A reader sent me an e-mail received from Coca-Cola:

As you know, obesity is an issue that affects all of us. At Coca-Cola, we believe we can help solve it by working together. As you heard back in January, we are committed to doing our part – by offering more low- and no-calorie choices, more portion controlled packages, and useful calorie information in more places than ever before.

As part of our ongoing commitment to provide more information about calories, we want to share a new “Calorie Balance”  infographic that we created. This is posted on our Company website here.

Our infographic is a simple, easy tool that informs people about where Americans’ calories are coming from and what we can all do to maintain a healthy, active lifestyle.

It communicates government data and third-party published studies in a compelling way, showing that too many calories consumed as compared to those expended can lead to weight gain.

OK.  I can’t resist.  Here’ just one piece of Coke’s infographic:

Guess what #4 is.   And what food is responsible for more than one-third of calories from sugars in U.S. diets?

The infographic gives no guidance about food choices or amounts best for health, but it is quite specific about physical activity.  Do lots!

Overall, I read the infographic as saying “Hey, it’s not our sugar-water that’s making you put on weight.  It’s up to you to choose what you drink and work it off with physical activity.”

Getting active is always good advice, but doesn’t Coke’s phenomenally comprehensive and astronomically expensive  marketing offensive have anything to do with food choices?  Coke must think all that is irrelevant.

I think it’s quite relevant.  And so does the research.

Earlier this month, the Environmental Working Group (EWG) issued a report on antibiotic-resistant bacteria in meat: Superbugs Invade American Supermarkets.

Its message:

Consumers have a right to know that federal scientists are finding antibiotic-resistant bacteria on retail meat in high percentages.

The report must have struck a nerve.  The FDA has now posted a rebuttal on its website, along with the agency’s interpretation of data in the 2011 Retail Meat Annual Report of the National Antimicrobial Resistance Monitoring System (NARMS).

The EWG, says FDA, “oversimplifies the NARMS data and provides misleading conclusions.”

The FDA particularly objects to EWG’s use of the term “superbugs.”

We believe that it is inaccurate and alarmist to define bacteria resistant to one, or even a few, antimicrobials as “superbugs” if these same bacteria are still treatable by other commonly used antibiotics.

The FDA says the NARMS data show:

• No fluoroquinolone resistance in Salmonella from any source (the drug of choice for treating adults with Salmonella).
• Resistance to trimethoprim-sulfonamide is also low (0% to 3.7%).
• Fluoroquinolone resistance in Campylobacter has remained essentially unchanged since it was banned for use in poultry in 2005.
• Macrolide antibiotic resistance in retail chicken isolates remains low (this is the drug of choice for treating Campylobacter)
• Multidrug resistance is rare in Campylobacter except that gentamicin resistance increased from 0.7% in 2007 to 18.1% in 2011.
• Resistance to third-generation cephalosporins, which are used to treat salmonellosis, increased in Salmonella from chicken (10 to 33.5%) and turkey (8.1 to 22.4%) from 2002 to 2011.  FDA has already taken action by prohibiting certain extra-label uses of cephalosporins in cows, pigs, chickens and turkeys.

The EWG’s response to the FDA’s rebuttal:

This is the best the agency can do?

It has been failing to protect the public health on this issue for 40 years, only recently issuing a voluntary guidance to scale back on the worst antibiotic abuses.

What are we to make of this dispute?

Beyond questions about how best to frame antibiotic resistance, some facts are clear.

• Most antibiotics in the United States are used as growth promoters for raising meat animals, not as treatment for infections in animals or people.
• Frequent use of antibiotics selects for and promotes the growth of antibiotic-resistant bacteria.
• Infections with antibiotic-resistant bacteria are difficult to treat, and sometimes very difficult to treat.

It would be better for public health to end the use of antibiotics as growth promoters.

The FDA’s current stance on use of animal antibiotics appears to be more about protecting the meat industry than about protecting public health.

While waiting for the politics to get better (and this might be a long wait), the EWG has some tips for avoiding antibiotic-resistant bacteria in meat.  I can’t think of a single good reason not to follow these recommendations, except that they place the burden of avoiding antibiotic-resistant bacteria on you rather than on the meat industry.

That’s why EWG’s advice to Be Vocal makes especially good sense:

Be vocal: 

• When you’re eating out: ask if the meat was raised without unnecessary antibiotics. 
• „At the doctor’s office: don’t press for unnecessary antibiotics. 
• With your friends: share this tip sheet or a wallet guide with them. 
• „Make your voice heard: Go to ewg.org/antibioticsaction to find out how you can help preserve the effectiveness of antibiotics [Try www.ewg.org–the link given here doesn’t seem to work].

I’ve just been sent a new report on the current status of marketing foods and beverages to children at school: Promoting Consumption at School: Health Threats Associated with Schoolhouse Commercialism.

This report, from the National Education Policy Center at University of Colorado, Boulder,  makes sobering reading.

As the press release explains,

In their quest for additional funding, many schools and school districts have allowed corporations to promote the consumption of sweetened beverages and foods of little or no nutritional value in school and in conjunction with school projects…corporations can seem philanthropic when they provide sponsored educational materials…to schools and teachers. These materials can be colorful and engaging, and may align with state and now Common Core standards, but they also present a worldview consistent with that of the sponsor.

If you think that the food companies are making good on their pledges to reduce marketing to kids, this report will make you think again.

Here are a few snippets:

• Available data suggest that the total amount of money spent on advertising food and beverages to children, both in and out of schools, has decreased over the past few years.  However, any reduction in spending reflects at least in part a shift to less expensive, but more effective, alternative media advertising.
• Food and beverage companies advertise in schools in multiple ways: (1) appropriation of space on school property, (2) exclusive agreements, (3) sponsorship of school programs, (4) sponsorship of supplementary educational materials, (5) digital marketing, (6) sponsorship of incentive programs, and (7) fundraising.
• Teaching materials may not mention the sponsor but reflect the sponsor’s views, such as that all beverages count toward hydration.
• Digital marketing to school kids is a deliberate strategy, as explained by a Coca-Cola executive:  “We’re especially targeting a teen or young adult audience. They’re always on their mobile phones and they spend an inordinate amount of time on the Internet.”
• Health and wellness initiatives designed to promote physical activity and movement may appear to meet federal guidelines but “are problematic in that they shift the onus for obesity from the corporation’s responsibility to market healthy food to the consumer’s responsibility for making healthy choices.”

The report is a terrific summary of what’s happening with food marketing in schools, loaded with facts, figures, and references.  

In light of the evidence it provides, the report’s recommendation seems grossly understated:

Policymakers should prohibit advertising in schools unless the school provides compelling evidence that their intended advertising program causes no harm to children.

What’s missing from this report is a blueprint for action.

For that, you must go elsewhere, for example, to the Center for Science in the Public Interest, the Berkeley Media Studies Group, or the Rudd Center for Food Policy and Obesity.

Do you know of other good sources for taking action on marketing in schools?  Do tell.

Last week, I wrote about the dairy industry’s petition to avoid having to follow FDA rules about labeling artificial sweeteners on the front of milk cartons.

Cara Wilking, Senior Staff Attorney at the Public Health Advocacy Institute at Northeastern University points out that the Sugar Association, the trade association for producers of cane and beet sugar, is right on top of this issue.

To assist consumers in making informed choices about what is sweetening the products they purchase, the Sugar Association petitioned the Food and Drug Administration (FDA) requesting changes to labeling regulations on sugar and alternative sweeteners.

In this petition we asked that artificial sweeteners and sugar alcohols be identified on the front of the package along with the amounts, similar to what is required in Canada.

If it is important to you to know if the product you purchase contains artificial sweeteners, let your congressional representatives know that FDA needs to take action on this important consumer issue.

The Sugar Association, obviously, represents the producers of cane and beet sugar. It wants to sell more sugar.  It doesn’t like artificial sweeteners much.  [Recall: it doesn’t like me much either—go to Media and scroll down to the bottom to read the Sugar Association’s letter threatening to sue me].

In contrast, the dairy industry wants to sell more milk.  Sweetened milk, no matter with what, sells to kids.  School kids are a big market for the dairy industry.  This market, however, is not doing well these days, according to the dairy industry’s August 2012 School Channel Survey.

Schools and processors are realizing 59% of current potential…Milk potential stands at 6.29 milks per student each week…Actual usage is 3.74 milks per student each week.  Elementary schools: 70% of potential being realized, down 1 point Secondary schools: 50%, down 1 point over last year.

Achieving ‘a milk with every meal’ translates into nearly 300 million incremental gallons….

Of course artificial sweeteners should be prominently labeled.  The Sugar Association has this one right.

Whatever your opinion, you can file comments at www.regulations.gov. Search for docket number FDA-2009-P-0147.

The FDA is collecting opinions on a dairy industry petition to change the standard of identity for milk.  The dairy industry wants to be able to add artificial sweeteners to chocolate- and strawberry-flavored milk without saying so on the front panel of the package.

Why is the dairy industry doing this?  Because it believes that:

Labels such as “reduced calorie” or “no added sugar” are a turn-off to kids who might otherwise reach for flavored milk with non-nutritive (artificial) sweeteners at the school cafeteria or from the grocery store cooler.

As if kids should be reaching for milk with artificial sweeteners.  

The FDA wants to hear from YOU about this.  It wants your comments on these questions (my translation):

• If the label just says Chocolate Milk, will consumers understand that the milk is artificially sweetened?
• Are descriptions like “reduced calorie” really unattractive to children?
• Will it be hard for consumers to figure out whether a product contains sugar or an artificial sweetener?

Go to www.regulations.gov. Search for docket number FDA-2009-P-0147. 

Michael Pollan’s Cooked comes out April 23 but the New York Times jumped the gun and reviewed it yesterday.   I can’t wait for the copy I ordered to arrive so I can read it for myself.

Whenever the book comes, this seems like a good time to post Geoffrey Cannon’s interviews with some of Pollan’s academic foodie fans (including me) about how we assess his work.  These appraisals are now posted in World Nutrition, the online journal of the World Public Health Nutrition Association.

Geoffrey Cannon: When did you come across Michael Pollan?

I had been reading Michael Pollan’s articles in the New York Times Magazine with admiration, to say the least, so when he invited me to participate in a food conference he was running at Berkeley in the fall of 2002, soon after he arrived to teach there, I was looking forward to meeting him. The conference was splendid. It brought together a huge number of journalists, academics, filmmakers, and government and industry officials. The speakers were glittery. Alice Waters did the catering. The side trips were to a farm in Bolinas and an olive orchard in Sonoma run by the owners of the San Francisco Chronicle (they had sketches by Wayne Thibaud tacked to the bathroom walls). Sometime after that, I spoke in one of his classes. But the first meeting I remember in detail must have been in about 2004. I asked for his advice about the book I was working on at the time, which later became What to Eat.

What impressed you at that time?

We met for lunch at Chez Panisse, where he was clearly a regular (I was still having trouble getting a reservation). I wanted his advice about how to write for a general audience. He said he wasn’t the right person to ask, because he didn’t write as an expert. His starting point in developing books was from lack of expertise. As he learned, he brought readers along with him. This turned out to be hugely helpful.

I got to know him better in the spring of 2006 when I taught at Berkeley in a complicated arrangement between three schools. I was paid by public policy, had an office in public health, but journalism – meaning Michael – ran the life support. The following spring I went back to Berkeley to teach a course in science journalism in his program. We did some speaking gigs together.

Rate his work and impact

Obviously, I think he is terrific but I have to do full disclosure. He just wrote the splendid foreword to the tenth anniversary edition of Food Politics. I’ll just say this: lots of people in the US have been working on the food movement for decades, but his work reaches so large and so passionate an audience that he has to be given much of the credit for its expansion.

Quote one of his sayings that stays with you

In What to Eat, I said dietary principles were simple: eat less, move more, eat plenty of fruits and vegetables, don’t eat too much junk food. Pollan says: Eat food. Mostly plants. Not too much. Oh to be able to write like that.

 Give an example of where he has made a difference

Students read his work and want to act. Our NYU programs in food studies are filled with people who read Pollan and want to do something to make the food system healthier and better for the planet.

Has his work changed your thinking and if so, how?

I don’t think I ever understood the importance of meat animals in balanced ecological systems to the extent that I now do. The idea of the omnivore’s dilemma is mind-changing on its own. I like it because it is so inclusive of different ways of eating and enjoying food. And I can’t wait to read Cooked.

Does his work have relevance outside the USA?

People outside the US are going to have to answer this one but of course it does. Food systems are global. How we in America eat affects the food systems of countries everywhere else and, to some extent, vice versa.

In what ways if any do you think he is mistaken?

I’m of the belief that although health very much depends on what you eat, body weight depends on how much you eat no matter where the calories come from (one of the theses of my new book Why Calories Count). We argue about this all the time. Eventually, the science will get to the point where this gets resolved one way or the other. In the meantime, it’s fun to debate.

Reference: Gussow J, Kirschenmann F, Uauy R, Schell O, Nestle M, Popkin B, Cannon G, Monteiro C. The American genius. [Appraisals].  World Nutrition 2013;4:150-170.  My answers to Geoffrey Cannon’s questions start on page 161.

Addition, May 1.  World Nutrition has published a second set of Appraisals, with some commentary.

At your local bookstore now:

Daphne Miller, MD.  Farmacology: What Innovative Family Farming Can Teach Us About Health and Healing.  William Morrow, 2013

I blurbed it:

Farmacology is an eloquent call for better systems of sustainable agriculture and humanistic health care.  In linking the two, Dr. Miller brings a physician’s critical eye and understanding to this lovely, touching, and sometimes quite funny account of what she learned about taking care of patients from visits to farmers who view growing food as part of an self-sustaining, integrated, natural cycle.  Her insight: both soil and people do better when treated as complex systems, not fragments.  This is a fresh, original, and utterly charming book that belongs on the shelves of everyone who loves food or thinks about health care.

Dr. Miller provides a link to a page on her website with more information on the book, reviews and her “official” Farmacology slide show.

Enjoy!