Search results: food policy action

 The New England Journal of Medicine has just published a series of articles on sugar-sweetened beverages to  coincide with presentations at The Obesity Society’s annual meeting.  Here are links to the articles.  I’ve extracted brief quotes from some of them.  And here’s a summary in the New York Times.

Perspective: J.L. Pomeranz and K.D. Brownell, Portion Sizes and Beyond — Government’s Legal Authority to Regulate Food-Industry Practices.

Regulations that affect “ordinary commercial transactions” (such as the sale of a product) are presumed to be constitutional if they have a rational basis and if the government body enacting them has the appropriate knowledge and experience to do so.

In the case of New York City’s portion-size restrictions, for example, the health department is an expert public health body that reviewed relevant scientific evidence on the health hazards associated with consumption of sugar-sweetened beverages and the effect of portion sizes on consumption patterns. The proposed policy thus has a rational basis….

Original Article: Q. Qi and Others, Sugar-Sweetened Beverages and Genetic Risk of Obesity

The study concludes: “the genetic association with adiposity appeared to be more pronounced with greater intake of sugar-sweetened beverages.”

Original Article: J.C. de Ruyter and Others,  A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children

We conducted an 18-month trial involving 641 primarily normal-weight children from 4 years 10 months to 11 years 11 months of age. Participants were randomly assigned to receive 250 ml (8 oz) per day of a sugar-free, artificially sweetened beverage (sugar-free group) or a similar sugar-containing beverage that provided 104 kcal (sugar group). Beverages were distributed through schools….Masked replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in normal-weight children.

Original Article: C.B. Ebbeling and Others, A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight

We randomly assigned 224 overweight and obese adolescents who regularly consumed sugar-sweetened beverages to experimental and control groups. The experimental group received a 1-year intervention designed to decrease consumption of sugar-sweetened beverages, with follow-up for an additional year without intervention….Among overweight and obese adolescents, the increase in BMI was smaller in the experimental group than in the control group after a 1-year intervention designed to reduce consumption of sugar-sweetened beverages, but not at the 2-year follow-up

Editorial: S. Caprio, Calories from Soft Drinks — Do They Matter?

These randomized, controlled studies — in particular, the study by de Ruyter et al. — provide a strong impetus to develop recommendations and policy decisions to limit consumption of sugar-sweetened beverages, especially those served at low cost and in excessive portions, to attempt to reverse the increase in childhood obesity.

Clinical Decisions: T. Farley, D.R. Just, and B. Wansink, Regulation of Sugar-Sweetened Beverages

This one is a point/counterpoint.  On the basis of the evidence just presented, should government regulate sugary drinks?

New York City Health Commissioner Tom Farley says yes:

If a harmful chemical in schools were causing our children to get sick, people would demand government regulation to protect them. It is therefore difficult to argue against a government response to an epidemic of obesity that kills more than 100,000 persons a year in the United States and has an environmental origin.7

Federal, state, and local governments already regulate the food system, from farm to retail, in many ways and for many purposes, ranging from support of agriculture to prevention of foodborne illness. The question is not whether we should regulate food, but rather whether we should update food regulations to address this new epidemic.

David Just and Brian Wansink say no:

We must also recognize that the universe of foods that contribute to childhood obesity is much larger than sugar-sweetened beverages. Such a narrowly defined approach would have minimal chance for overall success. Rather, we must consider approaches that will involve parents, schools, and pediatricians in leading children toward more healthful eating habits and increased physical activity. In truth, we cannot hope to create regulations that restrict behavior holistically.

I’d say we now have plenty of evidence that habitual use of soft drinks raises risks for obesity, and plenty of evidence for the need for regulation.

Yes, it would be nice if “leading children to eat better” worked, but parents, teachers, and everyone else needs lots of help in coping with today’s food environment.

The New England Journal has done a great public service in publishing these papers as a series, and the authors all deserve much praise for taking on these difficult research projects.

OK city agencies: get to work!

California’s ballot initiative to label GMO’s has caused quite a stir.

Food biotechnology companies are spending millions to defeat the initiative.

The Yes on 37 California Right to Know people don’t have nearly as much money, but they are doing what they can.  They have a new video ad, well worth a look: “Agent Orange is harmless.”

And another: “Vote Yes for Labeling GMOs.”

But the “don’t miss” has to be this fast-paced rap taking a broad look at the issues: “OMG GMOs!” 

The polls say voters approve GMO labeling by a very wide margin: 65% to 24%.

Will they vote this way in November?  Or will outspending by opponents prevail?

Stay tuned. 

Here’s my once a month on the first Sunday Food Matters column for the San Francisco Chronicle, out today:

Nutrition and public policy expert Marion Nestle answers readers’ questions in this column written exclusively for The Chronicle. E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.

Q: I’m confused about calories. If I cut calories to lose weight, does it matter what foods I eat? Or are all calories the same?

A: As the co-author of “Why Calories Count: From Science to Politics,” I hear this question all the time.

The short answer: Calories matter for weight. The choice of foods that provide the calories matters a lot for health and may make it easier for you to diet successfully.

To lose weight, reducing calorie intake below expenditure works every time.

To prove this point, a professor at Kansas State University lost 27 pounds in 10 weeks on the Twinkies diet – one Twinkies every three hours with occasional snacks of chips, sugary cereals and cookies. Even so, he cut his usual calorie intake by 800 a day. Anyone would lose weight doing that.

Only four dietary components provide calories: fat (9 per gram), carbohydrate and protein (4 per gram each) – and alcohol (7 per gram).

Does the particular mix of these components make any difference to weight loss? Yes, say proponents of diets low in carbohydrate, especially rapidly absorbable sugars and refined starches.

Low-carbohydrate diets are necessarily high in fat, and somewhat higher in protein. Do people lose weight on them because of the effects of carbohydrates on insulin levels or because low-carbohydrate diets help reduce calories?

This question does not have an easy answer, but not for lack of trying. Weight-loss studies are hard to do. Estimating calorie intake is notoriously inaccurate, and measuring calories is difficult and expensive.

The first measurement study I know of took place in 1964. Investigators from the Oakland Institute for Medical Research studied weight loss in five obese patients in a hospital metabolic ward. They calculated the number of calories needed to induce rapid weight loss in each patient, and fed each of them a liquid formula diet containing that number every day. Every few weeks, they changed the formula to vary the proportions of protein (ranging from 14 percent to 36 percent of calories), fat (12 percent to 83 percent), and carbohydrate (3 percent to 64 percent).

Regardless of the proportions, all patients lost weight at a constant rate. The investigators titled their study “Calories Do Count.”

This study was conducted under rigidly controlled conditions of hospitalization and involved actual measurements – not estimations – of calorie intake and body weight.

But what about weight-loss studies involving people who are not incarcerated? Since the early 2000s, numerous clinical trials have shown low-carbohydrate diets to produce greater weight loss than low-fat diets. Some also have observed improvements in blood pressure, blood glucose levels and blood lipids.

But it is so inaccurate to estimate calorie intake in such studies that most didn’t bother to try. This means they can’t say whether the weight loss was due to composition of the diet or to calorie reduction.

It’s possible that low-carbohydrate, high-fat diets make people less hungry, but the evidence for this is mixed. Most studies of extreme diets of any type report high dropout rates or failure to stick to the diet for more than six months or so. And even though initial weight loss is rapid on low-carbohydrate diets because of water loss, these diets are low in fiber and some vitamins.

One problem with losing weight is that it takes fewer calories to maintain smaller bodies. Dieting also reduces energy expenditure.

One recent study of that problem involved taking detailed measurements for several years, and illustrates the difficulties of obtaining definitive answers to questions about diet composition and energy balance.

The researchers wanted to know whether diet composition affected energy expenditure in very obese people who had just dieted off up to 15 percent of their weight. They found that a low-carbohydrate diet did not slow down energy expenditure nearly as much as a low-fat diet, meaning that low-carbohydrate diets might make it easier for people to maintain weight loss.

On this basis, the investigators said, “The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective.”

Perhaps, but study subjects were fed prepared calorie-controlled diets for only four weeks, and lost and maintained weight under highly controlled conditions. Does diet composition matter for weight maintenance in the real world? Longer-term studies by other investigators show that diet composition makes little difference in the ability to maintain weight loss.

Most reviews of the subject conclude that any diet will lead to weight loss if it cuts calories sufficiently.

Obviously, some diets are better for health than others.

Face it. The greatest challenge in dieting is to figure out how to eat less – and to eat healthfully on a regular basis – in the midst of today’s “eat more” food environment. And that’s a much more important research problem than whether low-carbohydrate or low-fat diets work better for weight loss.

Marion Nestle is an author and a professor in the nutrition, food studies and public health department at New York University. She blogs at foodpolitics.com. E-mail: food@sfchronicle.com

I’m in Europe trying to keep up with the farm bill from afar.  The House Ag Committee has come up with a a 557-page “discussion draft” of what it cutely calls the Federal Agriculture Reform and Risk Management (FARRM) Act.

Its stated purposes are to (1) cut spending, (2) reduce the size of government, and (3) “make common-sense reforms to agricultural policy.”

The first two make the third goal an oxymoron.  I don’t see how #3 is possible, given #1 and #2.

Unlike the Senate version, the House bill:

• Cuts current spending by $35 billion over 10 years (as compared to the Senate’s $23 billion or so).
• Takes the difference out of SNAP (food stamps).  The proposed cut is $16 billion compared to $4.5 billion in the Senate version, an action that is ostensibly supposed to improve “program integrity and accountability.”

As Politico puts it, the House is

demanding deeper cuts from nutrition programs for the poor while embracing a greater government role in supporting farmers — something that won’t sit well with tea party conservatives.

Virtually all of that difference is explained by the much larger savings from food stamps — a $16 billion-plus package that triples what the Senate approved and imposes tougher income and asset tests that will disqualify hundreds of thousands of working-class households now getting aid.

The proposed deep cuts to SNAP are shocking for two reasons:

• The harm they will do to low-income households
• The breach in the long-standing deal that put SNAP in the farm bill in the first place

SNAP is in the farm bill because rural states needed the votes of urban states to pass subsidies and other supports for Big Ag producers of commodities.

This deal worked for states with large numbers of urban poor.  If their representatives voted for farm supports, farm-state representatives would vote for SNAP benefits.

This was classic logrolling.

Is the deal now breaking down?   Is Congress really willing to sacrifice benefits to the poor to maintain benefits for Big Ag?

According to The Hill, the House cuts are nothing but political posturing:

Rep. Collin Peterson (Minn.), the top Democrat on the House Agriculture Committee, agreed to the cuts as a pragmatic way of moving forward with legislation important to rural lawmakers.

In an interview with The Hill, he said much of the cuts would be restored in a conference with the Senate.

…Peterson said he would have made different reforms to food stamps, and had offered an alternative plan to the GOP that was rejected. He defended his decision to back the final product as both pragmatic and politically savvy.

“It is what had to be done in order to get through committee and through the House floor,” he said.

Pragmatic and politically savvvy?  Let’s hope he’s right.

Anti-hunger advocates, however, are taking no chances.  They gathered in Washington this week to oppose the cuts.

This is a critical time.  Add your voice!

Whoever at the National Sustainable Agriculture Coalition (NSAC) is doing the analysis and summaries of the farm bill deserves much praise for performing a major public service.

The Senate version of the bill under discussion right now is 1009 pages long and estimated to cost taxpayers $969 billion over the next ten years, of which nearly 80% goes for the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps).

The NSAC account deals with the big issues: the lack of conservation requirements attached to taxpayer subsidies for crop insurance, the enormous complexity of the bill, and the lack of an overriding vision of what the farm bill should do. 

In one sense, the Senate bill reflects not so much a new farm policy as a new, confusing, and costly set of options targeted at different segments of commodity agriculture…the emerging bill is a bundle of contradictions with respect to subsidy caps and conservation requirements…. This results from, among other things, the complete lack of clearly identified policy goals.…All of this would be complicated enough by itself, but as the headlines and hearings of the past several weeks amply demonstrate, before this farm bill is finished, it will very likely get more complicated still.

As I have said repeatedly, the farm bill is a vast collection of specific programs aimed at specific constituencies, each with its own lobbyists and congressional supporters.  It is so big and covers so many issues that nobody in Congress can possibly be expected to understand more than a tiny fraction of what is involved.  Hence: lobbyists.

I will leave consideration of the big issues to the NSAC analysts, and just focus on a few very small ones that caught my eye as an example of the absurdity of conducting farm policy through this mechanism.  The current Senate proposal:

Adds popcorn to covered commodities: Only some crops are eligible for federal support.  These include wheat, corn, grain sorghum,barley, oats, long grain rice, medium grain rice,pulse crops, soybeans, other oilseeds, and peanuts.  Now: “The Secretary shall study the feasibility of including popcorn as a covered commodity by 2014.”

Specifies use of fortified foods in international food aid: “adjust products and formulations,including potential introduction of new fortificants and products, as necessary to cost ffectively meet nutrient needs of target populations, to test prototypes;to adopt new specifications or improve existing specifications for micronutrient fortified food aid products.”

Calls for a report on honey: “Not later than 180 days after the date of enactment of this Act, the Secretary, in consultation with affected stakeholders, shall submit to the Commissioner of Food and Drugs a report describing how an appropriate Federal standard for the identity of honey would promotes honesty and fair dealing and would be in the interest of consumers, the honey industry, and United States agriculture.

Removes Canada geese from within five miles of airports, especially JFK: “by the first subsequent molting period for Canada geese that occurs after the date of enactment of this Act, publish a management plan that provides for the removal, by not later than 1 year after the date of publication, of all Canada geese residing on the applicable land.”

On the brighter side, it also:

Expands farmers’ market promotion to include local food: “domestic farmers’ markets, roadside stands, community-supported agriculture programs, agritourism activities, and other direct producer-to-consumer market opportunities; and local and regional food enterprises that are not direct producer-to-consumer markets but process, distribute, aggregate, store,and market locally or regionally produced food products.”

NASC’s assessment:

that may be, as the saying goes, the best that can be accomplished under current circumstances.  If so, one would hope that if nothing else, it would spur a major re-evaluation and thorough overhaul between now and the next farm bill to create something that might begin to approximate a goal-driven, fairer, less costly, more rationale, less environmentally damaging, more economic opportunity-creating, and less market distorting approach then where it appears the current process will end up. 

Hey—we all can dream.

My monthly Food Matters column for the San Francisco Chronicle:

Q: I forced myself to watch all four hours of HBO’s “Weight of the Nation.” I get it that obesity is a scary problem and I’m supposed to be eating less. What I don’t get is how I’m supposed to do that when food companies can do what they want and the government lets them.

A: I am with you on this one. I also looked at the website (theweightofthenation.hbo.com) and a report from the Institute of Medicine, “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation.” These all are components of a public-private partnership campaign to bring the personal and economic costs of obesity to national attention.

As The Chronicle’s David Wiegand put it in his Datebook review (see: sfg.ly/KO2vgI), the show “pulls no punches, spares neither the multibillion-dollar food and advertising industries nor public officials for not only failing to fix the problem but actually making it worse.”

I thought the series focused too much on what you have to do on your own to manage your weight: take small steps, set realistic goals, focus on portion control, monitor your calorie intake.

I wish it had spent as much time on countering the actions of the food industry, called by Kelly Brownell of Yale’s Rudd Center as “powerful, pernicious and predatory.”

I also wish it had been more courageous in demanding that government help check the excesses of food industry marketing to make it easier for Americans to cope with the social, economic and business drivers of obesity that the series documented so well.

I saw that courage in an accompanying video for kids, which won’t be shown nationally until the fall. Watch for it. School kids in a Rethinkers club in New Orleans wanted to improve the lunches in their school. They went into action and figured out how to make the system work for them. They succeeded by learning to “speak truth to power” and “hold feet to the fire.”

Why aren’t adults doing the same? For an explanation, take a look at the institute’s report. Its recommendations do speak some truth to power. Although its No. 1 goal promotes physical activity (a thoroughly uncontroversial recommendation), its No. 2 is to fix the environment to make healthier food options routine and easy, especially by discouraging consumption of soft drinks.

As for holding feet to fire, the report warns that if companies don’t adopt nutrition standards for kids’ marketing within two years, policymakers should consider making them mandatory.

Consider? “Weight of the Nation” showed how the food industry reacted when the Federal Trade Commission tried to propose voluntary standards.

In two years? The institute already gave the food industry two years to act – six years ago. Its 2006 “Food Marketing to Children and Youth” report stated that if the industry didn’t stop advertising junk foods on children’s television programs within two years, Congress should legislate marketing standards.

In 1968, the CBS television documentary “Hunger in America” shocked the nation and galvanized Congress to pass legislation to reduce poverty and malnutrition.

“Weight of the Nation” is equally shocking. It impressively and compellingly defines the problem of obesity, its consequences and its causes, personal and societal.

But I wish the series – and the Institute of Medicine – had been able to rise above the politics and say more about how we as a society could do better to improve school food, limit the relentless marketing of sodas and junk foods, and make it easier for everyone to afford and have access to healthier foods.

Food companies are businesses. In today’s investment economy, they must not only make a profit but must increase the profit every 90 days. Business imperatives mean that they could help make healthier choices easier, but won’t unless forced to. That’s what New York Mayor Michael Bloomberg’s proposed ban on big sodas is trying to do (see: sfg.ly/L45K0t).

At the very least, I’m hoping the HBO program will encourage viewers to press for political action to prevent obesity. If it does, history will judge this documentary to be as important a democratizing influence on our society as was “Hunger in America.”

While Weight of the Nation is airing on HBO this week (I’ll comment on it after it’s fully aired), here’s what happens when public health officials try to do something to make it easier for kids to eat more healthfully.

The Massachusetts public health department came up with a proposal to ban bake sales in public schools 30 minutes before, during and after classes.

The reaction?  An uproar.  The ban, according to critics, would

• Make it harder to raise money for class trips and athletic equipment
• Undermine the fundraising efforts of parent and student groups
• Not help prevent obesity
• Take away choice from school districts (“government gone awry”)

Under this kind of pressure, “the governor spoke, emergency orders were issued, and the Legislature voted.”

End of ban.

Massachusetts public health commissioner John Auerbach pointed out:

The school nutrition standards have always been about reducing childhood obesity in Massachusetts and protecting our kids from the serious long-term health impacts that obesity can cause…At the direction of Governor Patrick, the department will seek to remove these provisions.

We hope to return the focus to how we can work together to make our schools healthy environments in which our children can thrive.

Best of luck.

This reminds me of what happened in Texas, when Susan Combs, then state agriculture director, attempted to ban cupcakes from public schools.

As Dr. Cathy Isoldi described in her study of school celebrations earlier this year (on which I am a co-author),

Such bans have prompted intense opposition in many areas of the country. In Texas in 2005, a ban on food service during classroom celebrations elicited parent outrage and resulted in the addition of a Safe Cupcake Amendment to the state’s nutrition policy. The amendment, known as Lauren’s Law, ensures that parents and grandparents of schoolchildren celebrating a birthday can bring in whatever food items they choose for classroom celebrations.

Cathy’s work makes it clear that school celebrations alone can account for a whopping 20% to 35% of a child’s daily calorie needs.  This percentage does not account for additional treats sent home with children,  given to them by teachers as rewards, or purchased in school at bake sales.

You don’t see an occasional cupcake as a problem?  Read Bettina Siegel’s post on what goes on in her kids’ school and how often schoolkids are exposed to junk foods during the school day.

Of course kids will eat treats rather than healthier foods if given half a chance.  Isn’t it an adult responsibility—at home and at school—to make sure that kids eat healthfully?

The environment of many schools is anything but conducive to good health practices.  While outright bans may be seen as going too far, some kind of restriction on junk food in schools seems like a sensible adult decision, given the impact of obesity on children, families, and the health care system so well documented in Weight of the Nation.

State legislatures should be promoting such efforts, not overturning them.

I am in Brazil at meetings of World Nutrition Rio 2012 but was deluged yesterday by links to a lengthy Reuters’ Special Report: How Washington went soft on childhood obesity.

In an e-mail, Reuters explains that its report is about how food and beverage companies dominate policymaking in Washington, doubled lobbying expenditures during the past three years, and defeated government proposals aimed at changing the nation’s diet.

• The White House, despite First Lady Michelle Obama’s child obesity campaign, kept silent as Congress killed a plan by four federal agencies to recommend reductions to sugar, salt and fat in food marketed to children.
• Corporate lobbying last year led Congress to declare pizza a vegetable to protect it from a nutritional overhaul in the school lunch program.
• The Center for Science in the Public Interest, widely regarded as the lead lobbying force for healthier food, spent about $70,000 lobbying– roughly what companies opposing stricter food guidelines spent every 13 hours.
• The food and beverage industry has a near-perfect record in political battle even while health authorities link unhealthy food to the child obesity epidemic.
• During the past two years, each of the 24 states and five cities that considered “soda taxes” has seen the efforts dropped or defeated.

Reuters Investigates also has a video about how the food industry fought back when the White House sought healthier school lunches and Congress directed federal agencies to set nutrition standards.

Readers of this blog may recall my post last December fretting about the White House pullback, and the vigorous denial the next day by White House senior food policy advisor Sam Kass.

I attributed White House caution to the upcoming election.  Reuters does too, apparently, and so does the New York Times. 

If the First Lady is to make real progress on Let’s Move, she needs all the support she can get.  This might be a good time to send a note to the White House strongly encouraging more vigorous action on methods to address childhood obesity.