IN).

HHS is to work with other federal agencies to “report initial findings” to the Hill about conference plans probably by late July.

This is great news.  Can’t wait to see how this develops.

You might not think that avocados need any special sales efforts, but the Haas Avocado marketers are particularly aggressive in funding research to demonstrate the health benefits of this food.

I’ve written about Haas-funded avocado research previously (most recently, here and here) but here’s yet another, this time initiated by a tweet:

I think avocados are fine foods, love them, but wish their marketers would not do this.  Here’s the Good News Network headline: “An Avocado a Day May Keep Your Gut Microbes Happy, Study Shows.”  As always, the operative word is “may.”  The headline would be equally correct saying “may not.”

The study: Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. Sharon V Thompson, Melisa A Bailey, Andrew M Taylor, Jennifer L Kaczmarek, Annemarie R Mysonhimer, Caitlyn G Edwards, Ginger E Reeser, Nicholas A Burd, Naiman A Khan, Hannah D Holscher.  The Journal of Nutrition, Volume 151, Issue 4, April 2021, Pages 753–762.

Conclusions: “Daily avocado consumption resulted in lower fecal bile acid concentrations, greater fecal fatty acid and SCFAs, and greater relative abundances of bacteria capable of fiber fermentation, providing evidence that this nutrient-dense food affects digestive physiology, as well as the composition and metabolic functions of the intestinal microbiota.”

Funding: Support for this research was provided by the Hass Avocado Board and the USDA National Institute of Food and Agriculture, Hatch project 1009249.

Author disclosures: NAB, NAK, and HDH received grant funding from the Hass Avocado Board.

Comment: All fruits and vegetables provide nutritional value and the best way to get the nutrients you need is by eating a variety of them.  If you like avocados, include them in that variety.  If not, don’t.

The Haas marketers want you to think that avocados are a superfood.  Alas, there is no such thing.  All fruits and vegetables provide nutritional value.  By that criterion, all fruits and vegetables are superfoods.

Here’s an example of how Haas advertises:

Did you know fresh avocados can be part of the MyPlate food guide?

• Make half your plate fruits and vegetables.

Avocados are a nutrient-dense fruit with naturally good fats and are easily incorporated into various meals and snacks. One serving (50g or one-third of a medium avocado) has only 80 calories and contributes nearly 20 vitamins, minerals, and phytonutrients along with dietary fiber.

The same could be said for most other fruits and vegetables, although most will be lower in calories.

Selenium, antioxidants, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis of randomized controlled trials. David JA Jenkins, David Kitts, Edward L Giovannucci, Sandhya Sahye-Pudaruth, Melanie Paquette, Sonia Blanco Mejia, Darshna Patel, Meaghan Kavanagh, Tom Tsirakis, Cyril WC Kendall, Sathish C Pichika, and John L Sievenpiper.  The American Journal of Clinical Nutrition, Volume 112, Issue 6, December 2020, Pages 1642–1652

Background: “Antioxidants have been promoted for cardiovascular disease (CVD) risk reduction and for the prevention of cancer. Our preliminary analysis suggested that only when selenium was present were antioxidant mixtures associated with reduced all-cause mortality.”

Results: No association of selenium alone or antioxidants was seen with CVD and all-cause mortality. However, a decreased risk with antioxidant mixtures was seen for CVD and all-cause mortality when selenium was part of the mix.

Conclusion: The addition of selenium should be considered for supplements containing antioxidant mixtures if they are to be associated with CVD and all-cause mortality risk reduction.

Comment: The results are statistically significant, but not by much (RR: 0.90; 95% CI: 0.82, 0.98; P = 0.02); the Confidence Interval reaches 0.98, which is very close to 1.00, which would show no difference.  But that’s not the real reason for my interest in this one.  The real reason in this astounding conflicts-of-interest statement and the disclaimer that follows it.

Conflicts of interest

DJAJ has received research grants from Loblaw Companies Ltd, the Almond Board of California, Soy Nutrition Institute (SNI), and the Canadian Institutes of Health Research (CIHR). He has received in-kind supplies for trials as a research support from the Almond Board of California, Walnut Council of California, American Peanut Council, Barilla, Unilever, Unico, Primo, Loblaw Companies, Quaker (Pepsico), Pristine Gourmet, Bunge Limited, Kellogg Canada, and WhiteWave Foods. He has been on the speakers’ panel, served on the scientific advisory board, and/or received travel support and/or honoraria from the Loblaw Companies Ltd, Diet Quality Photo Navigation (DQPN), Better Therapeutics (FareWell), Verywell, True Health Initiative (THI), Heali AI Corp, Institute of Food Technologists (IFT), Soy Nutrition Institure (SNI), Herbalife Nutrition Institute (HNI), Herbalife International, Pacific Health Laboratories, Nutritional Fundamentals for Health (NFH), the Soy Foods Association of North America, the Nutrition Foundation of Italy (NFI), the Toronto Knowledge Translation Group (St. Michael’s Hospital), the Canadian College of Naturopathic Medicine, The Hospital for Sick Children, the Canadian Nutrition Society (CNS), and the American Society of Nutrition (ASN). He received an honorarium from the USDA to present the 2013 W. O. Atwater Memorial Lecture. He is a member of the International Carbohydrate Quality Consortium (ICQC). His wife, Alexandra L Jenkins, is a director and partner of INQUIS Clinical Research for the Food Industry; his 2 daughters, Wendy Jenkins and Amy Jenkins, have published a vegetarian book that promotes the use of the plant foods advocated here, The Portfolio Diet for Cardiovascular Risk Reduction; and his sister, Caroline Brydson, received funding through a grant from the St. Michael’s Hospital Foundation to develop a cookbook for one of his studies. CWCK has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), Almond Board of California, American Peanut Council, Barilla, Canadian Institutes of Health Research (CIHR), Canola Council of Canada, International Nut and Dried Fruit Council, International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd, Pulse Canada, and Unilever. He has received in-kind research support from the Almond Board of California, American Peanut Council, Barilla, California Walnut Commission, Kellogg Canada, Loblaw Companies, Quaker (PepsiCo), Primo, Unico, Unilever, and WhiteWave Foods/Danone. He has received travel support and/or honoraria from the American Peanut Council, Barilla, California Walnut Commission, Canola Council of Canada, General Mills, International Nut and Dried Fruit Council, International Pasta Organization, Loblaw Brands Ltd, Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, Peanut Institute, Pulse Canada, Sun-Maid, Tate & Lyle, Unilever, and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, International Pasta Organization, McCormick Science Institute, and Oldways Preservation Trust. He is a member of the International Carbohydrate Quality Consortium (ICQC), is Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD and a director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. JLS has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of Health Research (CIHR), Diabetes Canada, PSI Foundation, Banting and Best Diabetes Centre (BBDC), American Society for Nutrition (ASN), INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), and the Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received in-kind food donations to support a randomized controlled trial from the Almond Board of California, California Walnut Commission, American Peanut Council, Barilla, Unilever, Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods, and Nutrartis. He has received travel support, speaker fees, and/or honoraria from Diabetes Canada, Dairy Farmers of Canada, FoodMinds LLC, International Sweeteners Association, Nestlé, Pulse Canada, Canadian Society for Endocrinology and Metabolism (CSEM), GI Foundation, Abbott, Biofortis, ASN, Northern Ontario School of Medicine, INC Nutrition Research & Education Foundation, European Food Safety Authority (EFSA), Comité Européen des Fabricants de Sucre (CEFS), and Physicians Committee for Responsible Medicine. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Wirtschaftliche Vereinigung Zucker e.V., and Inquis Clinical Research. He is a member of the European Fruit Juice Association Scientific Expert Panel and Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the Study of Diabetes (EASD), Canadian Cardiovascular Society (CCS), and Obesity Canada. He serves or has served as an unpaid scientific advisor for the Food, Nutrition, and Safety Program (FNSP) and the Technical Committee on Carbohydrates of the International Life Science Institute (ILSI) North America. He is a member of the International Carbohydrate Quality Consortium (ICQC), executive board member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of AB InBev. DK, ELG, SS-P, MP, SBM, DP, MK, TT, and SCP have no conflicts of interest to declare.

Disclaimer: The authors have no relevant conflicts of interest over the past 4 y. DJAJ has received funds for dietary studies from Loblaws, which, during the course of his funding, acquired Shopper’s Drugmart, which is a pharmaceutical company that also sells supplements.

Comment: Here’s one reason why I am not a fan of dietary supplements.  Most independently funded studies show no significant benefit when they are given to healthy people.  The industry needs studies like these for marketing purposes.  I’m not, but if you are worried about selenium, try food.

Evidence is pouring in that people with adequate vitamin D status seem to be better protected against harmful effects of Covid-19.

This is not surprising; people who practice healthful lifestyles—eating well, being active, getting out in the fresh air, maintaining a healthy weight, not smoking, not drinking too much—generally survive this infection more easily.

Vitamin D, I must remind you, is not really a vitamin.  It is a hormone induced by the effects of sunlight on skin.

Sunlight is by far the most effective way to get it.   Foods provide much less.

As for supplements, it’s hard to say.  They are under investigation.

I’ve been collecting items:

• An account of a clinical trial in Italy published in Medium: “Among the 26 hospitalized people who received standard care alone, fully half went on to the intensive care unit (ICU) because their disease had worsened. Two of them died. But among the 50 people who received the vitamin D treatment on top of standard care, only one person ended up in the ICU. None died.”  The study itself concludes: “…administration of a high dose of Calcifediol or 25-hydroxyvitamin D…significantly reduced the need for ICU treatment of patients requiring hospitalization due to proven COVID-19. Calcifediol seems to be able to reduce severity of the disease, but larger trials with groups properly matched will be required to show a definitive answer.”
• Medium’s discussion of what is known about Vitamin D supplements and Covid-19: “If we ask the question “Does vitamin D prevent/treat COVID-19?” the only real answer is “How could you possibly know?””
• Consumer Reports on whether you should be taking vitamin D supplements: its not-particularly-helpful conclusion: “Ultimately, whether to get tested or take a supplement and how to do it comes down to having a discussion with your doctor.”

As always with supplements, a market is involved.  This one is not trivial, even in the UK.

• Vitamin market set to hit £500m but where are the new users?  Use of Vitamin D supplements is growing fast thanks largely to growing media attention during the pandemic but interest in nearly all other single vitamins has dropped, and there’s still a lack of new consumers entering the market, according to new data from Mintel…. Read more

An obesity newsletter I subscribe to—Obesity and Energetics Offerings—provides items suggesting that conflicts of interest may be involved.

• Vitamin D deficiency linked to 54% higher SARS-CoV-2 positivity rate: Study: “The associations between vitamin D status and COVID-19 risk continue to strengthen, with new data from Quest Diagnostics and Boston University indicating that people with deficiency in the sunshine vitamin may have a significantly higher positivity rate for SARS-CoV-2, the coronavirus that causes COVID-19.“
• The study in question, Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, reports conflicted interests: “W.B.G receives funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR). H.L. sells vitamin D supplements. GrassrootsHealth works with various supplement suppliers to test the efficacy of their products in various custom projects. These suppliers may be listed as sponsors of GrassrootsHealth.”   Basically, it’s industry-funded.
• One letter in response to the study points out that “the efficacy of high-dose supplementation of vitamin D₃ in reducing risk of COVID-19 infection is mere extrapolation of currently available evidence, which is often conflicting, on the effectiveness of vitamin D3 in reducing risk of other respiratory tract infections.”
• To this, the authors have a lengthy rebuttal.

My bottom line at the moment: the science is still unfolding.  What to do while waiting for further research?  I like these Considerations for Obesity, Vitamin D, and Physical Activity Amid the COVID-19 Pandemic:

Until further breakthroughs emerge, we should remember that modifiable lifestyle factors such as diet and physical activity should not be marginalized. Decades of empirical evidence have supported both as key factors promoting health and wellness. In times of crisis, whether it be real or perceived, there is something to be said about the benefits of empowering people to actively preserve their own health.

Get outside, move around, expose some skin to sunlight.  Even in winter.

From the New York Times

Does food transmit Coronavirus?  

• Basically no (with some cautions).  See yesterday’s post for details.

Keeping up Coronoavirus  

• Healthroid has a summary.  The maps are updated daily
• Food Policy Watch: This weekly newsletter does a terrific job of keeping up with news reports, especially those explaining how to cope with what’s happening.

How to survive working at home (watch out for junk food) 

• Washington Post cartoonist Ann Telnaes has some suggestions

How to take action

• Beautiful Trouble has a guide to action against COVID-19: support your neighbors, change the system

Advice for the food industry

• US lays out new COVID-19 guidelines for food industry  The Trump Administration released a set of coronavirus guidelines for all Americans, with special provisions for critical infrastructure industries like food and beverage. Brands have been adapting this week to the new reality, while keeping employee safety a top priority…. Read more

What’s happening with supermarkets and supply chains?

• Empty shelves will soon be ‘a thing of the past,’ says grocery supply expert: As the novel coronavirus spreads, many people have stocked up on pantry items and paper products in anticipation of hunkering down at home for an extended period, creating temporary shortages of certain products. To better understand the grocery supply chain and how stores are stocked, FERN turned to Dr. Ananth Iyer, a professor of supply chain management at Purdue University and director of the university’s Global Supply Chain Management Initiative.
• Food chain tackles panic buying surge: Coronavirus concerns, sparking panic buying have forced manufacturers, distributors and retailers into special measures to manage the spending surge… Read
• Food delivery curfews relaxed to supermarkets: The Government is to relax food delivery hours to supermarkets and other retailers to help the supply chain cope with demand due to the Coronavirus COVID-19… Read
•  Grocers ‘have a viable supply chain’ & ‘are not shutting down,’ but product mix may change, FMI says:  The bare grocery shelves that many consumers have encountered over the last few days due to Covid-19-related stockpiling are not a harbinger of long-term shortages or a precursor to store closures, but they could signal a shift in the types of products retailers stock and manufacturers produce, according to FMI, the food industry association…. Read more 
• A Brooklyn co-op hustles as food demand spikes: Like other grocery stores in New York City, the Park Slope Food Co-op, in Brooklyn, is out of hand sanitizer. But even with 17,000 members and weekly sales of $1.23 million, shelves at one of the nation’s oldest and largest food co-ops are nearly full. “We got the hang of it very quickly after the initial enormous jolt of extra purchases hit 15 days ago,” Joe Holtz, the co-op’s general manager and co-founder, said late last week.
• Retailers, officials insist the food supply is strong as grocery stores are emptied:  A recent surge of demand has emptied some grocery store shelves of staples, as shoppers concerned about the spread of the novel coronavirus prepare to self-isolate at home. But the U.S. has plenty of food and Americans should not panic, urged food retailers, producers, and the federal government over the weekend.
• Cocoa disruption expected on markets as coronavirus continues to spread:  ‘During risk-off periods in markets, the prices of all products tend to move lower. When price carnage hits markets, rationality takes a holiday,’ said analyst Andrew Hecht…. Read more
• What will happen to the produce industry after coronavirus shut down visa processing?  The policy shift to limit the virus’ spread is likely to hamper this season’s planting and harvesting since fruit and vegetable growers heavily rely on foreign workers.

What to avoid: dubious schemes for immune boosting

• Coronavirus sparks ‘staggering growth’ in online searches for foods with functional benefits: report:  What foods are consumers looking to during coronavirus?…Read more
• Panic buying of immune products causes shortfalls; greater supply gaps loom in months ahead:  A pulse of supply and production issues caused by the COVID-19 crisis is making its way through the dietary supplement industry. Inventories of botanical ingredients continue to hold up, but unprecedented demand for immunity boosting products is causing some strain…. Read more
• Fight COVID-19 with dairy: China industry associations issue consumption guidelines to ‘build immune resistance’:  Four major dairy industry associations in China have formed a set of guidelines for dairy and dairy product consumption for local residents in hopes of strengthening public immune resistance to combat the recent COVID-19 novel coronavirus outbreak…. Read more
• COVID-19: Opportunities for health supplement firms to communicate immune-boosting role of micronutrients:  A panel of science researchers has put up a list of key findings on the role of micronutrients in supporting the immune system, which firms can tap on to educate the consumers in light of the coronavirus outbreak…. Read more
• COVID-19 brings strong China online sales for ANZ’s Comvita and AuMake:  Australia and New Zealand health foods companies are seeing strong online sales of immune boosting supplements from the China market…. Read more

Who profits from this?

• Could coronavirus hasten high times for CBD?  We’ve seen a run on toilet rolls, hand sanitizer and pasta. What about other foods and ingredients? Which might be set to be boosted by coronavirus?… Read more
• Trump encourages fast food brands to keep drive-thru open: so says QSR (Quick Service Restaurant) magazine.
• The ripple effects of COVID-19: A look into global dairy:  Rabobank assesses how the ‘corona hangover’ will impact global dairy markets in its latest report. Demand in China is already starting to bounce back after its virus exposure seems to have peaked, while the US will suffer in the coming months as cases rise…. Read more  
• Coronavirus concerns drive huge sales growth for pantry staples:  As U.S. consumers prepare for long isolation periods to slow the spread of the virus, Nielsen says the nation is in a potentially transformative pattern.
• ‘The change in consumer behaviour are the likes of which we have never seen’: Coronavirus-demand toys with General Mills’ bottom line:  The Cheerios and Nature’s Valley maker has raised its forecast for 2020, as social distancing efforts aimed at slowing the rapid spread of COVID-19 is causing consumers to stockpile, boosting demand for eat-at-home products like cereals and boredom-busting treats like snack bars…. Read more
• The TTB has authorized distilleries to make hand sanitizers: Due to the Coronavirus 2019 (COVID-19) pandemic, the Acting Administrator of the Alcohol and Tobacco Tax and Trade Bureau (TTB) has found that it is necessary or desirable to waive provisions of internal revenue law with regard to distilled spirits, and therefore is providing certain exemptions and authorizations to distilled spirits permittees who wish to produce ethanol-based hand sanitizers to address the demand for such products during this emergency.

What else?

• Canadian red meat industry donates $50,000 to coronavirus effort in China:  The Canadian red meat industry has made a $50,000 donation to the Canadian Red Cross to support work with the Red Cross Society of China and its efforts in responding to the coronavirus outbreak….

I could not keep up with the number of e-mails I got last week with the subject line “Have you seen this?”

“This” referred to an opinion piece in JAMA entitled Backlash Over Meat Dietary Recommendations Raises Questions About Corporate Ties to Nutrition Scientists.

Definitely up my alley.

The article describes the outraged reaction to a series of papers in the Annals of Internal Medicine last year arguing that recommendations to eat less meat are unfounded (I posted about this at the time).  Some of the investigators involved in the meat papers turned out to have undisclosed ties to meat industry interests.

The JAMA article points out that the most outraged objections to the Annals papers came from investigators who have plenty of industry ties (plant-based) of their own.

My book, Unsavory Truth: How Food Companies Skew the Science of What We Eat, provides loads of evidence for a basic observation: research funded by food companies, regardless of the particular food studied, tends to produce results favorable to the sponsor’s interests.

It also describes how industry influence occurs at an unconscious level; recipients are unaware that they are being influenced.

How the influence gets expressed is also the subject of research.  Bias most frequently turns up in the framing of the research question.  It also turns up frequently in the interpretation of results.

Here is an example from a study of a healthy plant food—walnuts.

The study: Effect of a 2-year diet intervention with walnuts on cognitive decline. The Walnuts And Healthy Aging (WAHA) study: a randomized controlled trial.  Aleix Sala-Vila, Cinta Valls-Pedret, Sujatha Rajaram, Nina Coll-Padrós, Montserrat Cofán, Mercè Serra-Mir,  Ana M Pérez-Heras, Irene Roth, Tania M Freitas-Simoes, Mónica Doménech, Carlos Calvo, Anna López-Illamola, Edward Bitok, Natalie K Buxton, Lynnley Huey, Adam Arechiga, Keiji Oda, Grace J Lee, Dolores Corella, Lídia Vaqué-Alcázar, Roser Sala-Llonch, David Bartrés-Faz, Joan Sabaté, and Emilio Ros1.  Am J Clin Nutr 2020;00:1–11.

Conclusions: Walnut supplementation for 2 y had no effect on cognition in healthy elders. However, brain fMRI and post hoc analyses by site suggest that walnuts might delay cognitive decline in subgroups at higher risk. These encouraging but inconclusive results warrant further investigation.

Conflicts of Interest: AS-V, SR, JS, and ER have received research funding through their institutions from the California Walnut Commission, Folsom, CA, USA. JS and ER were nonpaid members of the California Walnut Commission Scientific Advisory Council. ER was a paid member of the California Walnut Commission Health Research Advisory Group. JS has received honoraria from the California Walnut Commission for presentations.  AS-V has received support from the CaliforniaWalnut Commission to attend professional meetings. All other authors report no conflicts of interest.

Comment: This looks to me like a classic example of interpretation bias.  Although the study showed no effect of walnut supplementation, the authors interpret its overall results as encouraging.  This is putting a positive spin on null results.

Walnuts—and other kinds of nuts—are plant foods with healthy fats.  Why does the California Walnut Commission need to do this?  So you will buy walnuts rather than hazelnuts, pecans, or macadamia nuts (all of which are sponsoring their own positive-result studies).  Studies like these are mostly about marketing.

Questions of whether meat is healthy or unhealthy—and, if unhealthy, at what level of intake—are about much more than marketing.   They need to be studied as objectively as possible.  It’s best to keep industry influence far away from such studies.

Even if the science is done well from start to finish, researchers’ ties to food company sponsors give the appearance of conflicted interests.  Such ties are best avoided from the get-go.

Follow-up

• A detailed analysis of the JAMA piece by the anonymous CarbSane blog
• Naomi Oreske’s comment in Scientific American
• Texas A&M’s letter to Harvard requesting an investigation of faculty belonging to True Health Initiative (who complained about the meat guidelines)
• Texas A&M’s Chancellor Calls on Harvard to Look Into Faculty’s Beef-science Ethics (AgDaily)
• Beef with Harvard (Inside Higher Ed)
• From Beef to Bots? Harvard Professors Mired in Debate over Spam Emails, Industry-Funded Research (Harvard Crimson)
• Conflict of Interest in the Post-Truth Era: What Is It, Now? (David Katz)
• Processed Meat “Guidelines:” Why the Exceptional Reaction? (David Katz)
• Tobacco, Soda, and the Beef with Truth (David Katz)
• Massive Meat Mayhem, Part 3 (ConscienHealth)
• Perspective: Red and Processed Meats and Health Risks: How Strong Is the Evidence? (Frank Hu et al)

This is one of an ongoing series of examples of how industry funding skews, or to be more precise, is strongly associated with skewing, of research and opinion about matters of diet and health.

This example is an analysis of the scientific rigor of dietary approaches to controlling type 2 diabetes through diet.  The authors looked at the evidence for efficacy of the DASH, Mediterranean, Plant-Based, and Low-Carb diets.

Improving the Scientific Rigor of Nutritional Recommendations for Adults with Diabetes: A Comprehensive Review of the American Diabetes Association Guidelines Recommended Eating Patterns.  Hallberg S, Dockter NE, Kushner J, Athinarayanan S.  Preprints 2019.  Online March 5.  doi: 10.20944/preprints201812.0187.v2

Conclusion: “Our review of the current Standards and Recommendations finds significant shortcomings regarding scientific review methodologies, which are likely to translate to suboptimal clinical care decisions for patients with T2D.”  The study dismisses most studies of the DASH, Mediterranean, and Plant-based diets as poorly done or otherwise inappropriate for their review.  For the DASH diet, it says more research is needed.  It calls for more research on whether the benefits of Mediterranean diets are due to low carb or healthy fats, and suggests that the benefits of plant-based diets may be due to weight loss.  The best evidence supports the Low-Carb diet: “Evidence from 30 trials and 10 follow-up studies demonstrates that a low-carbohydrate diet is an effective dietary approach for addressing dyslipidemia.”

Conflict of Interest Statement:  SJH is an employee and shareholder of Virta Health, a for-profit company that provides remote diabetes care using a low-carbohydrate nutrition intervention, and serves as an advisor for Atkins Corp.  NED is a paid consultant for Virta Health.  JAK serves as medical director of McNair Interests, a private equity group with investments in type 1 diabetes and other chronic illnesses, and is also an advisor for Sanofi and Lexicon.

Comment:    All authors are employed by or consult for a company that uses low-carb dietary approaches in its for-profit business.  As I explain in Unsavory Truth, the influence of industry funding is often unconscious, unintentional, and unrecognized.  Nevertheless, the opinions of the authors can be predicted from their financial connections to Virta Health.