The latest obesity statistics from the Centers for Disease Control and Prevention show no change over the last several years in either adults or children.  No change is good news.

For adults in 2009-2010 the prevalence of obesity was 35.5% among men and 35.8% among women.  Obesity, in these surveys is defined as a Body Mass Index (BMI) at or greater than 30.

This represents no significant overall change compared to rates in 2003-2008.  

Going back to 1999, however, obesity rates increased significantly among men in general, and among black (non-Hispanic) and Mexican-American women in particular.  In more recent years, the rates among these groups leveled off.

 For children and adolescents in 2009-2010 the prevalence of obesity was 16.9%.  For this group, obesity is defined as a BMI at or greater than the 95th percentile of weight for height.

This represents no significant change compared to rates in 2007-2008, but with one exception: the rate of obesity among adolescent males aged 12 through 19 increased.

For decades, rates of overweight and obesity in the United States stayed about the same. But in the early 1980s, rates increased sharply and continued to increase through the 1990s.

The increases correlated closely with deregulatory policies that encouraged greater farm production and loosened restrictions on food marketing.  These led to an increase in the number of calories available in the food supply, pressures on food companies to sell those calories, a proliferation of fast food places, and marketing strategies that made it normal to drink sodas all day long, and to eat everywhere, at all times of day, and in larger portions.

Why are obesity rates leveling off now except among boys?  Nobody seems to know.

I can make up several reasons, all speculative (and I have my doubts about most of them).

• People have gained all the weight they can and are in equilibrium
• People are more careful about what they are eating
• The poor economy is encouraging people to eat less
• Junk food marketing is targeted more to boys
• Girls are more careful about their weight
• Boys are particularly susceptible to “eat more” marketing pressures
• Boys are under greater psychological tension and eat to relieve it

Anyone have any better ideas?  It would be good to figure out the reason(s) as a basis for more sensible public policy.

The huge fuss over Paula Deen’s type 2 diabetes is understandable.   She is, after all, the queen of high-calorie Southern cooking.  And diabetes rates are especially high in the South.

Perhaps less understandable is the reaction of the American Diabetes Association.  As reported in the New York Times,

Heredity, according to the American Diabetes Association, always plays some part. “You can’t just eat your way to Type 2 diabetes,” said Geralyn Spollett, the group’s director of education.

Wrong.  You most definitely can eat your way to type 2 diabetes.

Type 2 diabetes is closely linked to overweight and obesity.  No, not everyone who is overweight develops type 2 diabetes.  But most people who have type 2 diabetes are overweight.

The first line of defense?  Lose a few pounds.  Even a relatively small reversal of calorie balance can make symptoms of type 2 diabetes disappear and reduce or eliminate the need for drugs.

Mrs. Deen does not mention weight as a factor in her disease, or losing weight as an effective treatment.

Instead, she is now a spokesperson for the drug Victoza.

According to the Times’ account, Mrs. Dean says that it is elitist to criticize her food:

You know, not everybody can afford to pay $58 for prime rib or $650 for a bottle of wine. My friends and I cook for regular families who worry about feeding their kids and paying the bills.

Really?  Does Mrs. Deen think those families can afford to pay the $500 a month drug companies charge for Victoza?

Victoza costs in other ways too.  It has to be injected and is not exactly benign.

Victoza^® is not recommended as the first medication to treat diabetes. Victoza^® is not insulin and has not been studied in combination with insulin…It is not known if Victoza^® is safe and effective in children. Victoza^® is not recommended for use in children

In animal studies, Victoza^® caused thyroid tumors—including thyroid cancer—in some rats and mice.  It is not known whether Victoza^® causes thyroid tumors or a type of thyroid cancer called medullary thyroid cancer (MTC) in people which may be fatal if not detected and treated early…Inflammation of the pancreas (pancreatitis) may be severe and lead to death.

The company also advises:

Victoza^® is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes when used along with diet and exercise.

Diet and exercise?  Why not just do that in the first place?

As for the American Diabetes Association: its disinterest in promoting diet and exercise is easily explained.  It is funded by drug companies.

I gave a talk at an annual meeting of the Association a few years ago and was astounded by the number of drug companies giving things—writing pads, pens, and tape holders, but also lab coats and stethoscopes—at the trade exhibit.  Much of the scientific meeting was devoted to drug studies.  I spoke at the only session that year on dietary issues.  And Coca-Cola sponsored a session on sugars in diabetes.

Mrs. Deen’s food is best eaten in moderation.  She would do more for her own health and that of her fans if she used her television presence to promote healthier lifestyles.

Update, January 30: Brad Jacobson interviews drug reps on AlterNet (I’m quoted).

The food and chemical industries are lobbying hard against what is expected to be a tough report from the Environmental Protection Agency (EPA).

The report will set an upper limit for safe consumption of dioxins.

Most Americans consume dioxins at levels higher than this standard, mostly from food.

About 90% of dioxins come from foods, particularly high-fat animal foods.

Dioxins mainly enter the food chain as by-products of industrial processes.  To a lesser extent, they also come from natural processes such as volcanoes and forest fires.  They contaminate land and sea, are consumed in feed, move up the food chain, and end up in the fatty parts of meat, dairy products, and seafood.

Dioxins accumulate in fatty tissues.  They increase the risk of human cancer more than any other industrial chemical.

The EPA is expected to recommend an intake limit of 0.7 picograms of dioxin per kilogram body weight per day.  A picogram is one trillionth of a gram.  The World Health Organization and European Union limit is higher—from 1 to 4 picograms per kilogram per day.

The food and chemical industries argue that the proposed EPA limit is too low.

The EPA thinks less is better.  Dioxins are toxic and Americans typically consume amounts within the European range.   A single hot dog can contain more dioxin than the proposed limit for a 2-year-old.

Dioxin levels in the United States have been declining for the last 30 years due to reductions in man-made sources. But they break down slowly and persist for a long time in the environment.

How to avoid them?  The best way is to eat less high-fat meats, dairy foods, and seafood.

No wonder the food industry is alarmed.

A “Food Industry Dioxin Working Group” of trade associations such as the International Dairy Foods Association, the American Frozen Food Institute, and the National Chicken Council wrote to the White House:

Under EPA’s proposal…nearly every American – particularly young children – could easily exceed the daily RfD [reference dose] after consuming a single meal or heavy snack…The implications of this action are chilling.

Since the agency contends the primary route of human exposure to dioxin is through food, this could not only mislead and frighten consumers about the safety of their diets, but could have a significant negative economic impact on all US food producers.

These groups singled out the media for particular blame:

The media will inevitably report on this change and in all likelihood misinterpret the RFD as a ‘safe limit’. As a result, consumers may try to avoid any foods ‘identified’ as containing or likely to contain any dioxin.

Eat more fruits and vegetables anyone?

Congressman Ed Markey (Dem-MA) is urging the EPA to get busy and release its report:

The American public has been waiting for the completion of this dioxin study since 1985 and cannot afford any further delays…A baby born on the day the EPA completed its first draft health assessment would be 27 years old today. I’d like to see the final EPA analysis before it turns 28.

Let’s hope the EPA does not cave in to industry pressure and releases the report this month as promised.

Technical note:

“Dioxins” collectively refers to hundreds of chemical compounds that share certain structures and biological characteristics. They fall into three closely related groups: the chlorinated dibenzo-p-dioxins (CDDs), chlorinated dibenzofurans (CDFs) and certain polychlorinated biphenyls (PCBs). The most studied is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD).  PCBs are no longer produced in the U.S.

References:

• EPA
• FDA
• Food Safety News
• Food Quality News

According to rumors passed along by Dan Flynn at Food Safety News via the Hagstrom Report (an agricultural subscription news service costing $999 a year), the Office of Management and Budget wants to merge federal agencies, among them the food safety components of FDA and USDA.

Rumors are that the Obama administration wants to do this to make “food safety independent of USDA, which primarily exists to market and promote American farm products.”

If this happens, it could be one major benefit of cost-cutting measures.  At the moment, USDA gets about three quarters of the total appropriation for food safety (for roughly one quarter of the food supply) whereas FDA gets one quarter of the appropriation for three quarters of the food supply.

This inequity is a result of the way Congress funds the FDA—through agricultural appropriations committees, not, as any sensible person might expect, through health committees (this too needs to change).

The merger also would eliminate the dysfunctional distinctions between regulations for meat and poultry (USDA) and practically all other foods (FDA).   A merged agency could deal with the unpleasant fact that animal waste is the cause of many food safety problems with fruits and vegetables.

The idea of a single food safety agency is not new.  The Government Accountability Office (GAO) has been calling for its creation since 1990 or earlier, most recently in 2011.

In the 2011 report, GAO said, as it has for years:

Fragmented food safety system has caused inconsistent oversight, ineffective coordination, and inefficient uses of resources…The Department of Agriculture’s (USDA) Food Safety and Inspection Service and the Food and Drug Administration are the primary food safety agencies, but 15 agencies are involved in some way.

These, GAO points out, administer at least 30 food-related laws.

In addition, GAO urges Congress to ask the National Academy of Science to consider several organizational structures that might work better than the current system:

• A single food safety agency, either housed within an existing agency or established as an independent entity, that assumes responsibility for all aspects of food safety at the federal level
• A single food safety inspection agency that assumes responsibility for food safety inspection activities, but not other activities, under an existing department, such as USDA or FDA
•  A data collection and risk analysis center for food safety that consolidates data collected from a variety of sources and analyzes it at the national level to support risk-based decision making
• A coordination mechanism that provides centralized, executive leadership for the existing organizational structure, led by a central chair who would be appointed by the president and have control over resources

The rumors do not say which of these options is favored.

Not everyone is as enthusiastic about a single food safety agency as I am, in part because this and other issues remain to be resolved: where the new agency would go and what its resources might be.

And, as food safety lawyer Bill Marler points out, legal matters are also at stake:

We can’t overlook the legal issues in food safety. Right now there are too few legal consequences for sickening or killing customers by selling contaminated food. We should impose stiff fines, and even prison sentences, for violators, and even stiffer penalties for repeat violators.

So, let’s make some progress in stopping food poisoning and then later pick out the new stationery.

Former USDA official Richard Raymond, writing in Food Safety News argues:

It is my sincere belief that a merger of the two food safety agencies would be an unmitigated disaster in the short term because the cultures are so very different. And unless megadollars flowed with the merger, nothing more could be accomplished than is currently done.

And there are dozens of other valid reasons to “just say no” to the Administration’s thinking.

He suggests reading the comment posted on Dan Flynn’s article from Carol Tucker Foreman, also a former USDA official and a long-time food safety advocate.

The major point of her very long comment is that moving USDA’s meat and poultry inspection responsibilities to FDA

Would likely reduce the current level of health protection provided by food safety laws and curtail the progress that has been made in reducing foodborne illness.

The FDA, saddled by lack of funds, sufficient legal authority, and food safety leadership has been criticized…for its inability to provide a decent level of food safety protection in the domestic and imported food products it regulates.

…Today the FSIS [USDA] has surpassed the FDA in some areas. The agency has adequate resources and high official status in a relatively small Cabinet agency…FDA, despite its new law, is still strapped for funds, burdened by its low position at HHS and the need to manage multiple agendas…Reorganization would not address the continuing problems of either agency.

…We’re confident that trying to move other agencies to the FDA or HHS won’t save money. In fact we are confident it would reduce the effectiveness of the meat and poultry inspection program…leading to a potential increase in foodborne illness and the related costs. That makes it bad policy and a bad bargain.

But what if the new hypothetical single food safety agency does not go to FDA?  What if it goes someplace independent of either agency?   And what if the new entity started out with the highest possible safety standards, funded adequately?

If we are dealing with rumors, we can deal with dreams too, no?

Update, January 29:  Food SafetyNews says all rumors are false.  This isn’t going to happen because the meat industry doesn’t want it to happen.

Bacterial contamination of meat is an ongoing problem and everyone wishes for an easy fix—one that does not require meat producers and packers to prevent contamination.

Irradiation works, but raises feasibility and other concerns.

How about electrocution?

Food Production Daily reports that hitting meat with electrical current reduces toxic E. coli O157:H7 on meat surfaces by 2 log units.

The research report says researchers inoculated meat with the bacteria and then applied electrical current.  But by inoculation they must mean just on the surface, because they only counted surface bacteria.

Surface bacteria, alas, are not the problem.  Searing meat effectively kills surface bacteria.   Bacteria in the interior (of hamburger, for example) survive unless the meat is well cooked.

And 2 log units is unlikely to be good enough for bacteria that cause harm at low doses, as this kind does.  The FDA requires a 5 log reduction for fresh juices, for example.

I wish researchers would apply their talents to figuring out how to keep toxic bacteria from getting into and onto animals in the first place.  Then we wouldn’t have to worry about designing techno-fixes to deal with contaminated meat.

Yes, I know getting kids to eat their veggies can be challenging. 

Cornell researchers wondered this is because kids like different ways of presenting foods than adults.  They tested this idea in a study just published in Acta Pædiatrica.   

Contrary to the default assumption that parents and children share preferences for the ways in which food is presented on plates, we find that children have notably different preferences than adults. 

Most remarkably, we show that children tended to prefer seven different items and six different colours on their ideal plates, while adults tended to prefer three different colours and three different items….Given that adults often prepare plates of food for children to eat, these findings suggest new windows for encouraging diverse childhood nutrition.

I suppose this is the rationale behind the latest approach to getting kids to eat better diets: My Fruity Faces.  These are edible stickers that kids can stick on whatever fruits, vegetables and, presumably, any other food that happens to be handy.

The stickers are less interactive and creative than the old Mr. Potato Head toy, but kids can eat them.

And they ought to like eating them: Sugar is the first ingredient. 

Sugar is followed by Hydroxypropyl methylcellulose(Modified Cellulose), Water, Natural flavor, Modified corn starch, Glycerin, Polyglycerol esters of fatty acids, Citric acid, Red beet concentrate, Turmeric, Red cabbage extract, Caramel color, Sodium Bicarbonate.

Yum.

Will something like this reallyget kids to eat more fruits and vegetables?  Cornell researchers: get to work.

The New York Times reported a shocking statistic yesterday: about 42% of children under age 5 living in India suffer from malnutrition and are “wasted” (low weight for height). 

The figure comes from the Hungama survey of 73,000 Indian households conducted by the Naandi Foundation.  It reports an even more troubling statistic: nearly 59% of Indian children under age 5 are “stunted” (low height for age).

The Hangama report holds one hopeful note.  Rates of childhood malnutrition in India fell by 20% during the past 7 years.

But have they? 

According to a more detailed analysis in today’s New York Times, 

Despite the recent boom years of the 1990s and 2000s, there has been little improvement in overall nutrition in India, according to United Nations data. About 20 percent of India’s over 1 billion population remained “undernourished” during that time, meaning their “food intake regularly provides less than their minimum energy requirements.” The most recent”Global Hunger Index” shows that two-thirds of the 122 developing countries studied had reduced hunger levels in recent years, but that hunger levels in India have increased.

Ending malnutrition is a matter of political will.  If India wanted to address childhood malnutrition in any serious way, it could. 

How?  Feeding programs are emergency measures.  Long-term solutions require institution of social programs:

• Promote breastfeeding,
• Educate and empower women
• Build toilets
• Clean up water supplies
• Eradicate worms
• Reduce income inequality    

Two recent books summarize the research behind these ideas and explain what causes widespread hunger and what to do about it.  They make it clear that eradicating childhood malnutrition should be a first priority for any government:

• Olivier De Schutter and Kaitlin Cordes, editors: Accounting for Hunger: The Right to Food in the Era of Globalisation (Studies in International Law), Hart, 2011.
• Per Pinstrup-Anderson P and Derrill D. Watson II: Food Policy for Development Countries: The Role of Government in Global, National, and Local Food Systems, Cornell University Press, 2011.  

 USDA has announced that it is closing 259 domestic offices and 7 foreign offices “to meet the evolving needs of a 21st century agricultural economy.”

You have to love the government-speak explanation:

When fully implemented, these actions along with other recommended changes will provide efficiencies valued at about $150 million annually—and eventually more based on future realignment of the workforce—and will ensure that USDA continues to provide optimal service to the American people within available funding levels.

 Huh?

 What is this about?  I can only speculate. 

Over the years as a result of congressional earmarking—-putting government “pork” in the districts of members of House and Senate Agricultural committees—USDA’s bureaucracy became highly decentralized into hundreds of offices staffed by just a few people in throughout the country.  

 USDA has wanted to clean this up for years. 

I’m guessing that USDA is using congressional budget cutting pressures to do something its leaders have wanted to do for a long time. 

 Are so many of those offices redundant?  Some USDA oversight committee thought so. 

 The closures will not affect meat safety.  USDA still must maintain its legislated inspection responsibilities. 

 What surprises me is how little money this saves.  USDA’s annual budget is $145 billion.  If I have this right, this move will get rid of 7,000 jobs and save a mere $150 million, or just one-tenth of a percent of total annual expenditures.   

This seems like a lot of trouble to go through for something so relatively small.  

Maybe USDA Secretary Vilsack thinks this is enough of a sacrifice to head off further budget cuts?

In the meantime, expect cries of woe?