Search results: a life in food

Nick Freudenberg.  At What Cost: Modern Capitalism and the Future of Health.  Oxford University Press, 2021.   

I did a blurb for this terrific book:

At What Cost is a must-read for anyone who wants to understand why food insecurity, low-wage work, chronic disease, and environmental degradation are such widespread and seemingly intractable problems.  Capitalism may not be their only cause, but it is common to all of them.  This important book provides compelling evidence for the need to join together to change this system to one better for people and the planet.

Here are a few excerpts to give you the idea:

…how capitalism has evolved now undermines health, widens inequality, worsens climate change, and erodes democracy.  Food, education, healthcare, labor, transportation, and social relationships constitute the most basic necessities of life.  Converting them into commodities that must bring profits to their producers if they are to be offered imposes a cost on human and planetary well-being (p. 15).

[Goals for food justice require] changing the dominant corporate system of food and agriculture.  Focusing on the separate goals of each strand rather than the common overarching ones has made the food movement less powerful, less able to win concessions from the highly organized alliance of food and agriculture businesses, and more vulnerable to co-optation by trade groups who offer some factions grants or a seat at the policy table (p. 274).

Corporate-controlled globalization, financialization, deregulation, monopoly concentration, and the corporate capture of new technologies, the defining characteristics of twenty-first-century capitalism, are fundamental causes of multiple and growing threats to well-being.  This commonality justifies a sharp focus on the system that is the underlying cause (p. 277).

To fix food system problems, means fixing capitalism.  That’s the problem that needs our focused attention.  He’s got some ideas about that too.

Here’s another nutrition question that doesn’t go away.

This new study is just out: Egg and cholesterol consumption and mortality from cardiovascular and different causes in the United States: A population-based cohort study.

Its conclusion:

In this study, intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality. The increased mortality associated with egg consumption was largely influenced by cholesterol intake. Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival.

This gets right into the funny business of the 2015 Dietary Guidelines.  As I explained,

the recommendation to limit cholesterol has been dropped [from the 2015 Guidelines], but the document says, confusingly, that “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM, individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”  Could the dropping of the limit have anything to do with egg-industry funding of research on eggs, the largest source of dietary cholesterol, and blood cholesterol?  The Physicians Committee for Responsible Medicine has just filed a lawsuiton that very point.

Well, here we go again.  My thoughts:

This is association, not causation.  The paper gives this caveat: “At baseline, participants with higher whole egg consumption had a higher BMI and lower household income. They were less educated, less physically active, more likely to smoke and have a high cholesterol level, and less likely to take aspirin. They also had higher red meat intake; lower intakes of fruit, dairy products, and sugar-sweetened beverages; and lower HEI-2015 score.”

Eggs, it seems, track with other unhealthful dietary behaviors.

The egg situation is a mess to sort out because the egg industry funds so many studies in its own defense and these invariably show no effect.

But eggs are one food in complicated diets and it’s really hard to look at them independently of everything else in the diet and lifestyle.

What to do?  Moderation is always good advice.

The report, associated documents, and announcement video are on this Lancet website 

Palm oil is on my mind these days because I just did a blurb for a forthcoming book, Jocelyn Zuckerman’s Planet Palm: How Palm Oil Ended Up in Everything—and Endangered the World, which I will say more about when it is published in May.

Palm oil raises so many issues that it’s hard to know where to begin: unhealthy degree of fat saturation, deforestation, loss of biodiversity, child labor, labor exploitation, adulteration, and criminal behavior, with everyone who consumes products made with palm oil complicit in these problems.

Reporters for AP News have done some investigating.  Their most recent report talks about the links between child labor and Girl Scout Cookies. 

Olivia Chaffin, a Girl Scout in rural Tennessee, was a top cookie seller in her troop when she first heard rainforests were being destroyed to make way for ever-expanding palm oil plantations. On one of those plantations a continent away, 10-year-old Ima helped harvest the fruit that makes its way into a dizzying array of products sold by leading Western food and cosmetics brands….The AP’s investigation into child labor is part of a broader in-depth look at the industry that also exposed rape, forced labor, trafficking and slavery. Reporters crisscrossed Malaysia and Indonesia, speaking to more than 130 current and former workers – some two dozen of them child laborers – at nearly 25 companies…The AP found children working on plantations and corroborated accounts of abuse, whenever possible, by reviewing police reports and legal documents. Reporters also interviewed more than 100 activists, teachers, union leaders, government officials, researchers, lawyers and clergy, including some who helped victims of trafficking or sexual assault.

The AP also reports that abuses of labor in the palm oil industry are linked to world’s top brands and banks.

An Associated Press investigation found many like Jum in Malaysia and neighboring Indonesia – an invisible workforce consisting of millions of laborers from some of the poorest corners of Asia, many of them enduring various forms of exploitation, with the most serious abuses including child labor, outright slavery and allegations of rape. Together, the two countries produce about 85% of the world’s estimated $65 billion palm oil supply…The AP used the most recently published data from producers, traders and buyers of the world’s most-consumed vegetable oil, as well as U.S. Customs records, to link the laborers’ palm oil and its derivatives from the mills that process it to the supply chains of top Western companies like the makers of Oreo cookies, Lysol cleaners and Hershey’s chocolate treats.

Cargill, which is involved in this industry, has responded to the AP report; it denies the charges.

Cargill does not tolerate the use of human trafficking, forced labor or child labor in our operations or supply chains. We expect all Cargill employees and our suppliers to adhere to our formal Commitment to Human Rights, which we enhanced in 2019 to detail the principles we embed into our policies and systems to protect human rights around the world. This Commitment applies to our workplace, communities in which we operate, and supply chains….Our efforts on the ground in our palm supply chain in Malaysia, Indonesia, Guatemala and globally focus on health and safety, responsible recruitment, and transparent contract and pay practices to protect and empower our workers, especially women who depend on their work in palm oil to earn a living and support their families.

As for deforestation, the industry argues for shared responsibility: Palm oil: Why shared responsibility is needed to cement sustainability improvements:  There is a disconnect between the reputation and reality of palm oil. Popular media paint palm oil as a primary driver of deforestation…. Read more

All of this suggests: Turbulent times ahead? Malaysia palm oil faces uncertain 2021 with price, production and policy challengesThe palm oil industry in Malaysia needs to prepare itself for an uncertain year ahead with expected price volatility, production decrease and policy changes in the west, with the government attempting to shift to more value-added products in hopes of providing a boost…. Read more

One of the great ironies of all this is that palm oil, which is highly saturated (and, therefore, raises the risk of heart disease), has been promoted and used by the processed food industry as a replacement for trans fats, now mostly gone from the market since required to be listed on Nutrition Facts labels.

Can palm oil be produced fairly and sustainably?  The answer depends on whom you ask.  The Independent has a quick overview of the controversies.

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.

Saray Stancic.  What’s Missing From Medicine: Six Lifestyle Changes to Overcome Chronic Illness.  Hierophant Publishing, 2021.

I don’t usually recommend books about topics other than food politics, but this one has dietary changes at its core and although I have never met the author, I greatly admire her and her work.

I first heard about Dr. Stancic, who has a practice in New Jersey, when I was invited to watch a documentary film about her, Code Blue.   I was interested to see it because I was told I appeared in it, which I did for about 10 seconds.  I don’t remember meeting her or filming it (I tend not to remember such things), but the film is impressive and well worth seeing.

It tells her personal story of how she was able to get control of her formerly debilitating multiple sclerosis with a plant-based diet and exercise—good advice for everyone.  The film goes beyond the personal and talks about why she never understood the importance of diet: lack of nutrition education in medical schools, media confusion, inadequate government policies, and the overwhelming influence of drug, food, and beverage companies.   The film moves quickly and I thought it was much better than most documentaries of this type.

What made it work for me is Stancic, who comes across as committed, but sane and likable.  I would send anyone who has MS to see her in a shot.  She’s my kind of doctor—one who listens to patients and works with them.  The film’s message leans toward veganism, but without ideology and pushed only softly even by the strongest proponents she interviewed.

The book makes the same points.  It’s great strength is that it makes lifestyle changes seem possible for anyone.

Here’s what drove her to healthier eating:

My physicians warned me that it was irresponsble to wean myself off of the ten to twelve medications I was taking daily (and that were making my life unbearable) and solely manage my MS with an “unproven lifestyle change” [i.e., diet]…I adoped a whole foods, plant-based diet becasue the overwhelming body of scientific literature pointed to those foods as the best diet for optimal health for all people.  At that point, I knew I could not face a lifetime of living as I was—with a huge pillbox, cane, diapers, and the other physical and psychological burdens of MS [p. 36].

Her advice about how to eat more plant foods is sensible and easy to follow.  I particularly like her lack of dogmatism.  In a section on common food myths, she has two about meat:

Myth 1: We need to eat meat and dairy to be healthy.  FALSE [p. 57].

Myth 2. Eating animal products of any kind is bad for your health.  FALSE [p. 59]

Most of the book is about other changes that  can help everyone cope with chronic disease: movement, stress management, sleep, avoiding substances, human connections.  All of these messages are aimed at giving us the power to control our own health, and to make doing so seem entirely possible.

I found the book inspiring.  Her wish for us:

May we eat well, relish physical and mental challenges, enjoy restorative sleep, and connect deeply with others [p. xxxiii].

This is good advice for all of us these days.

Why, you must be asking, am I even asking a question like this?

Because of this study, obviously, which I somehow missed when it came out in August (thanks to toxicologist Marc Stifelman for sending it to me).

The study: Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID‐19.  Bousquet U, et al.  Allergy.  2020 Aug 6;10.1111/all.14549. Online ahead of print.

The hypothesis:

CAUTION:  Correlation does not necessarily mean causation.  The diets—and other lifestyle characteristics—of people in Romania and Latvia differ from those in the UK and Italy in other ways besides diet; other differences might well account for these variations.

Personally, I love cabbage in any form.

But for prevention of bad outcomes from Covid-19, I’m counting on vaccination, not kimchi or sauerkraut.

I only have a few more comments about the Dietary Guidelines beyond what I posted last week.

One is my surprise that the USDA did not do a new food guide.  The existing one, after all, dates from the Obama administration.  It has not changed.

Here’s how it is explained in the new guidelines:

My translation: Eat more plant foods, eat less meat, avoid ultraprocessed foods (including sugary beverages).

This requires a translation because the guidelines say nothing about ultraprocessed junk foods, and they try hard to avoid singling out foods to avoid.

These guidelines are similar to those in 2015 and are, therefore, woefully out of date.

They do mention the pandemic, once:

The importance of following the Dietary Guidelines across all life stages has been brought into focus even more with the emergence of COVID-19, as people living with diet-related chronic conditions and diseases are at an increased risk of severe illness from the novel coronavirus (p. 4).

They do mention food insecurity several times, for example:

In 2019, 10.5 percent of households were food insecure at least some time during the year. Food insecurity occurs when access to nutritionally adequate and safe food is limited or uncertain. Food insecurity can be temporary or persist over time, preventing individuals and families from following a healthy dietary pattern that aligns with the Dietary Guidelines. The prevalence of food insecurity typically rises during times of economic downturn as households experience greater hardship. Government and nongovernment nutrition assistance programs help alleviate food insecurity and play an essential role by providing food, meals, and educational resources so that participants can make healthy food choices within their budget (p. 50).

And they do mention food assistance programs (on page 81), although they do not discuss how the USDA has been relentless in trying to cut those programs.

Nothing about food systems.  Nothing about the effects of food production and consumption on climate change and sustainablity.

Nothing about eating less meat other than implying that eating less processed meat might be a good idea.

One other point: the complexity is increasing.  Here is the history of the page numbers:

As I’m fond of saying, Michael Pollan can do all this in seven words: “Eat food.  Not too much.  Mostly plants.”

If we can’t do better than this 164 pages of obfuscation, isn’t it about time to stop requiring these things every five years?

Here’s what other people are saying about them

• New York Times report (I’m quoted)
• Wall Street Journal (quotes American Beverage and Beer Associations)
• New York Daily News (I’m quoted)
• CNN (I’m quoted)
• Bipartisan Policy Center [Dan Glickman (Dem) and Ann Veneman (Rep), former USDA secretaries]
• Physicians Committee for Responsible Medicine (accuses guidelines of racial bias)
• USA Today
• National Fisheries Institute 
• Produce for Better Health Foundation