At long last, the USDA announced that it has released its proposed rules governing the nutritional content of snacks, sodas, and meals sold in competition with federally subsidized school breakfasts and lunches.

As soon as the rules get published in the Federal Register, which is supposed to happen this week, people will have 60 days to file comments.  Although USDA has not said when it will issue final rules, it did say that it will give schools another year to implement them.

The rules apply to foods sold outside the school meals in vending machines and a la carte lines.  They will not apply to fundraisers.  They set minimum standards.  States and localities that want stricter standards may do so.  A recent CDC analysis says states are already doing this (see Competitive Foods and Beverages in U.S. Schools: A State Policy Analysis).

Under the proposed rules, schools must provide:

• Potable water at no charge [this alone is cause for celebration].
• Real foods that are either something recognizable as a food or something that naturally contains 10% of the Daily Value in calcium, potassium, vitamin D, or fiber.
• Snacks with less than 200 mg sodium per serving.
• Desserts with less than 35% of calories from sugars or less than 35% of weight as sugars.
• Beverages with no more than 40 or 50 calories per 8-ounce serving.

There are plenty of exceptions.   I can only guess that the exemption for sweetened yogurt—30 grams of sugars in 8 ounces—has something to do with dairy lobbying.

My immediate reaction: these rules are a big improvement and deserve much support.

Applause to USDA for this one!

Here’s my monthly (first Sunday) Food Matters column from the San Francisco Chronicle. The question (edited) came from a reader of this blog.

Q: You view New York City’s cap on any soda larger than 16 ounces as good for public health. I don’t care if sodas are bad for us. The question is “Whose choice is it?” And what role should the nanny state play in this issue?

A: Your question comes up at a time when the New York State Supreme Court is hearing arguments about whether New York City’s health department has the right to establish a limit on soda sizes.

As an advocate for public health, I think a soda cap makes sense. Sixteen ounces provides two full servings, about 50 grams of sugars, and 200 calories – 10 percent of daily calories for someone who consumes 2,000 calories a day.

That’s a generous amount. In the 1950s, Coca-Cola advertised this size as large enough to serve three people.

You may not care whether sodas are bad for health, but plenty of other people do. These include, among others, officials who must spend taxpayer dollars to care for the health of people with obesity-related chronic illnesses, employers dealing with a chronically ill workforce, the parents and teachers of overweight children, dentists who treat tooth decay, and a military desperate for recruits who can meet fitness standards.

Poor health is much more than an individual, personal problem. If you are ill, your illness has consequences for others.

That is where public health measures come in. The closest analogy is food fortification. You have to eat vitamins and iron with your bread and cereals whether you want to or not. You have to wear seat belts in a car and a helmet on a motorcycle. You can’t drive much over the speed limit or under the influence. You can’t smoke in public places.

Would you leave it up to individuals to do as they please in these instances regardless of the effects of their choices on themselves, other people and society? Haven’t these “nanny state” measures, as you call them, made life healthier and safer for everyone?

All the soda cap is designed to do is to make the default food choice the healthier choice. This isn’t about denial of choice. If you want more than 16 ounces, no government official is stopping you from ordering as many of those sizes as you like.

What troubles me about the freedom-to-choose, nanny-state argument is that it deflects attention from the real issue: the ferocious efforts of the soda industry to protect sales of its products at any monetary or social cost.

The lawsuit against the soda cap is a perfect example. It is funded by the American Beverage Association, the trade association for Coca-Cola, PepsiCo and other soft-drink companies, at what must be astronomical expense.

To confuse the public about corporate profits as a motive, the beverage association enlisted two distinguished civil rights groups – the NAACP and the Hispanic Federation – to file an amicus brief on behalf of its lawsuit.

Never mind that the obesity rate for the communities these groups represent is considerably higher than average in New York City, and that these neighborhoods would benefit most from the soda cap. The amicus brief argues that the soda cap discriminates against them.

The brief, however, neglects to mention that both amicus groups received large donations from soda companies and that the NAACP in particular has a long history of partnership with Coca-Cola.

Financial arrangements between soda companies and ostensibly independent groups demand scrutiny. National and local reporters – bless them – have done just that.

They report, among other connections, that one of the law firms working for Coca-Cola wrote the amicus brief, and that a former president of the Hispanic Federation just took a job with that company.

Last fall, the East Bay Express exposed how the soda industry exploited race issues to divide the electorate and defeat the Measure N soda tax initiative in Richmond. It revealed

that the beverage association not only paid for the successful “grassroots” campaign against Measure N but also encouraged views of the soda tax as racist.

Driven by this experience, the soda industry is repeating this tactic in New York City.

Is a cap on soda sizes discriminatory against groups working for civil rights? Not a chance.

Public health measures are about alleviating health disparities and giving everyone equal access to healthy diets and lifestyles. This makes public health – and initiatives like the soda cap – broadly inclusive and democratic.

If anything is undemocratic and elitist, it is suing New York City over the soda cap.

In funding this lawsuit, the soda industry has made it clear that it will go to any length to protect its profits, even if it means discrediting the groups that would most benefit from this rather benign public health initiative.

Stephanie Strom reports in today’s New York Times that a group of food companies—among them several that put millions of dollars into opposing California’s Proposition 37 last November—are now favoring labeling of genetically modified foods.

Those companies won the election; Proposition 37 lost, although not by a very wide margin.   

But in the process, two things happened: they lost credibility, and they created a movement for GMO labeling initiatives in other states.

Advocates for GMO labeling figured out that although Big Food and Big Soda were willing to invest $40 million to defeat the California labeling initiative, they might hesitate if confronted with initiatives in many other states.

Good thinking.  Ms. Strom reports the previously unthinkable:

Some of the major food companies and Wal-Mart, the country’s largest grocery store operator, have been discussing lobbying for a national labeling program.

Executives from PepsiCo, ConAgra and about 20 other major food companies, as well as Wal-Mart and advocacy groups that favor labeling, attended a meeting in January in Washington convened by the Meridian Institute, which organizes discussions of major issues.

…“They spent an awful lot of money in California — talk about a lack of return on investment,” said Gary Hirshberg, co-chairman of the Just Label It campaign, which advocates national labeling, and chairman of Stonyfield, an organic dairy company.

…Mr. Hirshberg said some company representatives wanted to find ways to persuade the Food and Drug Administration to proceed with federal labeling.

I have to say that I never thought I’d live to see this happen.  I was one of four consumer representatives to the FDA’s Food Advisory Committee in the early 1990s when the FDA was considering approval of GMOs and whether or not to require them to be labeled.

We warned the FDA that if GMOs were not labeled, the public would wonder what the industry was trying to hide.  This, we said, would not only hurt the FDA’s credibility, but would end up hurting the GMO industry as well.

As I discuss in my book, Safe Food: The Politics of Food Safety, the FDA’s main arguments at the time were that (a) it would be misleading to label GMOs because they were no different from foods produced through traditional genetic crosses, and (b) the process by which foods are produced is not material.

Even then, it was evident that argument (b) made no sense.  The FDA already permitted foods to be labeled as Made from Concentrate, Previously Frozen, Irradiated, and, later, Organic.

As I’ve discussed previously, GMO labeling is no big deal.  All the label needs to say is “May be made from genetically modified corn, soy, or sugar,” as Hershey’s does in Great Britain.

Let’s hope the FDA takes notice.

Nutrition Facts panels on food labels are notoriously confusing.  People who use them usually look for only one item such as fat or calories.

As I’ve discussed previously. the label is so difficult to interpret that the FDA devotes pages on its website to explaining it.  When the FDA did the original research in the early 1990s, it tested a large number of formats.  When it became clear that people did not understand any of them very well, the FDA chose the least worst—the one that was understood least poorly.

Two decades later, the FDA is revisiting the Nutrition Facts panel to make it easier to understand in the light of today’s concerns about calories and obesity.  Once again, it is testing multiple formats.  The results of the first round of research have just been published in the Journal of the Academy of Nutrition and Dietetics (JAND), and reporters are trying to make sense of them.

FDA researchers tested 10 formats differing in number of servings and columns (1 or 2, each), font size, and wording.  They asked respondents for opinions about the healthfulness of the product, number of calories and nutrients per serving, perceptions of the label, and the ability to choose healthier products and those with fewer calories.  This, like the research in the early 1990s, is complicated.

The result:

For products that contain 2 servings but are customarily consumed at a single eating occasion, using a single-serving or dual-column labeling approach may help consumers make healthier food choices.

Here’s an example of one of the formats that may help:

Soda companies are already doing something like this, but a 20-ounce soda has more than 2 servings.  Serving size is what confuses.  If it’s 100 calories per serving, those calories have to be multiplied by the number of servings per container.

The Institute of Medicine produced two reports for the FDA on front-of-package labels and also suggested a way to integrate its ideas into the Nutrition Facts label.

Is the FDA testing this idea?  I hope so.

What is there to say about Girl Scout cookies.  Everybody loves them (or is forced to).

But now, if you worried that promoting cookies maybe wasn’t the best public health strategy, ABC Bakers, the company that makes them, has solved your problem.

Girl Scout cookies are now health foods.  How?

NutriFusion.

Translation: “major vitamins.”

As the company explains, NutriFusion is delicious made nutritious.

These crunchy vanilla and coconut cookies with a mango-flavored crème filling have all the nutrient benefits of eating cranberries, pomegranates, oranges, grapes, and strawberries.

As I keep saying, you can’t make this stuff up.

I’m teaching a course on food advocacy this semester at NYU and am always looking for instructive examples.  Here’s a good one.

PepsiCo announced that it would remove Brominated Vegetable Oil (BVO) from Gatorade and replace it with something less potentially harmful.

BVO, a flame retardant, keeps keep flavor oils in suspension and prevents a cloudy appearance in soft drinks.

According to the account in the New York Times, PepsiCo’s action followed soon after a 15-year-old activist in Mississippi, Sarah Kavanagh, filed a petition on Change.org to remove BVO.

The petition attracted more than 200,000 signatures, and this week, Ms. Kavanagh was in New York City to tape a segment for “The Dr. Oz Show.” She visited The New York Times on Wednesday and while there said, “I just don’t understand why they can’t use something else instead of B.V.O.”

…a spokesman for PepsiCo…said in an e-mail, “We appreciate Sarah as a fan of Gatorade, and her concern has been heard.”

…”Kudos to PepsiCo for doing the responsible thing on its own and not waiting for the F.D.A. to force it to,” said Michael Jacobson, executive director of the Center for Science in the Public Interest [CSPI].

Mr. Jacobson has championed the removal of brominated vegetable oil from foods and beverages for the last several decades, but the F.D.A. has left it in a sort of limbo, citing budgetary constraints that it says keep it from going through the process needed to formally ban the chemical or declare it safe once and for all.

I love Ms. Kavanagh’s response to BVO’s removal, as quoted in Beverage Daily:

I thought I might get a lot of support because no-one wants to gulp down flame retardant, especially from a drink they associate with being healthy. But with Gatorade being as big as they are, sometimes it was hard to know if we’d ever win. This is so, so awesome.

A teenager with social media skills accomplished what CSPI has been trying to do for decades. 

The FDA removed BVO from its list of ingredients Generally Recognized As Safe in 1970, but in 1977 allowed companies to use it on an “interim” basis.  It says getting rid of it is “not a priority.”

Animal studies show it causes lesions in the liver and impairs growth and behavior.   The medical literature contains occasional case reports of bromine toxicity in individuals who abuse brominated cola drinks.

Getting rid of it is good news.

But, as CSPI’s Michael Jacobson points out:

Gatorade without BVO is nutritionally no better than with it.  A typical 20oz (591ml) bottle has 130 calories, all from its 34 g of refined sugars.

NutraIngredients.com reports frequently on current research and opinion on dietary supplements.  Lots of people take these products and swear by them, but proving that they do much good is another matter.  It has been hard to find evidence that they make healthy people—those who take them most often—any healthier.

Here are some recent NutraIngredient reports on this topic, largely reflecting views of the supplement industry.

• Multivitamins: ‘The cheapest health insurance a person will ever buy
• Multivitamin supplements may cut cancer risk: JAMA paper
• Multivitamin Study: Making Lemons Out of Lemonade
• Multivitamins may not benefit heart disease risk, but ‘don’t forget the aim and other potential benefits of supplements’
• U.S. supplement use remains strong, CRN survey says
• Vitamin Shoppe: US supplement user confidence soars to 93% as usage increases
• Multivitamin Supplements Boost Brain Function, say U.K. Researchers
• Looking forward: The emerging evidence for vitamins and health
• Global population demands, ‘confusing’ media coverage and the 100 year old vitamin [Vitamin A]
• Multivitamins – They Won’t Wash the Windows or Change the Oil Either!
• Multivitamins may not benefit heart disease risk, but ‘don’t forget the aim and other potential benefits of supplements

Who knew that Wednesday’s New York State Supreme Court hearing on the lawsuit filed against New York City’s cap on sodas larger than 16 ounces would turn out to be a debate about race relations?

Let’s be clear.  This lawsuit is about only one thing and one thing only: to protect the profits of Big Soda—mainly, Coca-Cola and PepsiCo.  The lawsuit is funded by their trade association, the American Beverage Association (ABA), at what must be astronomical expense.

But to shift attention away from profit as a motive, the ABA enlisted two organizations of underrepresented groups—the NAACP and Hispanic Federation—to file an amicus brief on behalf of the soda companies.  The brief argues that the soda cap discriminates against citizens and small-business owners in African-American and Hispanic communities.  But it neglects to mention  that both “friends of the court” received funding from soda companies.

The financial arrangements between Big Soda and such groups demand further examination. Fortunately, we have Michael Grynbaum at the New York Times, who explains that:

The obesity rate for African-Americans in New York City is higher than the city average, and city health department officials say minority neighborhoods would be among the key beneficiaries of a rule that would limit the sale of super-size, calorie-laden beverages.

But the N.A.A.C.P. has close ties to big soft-drink companies, particularly Coca-Cola, whose longtime Atlanta law firm, King & Spalding, wrote the amicus brief filed by the civil rights group in support of a lawsuit aimed at blocking Mr. Bloomberg’s soda rules…Coca-Cola has also donated tens of thousands of dollars to a health education program, Project HELP, developed by the National Association for the Advancement of Colored People. The brief describes that program, but not the financial contributions of the beverage company. The brief was filed jointly with another organization, the Hispanic Federation, whose former president, Lillian Rodríguez López, recently took a job at Coca-Cola.

Soda companies have a long history of targeting their marketing efforts to Blacks and Hispanics, as shown in at least one book (and described in one of its reviews).

Last fall, the East Bay Express exposed how the soda industry exploited race issues and used them to divide and conquer in defeating the Measure N soda tax initiative in Richmond, California.

The No on Measure N workers’ paychecks were signed by political consultant Barnes Mosher Whitehurst Lauter & Partners (BMWL), which had been hired by the American Beverage Association….By the time that Big Soda had arrived, the issue of race was already a factor in the campaign. Some opponents of the tax had alleged that it was racist, arguing that it would unfairly harm low-income residents in the city. And the No on Measure N campaign…nurtured that sentiment. Indeed, there is evidence that the beverage association helped keep race at the forefront of the campaign as part of a strategy that exploited Richmond’s existing tensions.

…the beverage industry discovered a winning formula in Richmond last year that it might be able to replicate elsewhere…And if that were to happen, it could drive a wedge through traditional Democratic constituencies in many communities, with blacks and Latinos opposing their longtime political allies — progressives and environmentalists — just like they did in Richmond.

Is a cap on soda sizes discriminatory?  Quite the contrary.

Public health measures like this are about removing health disparities and giving everyone equal access to good nutrition and health.  This makes public health—and initiatives like the soda cap—democratic, inclusive, and anything but elitist.

But I can’t think of anything more elitist, less inclusive, and more undemocratic than suing New York City over the soda cap.

In funding this suit, the soda industry has made it clear that it will go to any lengths at any cost to protect its profitability—even to the point of dragging along with it the very groups that would most benefit from the initiative.

If the American Beverage Association and its corporate members really cared about Black and Hispanic groups, it would stop target marketing,  stop marketing to children, and stop pretending that sugar-sweetened beverages are an important part of active, healthy lifestyles.  It certainly would stop wasting these groups’ time and credibility on anti-public health lawsuits.