Search results: a life in food

NutraIngredients-USA.com has posted a set of articles celebrating the 25th anniversary of the Dietary Supplement Health and Education Act of 1994 (DSHEA), which effectively deregulated the supplement industry.  The articles that follow are from the perspective of that industry.

Personally, I’m not a fan of DSHEA, and view deregulation of dietary supplements as a mistake for the industry as well as for the public.  Strong regulation inspires trust.  Weak regulation encourages distrust of supplement products and the entire industry.  When I see a Supplement Facts label, I have no reason to trust that the label reflects the contents of the package.  Until supplements are subjected to the same level of regulation as food products, caveat emptor.

Special Edition: DSHEA at 25

The Dietary Supplement Health and Education Act of 1994 created the framework for the modern supplement industry. In 1994, the industry was worth $4 bn. Now it is estimated to be worth over $40 bn.

In this special edition we will talk to some of the industry legends who helped to craft the law, we’ll learn about NPQAA, we’ll hear from the head of the FDA’s Office of Dietary Supplement Programs on the need to modernize the law, get the views of some of the industry association leaders, and look to the future.

• DSHEA at 25: In conversation with Scott Bass and Loren Israelsen: The brilliant strategy of Sen. Orrin Hatch, the upswell of grassroots consumer pressure, and the ‘highly unusual’ personal intervention of an FDA Commissioner: The development and passage of the Dietary Supplement Health and Education Act is a fascinating story….. Read
• What was NPQAA and what role did it play in the successful passage of DSHEA?  While much of the focus around DSHEA was on Capitol Hill and the machinations of government, an important behind-the-scenes contribution came from the short lived Natural Products Quality Assurance Alliance. But what was NPQAA and how did it help?.. Watch now
• FDA’s Tave: ‘Opportunity to strengthen regulatory framework couldn’t come at a more pivotal time’: With scientific advances and the growth of the dietary supplements industry on one hand, and the proliferation of adulterated and misbranded products on the other, the opportunity to modernize DSHEA couldn’t come at a better time… Read
• DSHEA Was Not Carved in Stone: Want to spark controversy? Just suggest to some audiences that it’s time to amend DSHEA… Read
• Balancing consumer access and safety: Looking back 25 years, there are several remarkable aspects of the Dietary Supplement Health and Education Act (DSHEA) amendments to the Food Drug and Cosmetic Act (FD&C Act), which transformed how dietary supplements are regulated… Read
• Fabricant on DSHEA: ‘Why are we talking about modernizing something that has never been fully implemented?’  As talk in the industry and at the FDA continues around the modernization of DSHEA, not everyone thinks big changes are needed. “The best thing the Agency does is inspect and test,” says NPA’s Dr Daniel Fabricant… Watch now
• Critic says FDA’s slow enforcement makes ‘DSHEA 2.0’ a side issue: Industry critic Dr Pieter Cohen, MD, said FDA’s enforcement is overly deliberate, making any discussion about revisions to DSHEA more or less moot… Read
• Bodybuilding.com VP on DSHEA: What changes could improve the regulation of dietary supplements: Bodybuilding.com’s John Venardos shares some of his ideas to improve the regulation of the dietary supplements industry, from better transparency to greater FDA staff accountability, and how to level the playing field… Watch now
• If botanicals don’t fit easily under supplement heading, why not try to fix that?  Should the creation of a new herbal medicine category be one of the goals of the upcoming discussions about a new regulatory framework? If it were possible, such a change could clear up many of the ambiguities surrounding the marketing of these products as dietary supplements… Read
• What should DSHEA 2.0 look like? Here are a couple of suggestions: On Monday FDA Commissioner Scott Gottlieb put forward some ideas about where the regulation of dietary supplements should go in the coming years. This is an opportunity that should not be missed. What should be tops on the industry’s wish list?.. Read

 

Here is a summary of another funded study with results the funder must love.

Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity.  Li N, and 19 additional authors for the ISCOLE Research Group. International Journal of Obesity (2019) 43:691–700.

Conclusions: Lower levels of MVPA [moderate to vigorous physical activity] or higher levels of sedentary time on either weekdays or weekend were associated with increased odds of obesity in 9–11 year old children in 12 countries.

Funding: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was funded by The Coca-Cola Company… With the exception of requiring that the study be global in nature, the funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.

Comment: This is another paper from the ISCOLE study funded by Coca-Cola, that seems to be aimed at casting doubt on the idea that sugary beverages might promote weight gain.  Instead, these results suggest that physical activity is a more important factor.  Of course physical activity is important for health, but doesn’t expend nearly as many calories as is usually needed to compensate for soft drink intake.

I learned about this study from a Weighty Matters blog post by Dr. Yoni Freedhoff, who runs a weight management center in Ottawa.  In his view, the ISCOLE study ignores evidence that childhood obesity is a determinant of physical activity, “not the other way around.”

He also questions the “no influence” statement in the funding disclosure, on the basis of

emails between ISCOLE investigators and Coca-Cola that not surprisingly suggests that these relationships have the very real potential to influence the framing of results even if funders [are] not involved in study design.

As I discuss in Unsavory Truth, the influence of food-industry funders appears to occur at an unconscious level; investigators do not recognize the influence and typically deny it.

As I also discuss in that book, Coca-Cola generously funded the ISCOLE study some years ago.  It has since changed its policy on research funding.

I’m trying to keep up with what’s happening with Cannabis edibles and drinkables, still with borderline legality in most places, but gradually working their way to supermarkets near you.

Here’s what’s come up lately.

• The FDA is calling a public hearing on May 31 and asking for comments on Cannabis products.
• The Washington Post discusses the messy regulatory situation.
• Cannabidiol (CBD), extracted from hemp, does not have the psychoactive properties of marijuana.
• The 2018 Farm Bill legalized the raising of hemp, which contains CBD.
• On the local level: regulators in different agencies view regulation in different ways.
• On the global level: different countries are handling regulation of these products in different ways.
• CVS will be selling CBD products as over-the-counter drugs.
• As for edibles, CBD-infused water is predicted to be the big seller.
• The Sacramento Bee reported what happens when kids get into their parents’ marijuana edibles; it called for childproof packaging.
• A video from Fresno County shows unlicensed marijuana edibles, some of which look like candies aimed at children.
• The FDA will hold a public hearing on the safety, manufacturing, quality, marketing, labeling, and sale of Cannabis products on May 31.

And then there are the health claims.  As early as 2017, the FDA sent out warning letters to makers of CBD products; they were marketing their products as drugs not supplements or foods.

For example, the FDA sent a letter to That’s Natural, complaining that the company published testimonials saying things like this:

• “Scientific research by doctors have shown it actually kills cancer cells and provides a protective coating around our brain cells.”
• “as a Type 1 diabetic, my blood sugars have noticeably leveled off.”
• “My blood pressure and heart rate have also significantly improved as well.”

The FDA also sent a letter to Green Roads of Florida objecting to claims like these:

• “CBD .[has] anti-proliferative properties that inhibit cell division and growth in certain types of cancer, not allowing the tumor to grow.”
• “Almost all studies recognize CBD’s potential in preventing both cancer spread and growth…”
• “The following are some of the many ailments CBD oil can potentially be therapeutic for:  asthma, Alzheimer’s disease, arthritis, autism, bipolar disorder, various types of cancer….

Food, medicine, supplement, or snake oil?  We shall see.

The George Institute in Australia (see clarification below) publishes an annual index holding the ten largest U.S. food and beverage corporations accountable for how they addrss nutrition challenges.

The 2018 Index ranks corporations on their governance, products, accessability, marketing, lifestyle, labeling, and engagement.  Here’s what it looks like.

Here’s how this is explained:

Seven out of ten companies claim to focus on improving health and nutrition (all except Coca-Cola, Dr Pepper Snapple and Kraft Heinz), as expressed in their mission statements or corporate growth strategies, the objectives they defined related to health and wellness are mostly limited to product development, product reformulation and responsible marketing. Only two companies (Nestlé and Unilever) have defined a more comprehensive set of objectives within their nutrition strategy.

To remind you: food corporations are not social service or public health agencies.  They have stockholders to please as their first priority.  The conflicts of interest with public health approaches are obvious.  That’s why none of them does particularly well on this Index.

Clarification from a reader

I believe you are referring to the US Spotlight Index, a product of the Access to Nutrition Foundation, an independent nonprofit in the Netherlands.  (https://www.accesstonutrition.org).  The George Institute provided research support for the US Spotlight index. RWJF [Robert Wood Johnson Foundation] was a major funder.  The Foundation has also published an India Spotlight Index (2016) and a Global Index (latest in 2018).  Shiriki Kumanyika chairs the Expert Group.

Nico Slate.  Gandhi’s Search for the Perfect Diet: Eating with the World in Mind.  University of Washington Press, 2019.  

Let’s start with my blurb:

Nico Slate’s fascinating account reveals Gandhi as an evidence-based, self-experimenting nutrition guru who tried one diet after another—vegan, raw, calorie restriction–in his quest for physical and spiritual health.  Above all, Slate explains Gandhi’s use of fasting as a political means to inspire India to achieve independence.

Gandhi, it seems, was a food faddist well ahead of his time.  The author says:

As his commitment to vegetarianism deepened, Gandhi grappled with whether he should also forgo eggs and milk.  Ultimately, he became convinced that he should become vegan, and renounced all animal products.  Living without eggs was relatively easy.  Doing without milk, by contrast, proved to be one of the greatest challenges of his life.  He experimented with almond milk, peanut milk, and other vegan alternatives.  In 1914, he vowed to abstain from all dairy products.  But after contracting a serious illness, he decided that his pledge did not include goat’s milk. [p. 47]

The book explains how Gandhi’s dietary choices were tightly linked to his politics.

The social potential of a raw diet led Gandhi to explore the cheapest source of sustenance for the poor: wild food…The greatest ethical challenge stemmed from the limitations of wild food as a remedy for poverty.  If the goal was to end hunger, changes in diet would be insufficient if they were not linked to changes in land ownership and the distribution of wealth—change that seemed as impossible as eating ginger nonviolently. [ p. 97]

And one more:

In a world marred by inequality, charity could only do so much.  Ultimately, Gandhi did not want to help the poor; he wanted to end poverty.  Over time, he developed a deeper understanding of the link between famine and imperialism.  “India suffers from starvation because there is dearth not of grain,” he explained, “but of purchasing power.”  The absence of purchasing power was, in turn, a direct result of the economic structures of British rule…Recognizing famine as a result of empire inspired Gandhi to demand India’s freedom. [p.127]

Since my book Unsavory Truth came out late last year, I am posting occasional recent examples of issues I discussed in it.  Today’s issue: industry funding of research on potatoes of all things.

I am well aware that the role of white potatoes in the U.S. diet is hotly contested.   The EAT-Lancet report I wrote about recently advises against eating potatoes:

Potatoes, although containing large concentrations of potassium and some other vitamins, provide a large amount of rapidly absorbed carbohydrate, or glycaemic load. Daily consumption has been associated with increased risk of type 2 diabetes, hypertension, and weight gain.

Obviously, the potato industry would like to counter advise like that.  Its Alliance for Potato Research & Education is devoted to precisely that cause.  The Alliance explains that it is “Dedicated to advancing the scientific understanding of the role potatoes play in promoting the health of all people.”  It issues grants for up to $200,000 for “nutrition research proposals that help to advance scientific knowledge on the role of potatoes in various health outcomes” (the 2019 deadline just passed).

But I’ve just learned that the potato industry publishes its very own research journal: the American Journal of Potato Research.   It s subtitle: The Official Journal of the Potato Association of America, described as “A Professional Society for Advancement of the Potato Industry.”

Surprisingly, the papers in this journal are behind a paywall.  If the industry wants its research to be read and digested (sorry), I would think its papers would be open access (I was able to get this through NYU’s library).

One paper in particular caught my eye:

Invited review: Potatoes, Nutrition and Health.  Katherine A. Beals.  American Journal of Potato Research, 2018.  https://doi.org/10.1007/s12230-018-09705-4

Conclusion:  Until we have better research, “dietary guidance should continue to stress the importance of healthy eating patterns that consist of a variety of vegetables, including nutrient dense potatoes.”

Author’s funding disclosure: none.

Comment:  Evidently, this journal does not require authors to disclose funding.  Or perhaps every paper in this journal is sponsored by the potato industry?  Dr. Beals’ c.v. discloses consulting for the Potato Board.

I enjoy eating potatoes and view their effects on health as depending on how they are prepared, how much is eaten, and how often.

The purpose of potato-sponsored research is to cast doubt on studies suggesting that eating less of them would be better for your health.  When you see studies of potatoes and health, be sure to ask who paid for them.

The Lancet has been busy.  Last week, it published a blockbuster report on the need for worldwide dietary changes to improve human health and that of the environment.  I posted about this EAT-Forum report on Friday.

Now, The Lancet releases yet another report, this one taking a unified approach to dealing with the three most important nutrition issues facing the world: Malnutrition (undernutrition), obesity, and the effects of our food production and consumption system on the environment and climate change—for which this report coins a new term: The Global Syndemic.

This report breaks new ground in identifying the food industry as one of three main barriers to ending this “Syndemic.”  I’ve added the numbers for emphasis.

• Powerful opposition by [1] commercial vested interests, [2] lack of political leadership, and [3] insufficient societal demand for change are preventing action on The Global Syndemic, with rising rates of obesity and greenhouse gas emissions, and stagnating rates of undernutrition.
• New social movement for change and radical rethink of the relationship between policymakers, business, governance and civil society is urgently needed.
• The Commission calls for a global treaty to limit the political influence of Big Food (a proposed Framework Convention on Food Systems – modelled on global conventions on tobacco and climate change); redirection of US$5 trillion in government subsidies away from harmful products and towards sustainable alternatives; and advocacy from civil society to break decades of policy inertia.

Wow.  This is telling it like it is—at long last.  From the press release:

• A key recommendation from the Commission is the call to establish a new global treaty on food systems to limit the political influence of Big Food.
• The food industry’s obstructive power is further enhanced by governance arrangements that legitimise industry participation in public policy development, and the power that big corporations have to punish or reward governments by relocating investment and jobs.
• Regulatory approaches to product reformulation (eg. salt and sugar reduction), labelling and marketing to children are needed because industry-led, voluntary approaches have not been effective.

Yes!

The documents

• The Press Release
• The Policy Brief
• The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report – Boyd A Swinburn et al. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32822-8/fulltext
• Obesity needs to be put into a much wider context – Sabine Kleinert, Richard Horton, The Lancet https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33192-1/fulltext
• Rethinking systems to reverse the global syndemic – Rachel Nugent, RTI International https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33243-4/fulltext
• Transforming food systems for better health – José Graziano da Silva, Director-General, Food and Agriculture Organization of the United Nations https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33249-5/fulltext

The press

▪ The Guardian
▪ The Times (London)
▪ Irish Farmers Journal

Additional press, posted January 30

Newswires (syndicated in international outlets):

• ‘Radical rethink’ needed to tackle obesity, hunger, climate: report – Agence France-Presse
• To fix climate change, fix the obesity and starvation epidemics, reports say – CNN
• Obesity, bad nutrition, climate change pose triple danger, commission says – Reuters
• Also covered by Xinhua, IANS.

UK:

• Public health experts call for global food treaty – Financial Times
• Take on food industry to beat malnutrition and obesity, says report – The Guardian
• Tackling obesity ‘needs treaty like climate change’ – The Times
• Also covered by BBC Radio 4, BBC 1 Breakfast, BBC News 24, The Economist (Espresso), The Guardian (Op-ed), The Telegraph, The Independent, Daily Mail.

US:

• Report: ‘Radical Rethink’ Needed to Tackle Obesity, Hunger, Climate – Voice of America
• Big Food Blamed for Ills Far Beyond Flab in Sweeping Report – Bloomberg
• Want to fix obesity and climate change at the same time? Make Big Food companies pay. – Vox
• Also covered by Thomas Reuters Foundation, Devdiscourse.

Rest of world:

• Vested interests, misplaced economic incentive major drivers: Lancet report – Indian Express
• Obesity, malnutrition 2 sides of climate change – Hindustan Times
• Eat right to save the planet – Deccan Chronicle
• Also covered by El Pais, O Globo, The Wire, Sydney Morning Herald, The Age, Japan Times, New Zealand Herald, The Australian, El Confidential, Algemeen Dagblad, Nouvel Observateur.

The BMJ (the new name for what was formerly the British Medical Journal) has just published a report by Susan Greenhalgh, an anthropologist and China specialist at Harvard, of how Coca-Cola, working through the International Life Sciences Institute (ILSI), got the Chinese government to focus its anti-obesity efforts on promoting physical activity rather than dietary changes.

Professor Greenhalgh documented industry influence on Chinese health policy through review of published work as well as interviews with key players in this drama.

• The BMJ Press Release
• Greenhalgh’s article—“Making China safe for Coke: how Coca-Cola shaped obesity science and policy in China“—(plus a podcast interview)
• An accompanying editorial by Martin McKee, Sarah Steele, and David Stuckler: “The Hidden Power of Corporations.”

A more thorough report of her investigation with details of her interviews was released at the same time by the Journal of Public Health Policy: “Soda industry influence on obesity science and policy in China.”  This report comes with extensive supplemental information about her methods and interview details (these explain why training in anthropology is useful for this kind of work and provides information not otherwise available).

For readers familiar with Coca-Cola’s funding of the Global Energy Balance Network (GEBN), this is a familiar story.

I tell the GEBN story in a chapter in my recently released book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

One surprise in writing that book was how often ILSI turns up in its pages.  ILSI positions itself as an independent “nonprofit, worldwide organization whose mission is to provide science that improves human health and well-being and safeguards the environment,” but it was founded by Coca-Cola and is largely supported by food and beverage companies.  It works in many countries to promote food-industry interests.

Greenhalgh’s articles thoroughly expose how this organization accomplishes its objectives.  If you would like to know more about it, UCSF Food Industry Documents Library can help, as I learned about from this tweet.

Greenhalgh’s investigation has received extensive press coverage.

• The New York Times
• The Associated Press
• The Guardian
• The Harvard Gazette

I was particularly interested in the account by Crossfit’s Derek Fields and Russ Greene, which provides further documentation of the close connections between Chinese health agencies, ILSI, and programs funded by Coca-Cola.