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For my monthly (first Sunday) Food Matters column in the San Francisco Chronicle, I devote the one in January every year to predictions.  Last year I got them all pretty much on target.  It didn’t take much genius to figure out that election-year politics would bring things to a standstill.  This year’s column was much harder to do, not least because the FDA was releasing blocked initiatives right up to the printing deadline.

 Q: I just looked at your 2012 crystal ball column. Your predictions were spot on. But what about 2013? Any possibility for good news in food politics?

A: Food issues are invariably controversial and anyone could see that nothing would get done about them during an election year. With the election over, the big question is whether and when the stalled actions will be released.

The Food and Drug Administration has already unblocked one pending decision. In December, it released the draft environmental assessment on genetically modified salmon – dated May 4, 2012. Here comes my first prediction:

The FDA will approve production of genetically modified salmon: Because these salmon are raised in Canada and Panama with safeguards against escape, the FDA finds they have no environmental impact on the United States. The decision is now open for public comment. Unless responses force the FDA to seek further delays, expect to see genetically modified salmon in production by the end of the year.

Pressures to label genetically modified foods will increase: If approval of the genetically modified salmon does nothing else, it will intensify efforts to push states and the FDA to require GM labeling.

Whatever Congress does with the farm bill will reflect no fundamental change in policy: Unwilling to stand up to Southern farm lobbies, Congress extended the worst parts of the 2008 farm bill until September. Don’t count on this Congress to do what’s most needed in 2013: restructure agricultural policy to promote health and sustainability.

The FDA will start the formal rule-making process for more effective food safety regulations: President Obama signed the Food Safety Modernization Act in January 2011. Two years later, despite the FDA’s best efforts, its regulations – held up by the White House – have just been released for public comment. Lives are at stake on this one.

The FDA will issue rules for menu labels: The Affordable Care Act of 2010 required calorie information to be posted by fast-food and chain restaurants and vending machines. The FDA’s draft applied to foods served by movie theaters, lunch wagons, bowling alleys, trains and airlines, but lobbying led the FDA to propose rules that no longer covered those venues. Will its final rules at least apply to movie theaters? Fingers crossed.

The U.S. Department of Agriculture will delay issuing nutrition standards for competitive foods: When the USDA issued nutrition standards for school meals in January 2012, the rules elicited unexpected levels of opposition. Congress intervened and forced the tomato sauce on pizza to count as a vegetable serving. The USDA, reeling, agreed to give schools greater flexibility. Still to come are nutrition standards for snacks and sodas sold in competition with school meals. Unhappy prediction: an uproar from food companies defending their “right” to sell junk foods to kids in schools and more congressional micromanagement.

The FDA will delay revising food labels: Late in 2009, the FDA began research on the understanding of food labels and listed more relevant labels as a goal in its strategic plan for 2012-16. Although the Institute of Medicine produced two reports on how to deal with front-of-package labeling and advised the FDA to allow only four items – calories, saturated and trans fat, sodium and sugars – in such labels, food companies jumped the gun. They started using Facts Up Front labels that include “good” nutrients as well as “bad.”

Will the FDA insist on labels that actually help consumers make better choices? Will it require added sugars to be listed, define “natural” or clarify rules for whole-grain claims? I’m not holding my breath.

Supplemental Nutrition Assistance Program participation will increase, but so will pressure to cut benefits: Demands on Snap – food stamps – reached record levels in 2012 and show no sign of decline. Antihunger advocates will be working hard to retain the program’s benefits, while antiobesity advocates work to transform the benefits to promote purchases of healthier foods. My dream: The groups will join forces to do both.

Sugar-sweetened beverages will continue to be the flash point for efforts to counter childhood obesity: The defeat of soda tax initiatives in Richmond and El Monte (Los Angeles County) will inspire other communities to try their own versions of soda tax and size-cap initiatives. As research increasingly links sugary drinks to poor diets and health, soda companies will find it difficult to oppose such initiatives.

Grassroots efforts will have greater impact: Because so little progress can be expected from government these days, I’m predicting bigger and noisier grassroots efforts to create systems of food production and consumption that are healthier for people and the planet. Much work needs to be done. This is the year to do it.

And a personal note: In 2013, I’m looking forward to publication of the 10th anniversary edition of “Food Politics” and, in September, my new editorial cartoon book with Rodale Press: “Eat, Drink, Vote: An Illustrated Guide to Food Politics.”

If you happen to be in Washington DC, take a look at FOOD: Transforming the American Table 1950–2000 at the Smithsonian National Museum of American History.

Julia Child’s kitchen is the featured exhibit, but the history of the industrialization of the U.S. food supply is well worth a look.

I especially like quirky collections of food objects.  Here’s one from the exhibit:

If you are in New York City, you can see Our Global Kitchen: Food, Nature, Culture at the American Museum of Natural History and check out the New York Times review so you know what to look for.

Also in New York is Lunch Hour at the New York Public Library.  If you can’t get there, the library has an online version of the exhibition.

If you happen to be in Switzerland and anywhere near Lake Geneva, Nestlé’s Alimentarium in Vevey has a special display of quirky collections: sardine cans, sugar cubes, and fruit wrappers, for example.  You can find it easily from its fork stuck into Lake Geneva.

Food exhibits seem to be the current Big Thing.  I’m trying to take advantage of them while they are around.  You too?

My latest publication is a commentary on the reversal of the Danish fat tax in New Scientist, November 26:

Fighting the flab means fighting makers of fatty foods

A YEAR ago in these pages, I congratulated the Danish government on its revolutionary experiment. It had just implemented a world-first fiscal and public health measure – a tax on food products containing more than 2.3 per cent saturated fat.

This experiment has now been dropped. Under intense pressure from the food industry in an already weak economy, the Danish government has repealed the fat tax and abandoned an impending tax on sugars.

Nobody likes taxes, and the fat tax was especially unpopular among Danish consumers, who resented having to pay more for butter, dairy products and meats – foods naturally high in fat.

But the real reason for the repeal was to appease business interests. The ministry of taxation’s rationale was that the levy on fatty foods raised the costs of doing business, put Danish jobs at risk and drove customers to buy food in Sweden and Germany.

In June this year, a coalition of Danish food businesses organised a national repeal-the-tax campaign. The coalition said that fat and sugar taxes would cause the loss of 1300 jobs, generate high administrative costs and increase cross-border shopping – precisely the arguments cited by the government for its U-turn.

We can now ask the obvious questions. Did the tax achieve its aims? Was it good public policy? What should governments be doing to reduce dietary risk factors for obesity?

The purpose of food taxes is to reduce sales of the products concerned. In bringing in its fat tax, the Danish government also wanted to raise revenue, reduce costs associated with obesity-related diseases, and increase health and longevity. A year is hardly time to assess the impact on health, but the tax did bring in $216 million. Danes will now face higher income taxes to make up for the loss of the fat tax.

Business groups insist that the tax had no effect on the amount of fat that Danes ate, although they chose cheaper foods. In contrast, economists at the University of Copenhagen say Danish fat consumption fell by 10 to 20 per cent in the first three months after the tax went into effect. But it is not possible to know whether it fell, and cross-border shopping rose, because of the tax or because of the slump that hit the Danish economy.

A recent analysis in the BMJ suggests that 20 per cent is the minimum tax rate on food to produce a measurable improvement in public health. The price of Danish foods hit by the tax increased by up to 9 per cent, enough to cause a political firestorm but not to make much of a difference to health.

Is a saturated-fat tax good public policy? A tax on sugary drinks would be a better idea. To see why, recall that obesity is the result of an excess intake of calories over what we burn. Surplus calories, whether from carbohydrate, protein or fat, are stored as body fat. All food fats are a mix of unsaturated and saturated fatty acids; all provide the same number of calories per unit weight.

Saturated fats raise the risk of coronary heart disease, although not by much. Trans fats, banned in Denmark since 2003, are a greater risk factor. Because the different saturated fatty acids vary in their risk, imposing a single tax on them as if they are indistinguishable is difficult to support scientifically.

For these reasons, anti-obesity tax measures in other countries have tended to avoid targeting broad nutrient groups. Instead, they focus on processed foods, fast food or sugary drinks – all major sources of calories. Taxing them seems like a more promising strategy.

What else should governments be doing? That they have a role in addressing the health problems caused by obesity is beyond debate, not least because they bear much of the cost of dealing with such problems. In the US, economists estimate the cost of obesity-related healthcare and lost productivity at between $147 billion and $190 billion a year. The need to act is urgent. But how?

One lesson from Denmark is that small countries with open borders cannot raise the prices of food or anything else unless neighbouring countries also do so. But the greater lesson is that any attempt to encourage people to eat less will encounter fierce food-industry opposition. Eating less is bad for business.

In the US, state and city efforts to tax sugary drinks have met with overwhelming opposition from soft-drink companies. They have successfully spent tens of millions of dollars lobbying legislators and convincing the public that such measures deprive voters of their “right to choose” or, as in Denmark, can damage the economy.

What’s more, the poor cannot be expected to support measures that increase food costs, even though obesity-related problems are much more common among low-income groups.

If governments really want to reduce the costs of obesity-related chronic diseases, they will have to address the problem at its source: the production and marketing of unhealthy food products.

A review by the American Heart Association cites increasing evidence for the benefits of anti-obesity interventions: food taxes, subsidising healthy foods, media campaigns to promote exercise and good diet, restrictions on portion sizes, and restrictions on the marketing of unhealthy foods and their sale in schools.

Governments must decide whether they want to bear the political consequences of putting health before business interests. The Danish government cast a clear vote for business.

At some point, governments will need to find ways to make food firms responsible for the health problems their products cause. When they do, we are likely to see immediate improvements in food quality and health. Let’s hope this happens soon.

Marion Nestle is the author of Food Politics and What to Eat and is the Paulette Goddard professor of nutrition, food studies, and public health at New York University

The latest study on the evils of High Fructose Corn Syrup (HFCS) so annoys the Corn Refiners Association that it broke the study’s embargo.

Reporters were not supposed to write about the study until today, but the Corn Refiners issued a press release yesterday: “Caution: New Study Alleging HFCS-Diabetes Link is Flawed and Misleading.”

The New York Times quickly posted its own pre-embargo account.

Why the fuss?  The study reports that countries with the highest levels of HFCS in their food supplies also have a 20% higher prevalence of diabetes in their populations.  This is a correlation between HFCS and diabetes.  It does not mean that HFCS causes diabetes—an important distinction.

But the authors’ press release (sent to me in an e-mail message) makes it sound like causation.  They say (also see Dr. Goran’s comments added to this post below):

HFCS appears to pose a serious public health problem on a global scale,” said principal study author Michael I. Goran…The study adds to a growing body of scientific literature that indicates HFCS consumption may result in negative health consequences distinct from and more deleterious than natural sugar.

This conclusion is based on their observations that the amounts of other sugars in the food supplies of countries with high and low HFCS are about the same.  But HFCS is a form of sugars that adds to total sugar availability.

The authors obtained information about diabetes and obesity prevalence and HFCS and other dietary factors in the food supply from existing sources of data, all of them questionable.   The data do not distinguish between type 1 and type 2 diabetes, for example, and the two different sources of data on diabetes prevalence give different results.

Inconsistencies abound.  For example, Mexico has more diabetes than does the U.S., but rather low HFCS availability (Mexicans prefer sucrose in their sodas).  Some countries with high diabetes rates report no HFCS availability at all.

As with all correlational studies, something else could be going on that causes HFCS, sugars of all types, and diabetes to increase.

That was the point I was trying to make when I spoke to Stephanie Strom of the New York Times:

 “I think it’s a stretch to say the study shows high-fructose corn syrup has anything special to do with diabetes,” Dr. Nestle said. “Diabetes is a function of development. The more cars, more TVs, more cellphones, more sugar, more meat, more fat, more calories, more obesity, the more diabetes you have.”

She noted that the study “falls right in the middle of the Corn Refiners fight with the Sugar Association,” a reference to the legal war being waged between the two industry groups over the marketing of high-fructose corn syrup.

The Corn Refiners press release quotes its president, Audrae Erickson:

This latest article by Dr. Goran is severely flawed, misleading and risks setting off unfounded alarm about a safe and proven food and beverage ingredient.  There is broad scientific consensus that table sugar and high fructose corn syrup are nutritionally and metabolically equivalent…The bottom line is this is a poorly conducted analysis, based on a well-known statistical fallacy, by a known detractor of HFCS whose previous attack on the ingredient was deeply flawed and roundly criticized.

Whew.

Yes, HFCS is sugar(s)—glucose and fructose.  So is table sugar (sucrose).

But the bottom line goes for both: Everyone would be better off eating less sugar(s).

Addition to post: Dr. Goren wrote two e-mails to me in response.  With his permission, they follow.

Hi Marion,

I saw your comments in the NYT article that was published about our global HFCS paper.

You say that: “Diabetes is a function of development. The more cars, more TVs, more cellphones, more sugar, more meat, more fat, more calories, more obesity, the more diabetes you have.”

I wanted to mention that an often overlooked issue is that obesity is not the only factor contributing to type 2 diabetes and even the causal link between obesity and type 2 diabetes is unknown. Other factors include inflammation, oxidative stress, insulin resistance etc. In the study that was done with my colleague at the University of Oxford, the countries with high and low/zero HFCS were matched for obesity levels as well as total calorie and sugar availability. In essence this allowed us to isolate the effects of HFCS as a contributing factor, independent of obesity and the other factors that you mention that are related to obesity. I agree, as stated in the paper, that the ecological type analysis has its limitations, but in the case of HFCS it provided an opportunity to study its effects at the broader macro level. We did this because it is impossible to evaluate individual levels of HFCS consumption because we don’t know specifically how much is added to food/beverages.

The main critique of our study from the corn refiners association is based on their assertion that fructose and glucose are the same when in fact its textbook knowledge that their metabolic fate/pathways are very different. The CRA now says that sucrose and HFCS are “almost identical”. Almost identical acknowledges that they are different in some way which they are. Its a fact that HFCS-55 has at least 10% more fructose than sucrose and our prior study in which we analyzed popular beverages showed this was on average 20% and in some cases as much as 30% higher fructose. The key question in my mind is whether the additional fructose in HFCS is enough (even if its only 10% higher) to tip the balance towards the negative metabolic effects of fructose on health. This is at the heart of the issue and should be the focus of investigation. Our study, with its accepted limitations, adds to the growing body of evidence that the additional fructose coming from HFCS may indeed be enough to tip this balance.

His second message:

Thanks for responding, and yes, I’d be pleased if you added this to your blog –  – I think this will be a good addition. The question of whether the extra 10% fructose matters is indeed critical.

We also by the way did analyze total sugars versus diabetes in a much larger data set of 200 countries but the reviewers asked for that to be taken out which we did because we also thought the focus on HFCS would be unique. We also did see a clear relationship between total sugar and diabetes – some of that relationship was mediated by obesity but there also was an independent association between total sugars and diabetes. So, I agree – – both obesity and total sugars contribute to diabetes – – but I also believe, as shown in our paper, that HFCS has a separate link, and that this is probably due to the higher fructose content in HFCS.

Also, you mentioned in your blog that the different estimates of diabetes gave different results. That’s not really correct. The estimates of diabetes were different from each other, but regardless of which diabetes estimate we used, we still found a consistent association between HFCS and the 2 prevalence estimates of diabetes as well as fasting glucose. So in essence the results were validated using different prevalence estimates of type 2 diabetes.

My NYU Food Policy class meets tonight and we’ll be talking about the farm bill and Dan Imhoff’s most helpful book Food Fight: The Citizens’ Guide to the Next Food and Farm Bill.

To review what’s up with the 2012 farm bill:

Congress updates farm bills every five years or so.  It passed the last one in 2008, with an expiration date at midnight on September 30, 2012.  This was the first time Congress ever set an expiration date to land in the midst of a presidential election.  This was asking for trouble.  Congress is paralyzed in election years.

That date has now come and gone.

But in June 2011, the Senate passed its version of the bill: The Agriculture Reform, Food and Jobs Act of 2012.

The House, however, was unable to come to agreement on its version: The Federal Agriculture Reform and Risk Management Act of 2012.

Why?  Election-year politics and disagreements about whether and by how much the SNAP (food stamps) budget should be cut.  More than 80% of farm bill spending goes to SNAP benefits—a whopping $72 billion last year–making it a prime target for budget cutting.

This situation puts us in farm bill limbo.

The significance of limbo is best explained by the National Sustainable Agriculture Coalition (NSAC).

• Without a new farm bill, commodity (corn, soybean, etc) support programs revert to permanent law contained in the farm bills passed in 1938 and 1949.  Why?  Because unlike subsequent bills, these did not have expiration dates.
• The old laws reintroduce much higher support prices (through certain loans instead of payments), require much smaller crop production, and lead to much higher consumer prices.  They do not include  support for soybeans, other oilseeds, peanuts, or sugar, making them woefully out of date.
• Limbo has no effect on SNAP or crop insurance.  Congress covered SNAP with a resolution for continued funding through March 2013.  The Federal Crop Insurance Act effectively authorizes crop insurance permanently.
• Dairy programs are in turmoil.  Milk payments to farmers ended in September.  The dairy price support program ends on January 1.   Under the 1949 law, government-supported prices would be about four times higher than current law and about twice as high as current market prices.
• The Agricultural Appropriations Act extended some—but not all—conservation programs through 2014.
• The permanent law does not support the hard-won programs that encourage fruit and vegetable production: organic, farmers’ market, beginning farmer, socially disadvantaged farmer, or specialty crop programs.  These now have no funding.

This leaves Congress with three options between now and January:

• Finish the current process and pass a bill (unlikely since it only has a few weeks to do this)
• Vote to extend provisions through the 2013 crop year, or
• Start from scratch all over again in a much tighter budget environment—the infamous “fiscal cliff.”

As NSAC explains:

The farm bill is the nation’s major food and agricultural policy vehicle and is about much more than the big ticket items: food stamps, crop insurance, and commodity support.  The farm bill is also about conservation and environmental protection, rural economic and community development, food system reform and agricultural research.

With no new farm bill or extension, the programs that address rural and urban job creation, natural resource conservation, renewable energy, and improved production and access to healthy food are in big trouble.

This is a big mess, and a serious result of dysfunctional government.  It will be interesting spectator sport to see how Congress handles it.

Will Congress find a way to bring agricultural policy in line with health policy?

Or will Congress simply do whatever is most expedient, given the budgetary mess it has also created.

It’s too bad so much is at stake.

My post-hurricane Manhattan apartment still does not have telephone, internet, or television service, so I followed the election results on Twitter.

I knew that President Obama had been reelected when the Empire State Building turned on blue lights.

What’s ahead for food politics?

With the election out of the way, maybe the FDA can now:

• Release final food safety rules (please!)
• Issue proposed rules for front-of-package labels
• Issue proposed rules for revising food labels
• Require “added sugars” to be listed on labels
• Define “natural”
• Clarify “whole grain”
• Release rules for menu labeling in fast-food restaurants

Maybe the USDA can

• Release nutrition standards for competitive foods served in schools

And maybe Congress can pass the farm bill?

As for lessons learned:

• The food industry has proven that it can defeat consumer initiatives by spending lots of money: $45 to $50 million on California’s Proposition 37 (GMO labeling), $4 million on soda tax initiatives in Richmond and El Monte.
• But if enough such initiatives get started, food companies might get the message?

The Federal Trade Commission (FTC), which is responsible for regulating advertising, has just revised its “Green Guide” to eco-labeling.

The FTC warns that

• Explanations of specific attributes, even when true and substantiated, will not adequately qualify general environmental marketing claims if an advertisement’s context implies other deceptive claims.
• Marketers [are] not to imply that any specific benefit is significant if it is, in fact, negligible.
• If a qualified general claim conveys that a product is more environmentally beneficial overall because of the particular touted benefit, marketers should analyze trade-offs resulting from the benefit to substantiate this claim.

The FTC did this, according to the New York Times, to reduce the confusion caused by the proliferation of eco-labels.

In surveying consumers, the F.T.C. found that products that were promoted as “environmentally friendly” were perceived by consumers to have “specific and far-reaching” benefits, which, the government says, they often did not have.

“Very few products, if any, have all the attributes consumers seem to perceive from such claims, making these claims nearly impossible to substantiate,” the commission said.

No wonder the public is confused.  The Consumer Reports Greener Choices index of eco-labels goes on for pages, and the international EcoLabel index currently lists 432 icons and programs.

But the FTC guide says nothing about claims that a product is natural, organic, or sustainable.

“Natural” still has no regulatory definition.  Of Natural, the FDA says:

From a food science perspective, it is difficult to define a food product that is ‘natural’ because the food has probably been processed and is no longer the product of the earth. That said, FDA has not developed a definition for use of the term natural or its derivatives. However, the agency has not objected to the use of the term if the food does not contain added color, artificial flavors, or synthetic substances.

“Organic” is defined by the USDA through its National Organic Program.

“Sustainable” has no regulatory definition.

Will the FTC’s guide help alleviate confusion?  Perhaps, if companies follow it.

I’ve been trying to keep track of the legal dispute between the Corn Refiners (representing manufacturers of high fructose corn syrup—HFCS) and the Sugar Association, which represents growers of sugar beets and cane (sucrose).

Recall: HFCS is glucose and fructose separated, whereas sucrose is glucose and fructose stuck together.  Because they are biochemically pretty much the same (enzymes that split sucrose act quickly), they have the same effects in the body.

So the dispute is about market share, not science.

First, the Corn Refiners tried to change the name of HFCS to “corn sugar.”  The FDA turned this down (as well it should).

Then, the Sugar makers sued the Corn Refiners, claiming that the Corn Refiners’ public education marketing campaign was false and misleading because it promoted HFCS as “natural” (It’s not, in my opinion) and nutritionally and metabolically equivalent to other forms of sugar (which it is).

Then, the Corn Refiners countersued on the basis that Sugar lobbying groups are tricking the public into believing that sucrose is healthier than HFCS (it’s not) and trying to create a “health halo” for sucrose (absurd).

As Food Navigator puts it, the two associations are “trading insults.”

While all this is going on, a group called Citizens for Health has filed a petition with FDA to put the concentration of fructose in HFCS on package labels.  HFCS is usually 42% or 55% fructose (it is 50% in sucrose).  These forms of HFCS are considered by FDA to be generally recognized as safe (GRAS).

The petition argues that some products have more fructose—65% or 90%—and should say so.

All sugars should be consumed in small quantities, but fructose especially so.

The Corn Refiners say that Citizens for Health, which sponsors a website called foodidentitytheft.com, is funded by the Sugar Association.

Also in the meantime, a new study says HFCS has nothing whatsoever to do with obesity.  Guess who sponsored the study.

Advice for today: eat less sugar(s), meaning sucrose, glucose, fructose, table sugar, HFCS, corn sugar, and all the other euphemisms food companies use to deflect attention from how much their products contain.