by Marion Nestle

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Apr 17 2010

Can KFC help prevent breast cancer?

Really, you can’t make this stuff up.  KFC has a new promotion with Susan G. Komen for the Cure, the group that raises funds to fight breast cancer.  The campaign is called “Buckets for the Cure.”

Participating KFC franchise locations will be selling specially designed pink buckets of grilled and Original Recipe chicken. KFC has pledged 50 cents to Komen for every pink bucket ordered by its restaurant operators during the promotion period, with a minimum donation of $1 million and a goal to raise more than $8 million. Twenty-five percent of the funds raised will be earmarked to Komen’s 120-plus domestic Affiliates for breast cancer programs in their communities. The remainder of the funds will support Komen’s national research and community programs.

OK, scientists are still arguing about the dietary determinants of breast cancer and aren’t too worried about fat, but they do worry about body weight.  Maintaining a healthy body weight is still the first recommendation of the American Cancer Society, for example.  Isn’t this campaign an incentive to buy as many buckets of KFC as you can?

On the topic of KFC’s pink buckets: the Dogwood Alliance is collecting signatures on a petition to stop KFC from destroying forests to make them in any color.

KFC buys from International Paper, a company notorious for “business as usual” destructive forest management practices like large-scale clearcutting, conversion of natural forests to plantations and reliance on toxic chemicals in forest management.

Dogwood wants KFC to use more environmentally friendly packaging for its buckets.  It has collected more than 9,000 signatures so far.  Here’s where you can add yours.

Addition, May 1: Thanks to Michelle Simon for forwarding this clip from Colbert.  A must-see.  It starts after the worm story at 1:15.

Apr 7 2010

Eating Liberally: The Child Nutrition Act

I keep getting asked what I think about the Child Nutrition Act wending its way through Congress.  Kerry Trueman of Eating Liberally posed this as a Q and A:

Let’s Ask Marion: Does The USDA Stand for Ultra Silly Dietary Agenda?

(With a click of her mouse, EatingLiberally’s kat corners Dr. Marion Nestle, NYU professor of nutrition and author of Pet Food Politics, What to Eat and Food Politics🙂

KT: Monday’s New York Times had an editorial supporting the reauthorization of the Child Nutrition Act, a bill that would give the US Agriculture Department “new powers to set nutritional standards for any food sold on school grounds, particularly junk foods that contribute to obesity.”

The current standards leave a lot to be desired, as Jamie Oliver’s Food Revolution has revealed. In the first episode, Jamie stood accused of shortchanging the kids on carbohydrates because he omitted the bread from a meal that already included rice.

Last Friday, in episode three, Jamie found himself charged with the violation of “insufficient vegetables,” despite the fact that his noodle-based entree featured seven different vegetables. The remedy? Add a bunch of french fries to the meal to meet the veggie quota.

How did the USDA’s school lunch standards ever get so nutritionally nutty? Would passage of the CNA support the wholesome, made-from-scratch meals that Jamie Oliver’s trying to bring back to our cafeterias?

Dr. Nestle: You are asking about the history of the USDA’s school lunch program? Nothing could be more complicated or arcane. Fortunately, two new books take this on: Susan Levine’s School Lunch Politics: The Surprising History of America’s Favorite Welfare Program (Princeton, 2010), and Janet Poppendieck’s Free for All: Fixing School Food in America (California, 2010).

I used Poppendieck’s book in my Food Ethics class at NYU this semester and reading it while watching Jamie Oliver’s programs was a lot of fun. Yes, Oliver is doing reality television but no, he’s not exaggerating. If you find this difficult to believe, read Poppendieck’s book or take a quick look at Kate Adamick’s review of Oliver’s Food Revolution on the Atlantic Food Channel.

As Levine and Poppendieck explain, and as I discussed in Food Politics (California, 2007), school lunches started out as a way to dispose of surplus agricultural commodities by feeding hungry kids. Over the years, it got caught up in a series of “wars”–first on poverty, hunger, and malnutrition and later on welfare and obesity.

The politics of school lunch, and of the CNA in particular, have always reflected the tension inherent in any welfare program, in this case feeding the poor vs. inducing dependency and overspending. In recent years, as obesity became much more of a public health problem than malnutrition, the politics came to reflect the tensions between commercial interests and those of nutrition reformers. Congress is always involved as it endlessly tinkers with the rules for “competitive foods”–the sodas and snacks sold in competition with federally supported school meals.

Competitive foods put schools in a dilemma and in conflict of interest. They make money from competitive foods to help support the school lunch program. But sodas and snacks undermine participation in school meals programs.

Poppendieck points out that the result is a mess that leaves financially strapped school districts with few choices. It’s not that the “lunch ladies” (you have to love Jamie Oliver’s term) don’t know how to make decent meals. It’s that they are up against inadequate funding and equipment, and impossible nutrition standards that can be met most easily by commercial products like Uncrustables that are designed to meet USDA standards. My favorite example contains 51 ingredients (my rule is “no more than five”).  See Note below.

Inadequate funding is a big consideration in the Child Nutrition Act. This act provides $4.5 billion over 10 years for school meals. Although this represents a 10-fold increase over previous (2004) funding, it works out to an additional measly six cents per meal–not nearly enough to solve school districts’ financial problems.

But–and this is a huge step forward–the act gives USDA the authority to set nutrition standards not only for foods sold in the cafeteria but also in vending machines and a la carte lines.

And the bill does a few other Very Good Things. It provides:

  • An estimated $1.2 billion over 10 years for meals at after-school programs, free meals to all students in schools with high poverty levels, and increased availability of meals during summer months.
  • An estimated $3.2 billion for establishing nutrition standards, strengthening local wellness policies, and increasing reimbursement rates.
  • Mandatory funding for schools to establish school gardens and buy foods from local sources.
  • Increased training for local food service personnel.
  • Automatic enrollment of foster children for free school meals.

As for the pesky nutrition standards: the bill expects the USDA to revise them according to the recent report of the Institute of Medicine (IOM), School Meals: Building Blocks for Health Children. This report recommended a conversion to food-based, rather than nutrient-based, standards along with increases in the amount and variety of fruits, vegetables, and whole grains and limits on calories, saturated fat, and sodium.

All of this makes the CNA well worth supporting. Is it perfect? Of course not. But it is a good first step to making big improvements eventually. In the meantime, plenty of schools are already doing great work and more are joining the food revolution one meal at a time. These deserve all the help we can give them.

*NOTE: the label of this particular Uncrustable was sent to me by Daniel of Ithaca, who works in an upstate New York school district:

BREAD; ENRICHED UNBLEACHED FLOUR (WHEAT FLOUR, MALTED BARLEY FLOUR, NIACIN, REDUCED IRON, THIAMIN MONONITRATE, RIBOFLAVIN, FOLIC ACID), WATER, HIGH FRUCTOSE CORN SYRUP, YEAST, PARTIALLY HYDROGENATED SOYBEAN OIL AND/OR SOYBEAN OIL, CONTAINS 2% OR LESS OF: WHEAT GLUTEN, SALT, DOUGH CONDITIONERS (MAY CONTAIN ONE OR MORE OF: DIACETYL TARTARIC ACID ESTERS OF MONO AND DIGLYCERIDES [DATEM], MONO AND DIGLYCERIDES, ETHOXYLATED MONO AND DIGLYCERIDES, SODIUM STEAROYL LACTYLATE, CALCIUM PEROXIDE, ASCORBIC ACID, AZODICARBONAMIDE, L-CYSTEINE), YEAST NUTRIENTS (MAY CONTAIN ONE OR MORE OF: MONOCALCIUM PHOSPHATE, CALCIUM SULFATE, AMMONIUM SULFATE), CALCIUM PROPIONATE (MAINTAIN FRESHNESS), CORNSTARCH, ENZYMES (WITH WHEAT). PASTEURIZED PROCESS CHEESE SPREAD: CULTURED MILK AND SKIM MILK, WATER, WHEY (FROM MILK), SODIUM PHOSPHATE, SALT, CREAM (FROM MILK), CORN SYRUP, LACTIC ACID, SORBIC ACID (PRESERVATIVE), GUAR GUM, ARTIFICIAL COLOR, ENZYMES. BUTTER FLAVORED OIL: PARTIALLY HYDROGENATED SOYBEAN OIL, SALT, SOY LECITHIN, NATURAL AND ARTIFICAL FLAVORS (WITH MILK), VITAMIN A PALMITATE, BETA CAROTENE ADDED FOR COLOR.

Mar 4 2010

Research alert: childhood obesity and how to fix it

It’s almost impossible to keep up with what’s being written about childhood obesity.  The papers and commentary pour in.  Much of this is well worth reading.  If you want to keep up on the latest thinking about the issue, here are some places to start:

1.  Health Affairs: Thanks to Matt Gruenberg for alerting me to the issue of Health Affairs devoted entirely to obesity topics.  Here’s the Table of  Contents.

The Robert Wood Johnson Foundation had a hand in this and discusses some of the papers on its website.

Even better, Health Affairs has produced a series of “issue briefs” to go with the journal articles.  These are available on the Health Affairs blog. They cover:

2.  FoodNavigator.com has a “special issue” on childhood obesity from the business standpoint:

Giving children the best nutritional start: With childhood obesity rates apparently sky rocketing around the world, celebrity chefs redesigning school meals, and international initiatives to influence what our children eat, now is an interesting time for child nutrition.

Kids’ food trends in the spotlight: Some major trends in children’s eating habits could change as the economy recovers – but foods marketed as natural and healthful are here to stay, according to a senior analyst at Mintel. 

How characters can help children eat healthily: From Disney to Tony the Tiger, consumer groups have been campaigning hard to break the links between childhood icons and unhealthy foods. But furry friends and super-heroes are now putting in more of an appearance on healthy products.

Kids’ TV food commercials down, but cross-promotions soar: Cross-promotions on food packaging targeted at children increased by 78 percent between 2006 and 2008, according to a study from Yale’s Rudd Center for Food Policy.

3.  Michelle Obama’s campaign:USA Today reports on Mrs. Obama’s talk to the school nutrition association, the organization of people who work in school lunchrooms – those who Jamie Oliver refers to as “lunch ladies.”  Check out the coverage and see the video.

What is one to make of all this?  Childhood obesity is a huge public health issue and deserves the attention it is getting.  Let’s hope some of it works.

Feb 9 2010

Confused about nutrition? Eat food!

I can’t resist dealing with the questions just asked by Elliot and Johannes.  From Elliot:

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease (see: American Journal of Clinical Nutrition, January 13, 2010)…[but] in his book, Good Calories Bad Calories, Gary Taubes clearly attributes most of our chronic disease problems — including heart disease — to carbohydrates (see page 454).  In contrast, Colin Campbell in his book The China Study (pages 113-133) forcefully argues that animal proteins contribute to CVD.  Yet, Dr. David Katz in his book Nutrition in Clinical Practice (pages 130, 133) asserts that to prevent heart disease, “saturated and trans fat should be restricted to below 7% (or even 5%) of total calories . . . .”  Who’s right?  We badly need your unbiased wisdom on this topic.

Joannes says that according to the Weston A Price Foundation,

it seems as if (naturally-occurring) saturated fats are almost better for you than the unsaturated fats we get fed these days, which mainly consist of rancid oils which more than anything contribute to heart disease, whereas many saturated fats are actually quite beneficial.

OK.  Here’s my “unbiased wisdom” (if such a thing exists).  I like to ask: What do saturated fats, sugars, and animal proteins have in common as factors in the development of heart disease?   Answer: They are all single nutrients.

Recall that nutrition research is difficult to do because diets contain many foods, foods contain many nutrients and other chemicals that affect health, and other behavioral, socioeconomic, and genetic factors influence heart disease.  Studies of single nutrients take these chemicals out of their food, dietary, caloric, and lifestyle contexts and are, therefore, reductive.

Such studies tend to produce ambiguous results that demonstrate small differences, if any.  Small differences create situations ripe for interpretation.  Interpretation depends on the viewpoint of the interpreter.  That is why it helps to know who is doing the interpreting and who sponsored the studies.

Short of that, you would have to read every study cited by these authors and come to your own decision about how to interpret them – a daunting task.

My approach to conflicting research?  I look for points of agreement. The authors cited here do not disagree about the basic principles of healthful diets: variety in food intake, moderation in calories, largely plant-based (although not necessarily exclusively), and minimally processed.  Eat according to those principles and you do not have to worry about nutritional details.

All of that boils down to the advice I propose in What to Eat: eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.

Let the scientists and their interpreters fight it out over single nutrients.  Eat food and enjoy your dinner.

Jan 25 2010

A quick Q and A: sugars and fats

I wish I could answer all of the questions that come into Feedback or Comments, but I cannot except occasionally.  It’s a rainy day in New York and today seems to be one of those occasions.

Q: Does the caloric value of a food change when it’s cooked?  In his latest book, “Catching Fire: How Cooking Made us Human,” Harvard Primatologist Richard Wrangham argues that cooking foods changes the available nutrient content and actually raises the available calories.

A:  The rules of physical chemistry tell us that matter cannot be destroyed or created so the number of calories available in a food does not change with temperature.  What can change is our ability to use (digest, absorb) the calories that are there as well as our desire to eat the foods.  Cooking makes the calories in potato starch more available, for example, but has hardly any effect on the calories in meat.  Both, in my opinion at least, taste better cooked.    But cooked or not, the calorie differences will be small and unlikely to account significantly for weight change.

The nutrient situation is also complicated.  Cooking destroys some nutrients (vitamin C is a good example) but makes others more available (beta-carotene).  This is another reason why nutritionists are always advising variety in food intake.  Variety applies to cooked and raw, as well.

Q.  Can you please explain what benefits, if any, there are in using a “natural” sweetener, e.g. agave, over regular sugar?  Are there any differences in terms of glucose/fructose makeup?

A.  Agave is more expensive so you probably won’t use as much of it.  Beyond that, it is higher in fructose than table sugar or honey.  This is because agave contains inulin, a polymer of fructose, which must be hydrolyzed (broken down by heat or enzymes) to fructose to make the sweetener.  It’s a processed sweetener requiring one hydrolysis step, requiring more processing than honey and less than high fructose corn syrup.  It has the same number of calories as any other sugar, about 4 per gram or 16 per teaspoon.

Q.  Also, you’ve written on a prior blog that fructose is “preferentially” metabolized into fat by the body.  Can you explain in more detail what that means?

A.  More and more evidence suggests that high amounts of fructose in the diet are not good for health.  Fructose occurs naturally in fruit and nobody worries about that because fruits don’t contain all that much and the sugar is accompanies by vitamins, minerals, and fiber that are well worth eating.  Honey, table sugar, and high fructose corn syrup (a misnomer) are about 50% each glucose and fructose.  Glucose and fructose are metabolized differently and some investigators believe that excessive amounts of fructose stress metabolism in ways that encourage fat deposition.  Eating a lot of sugars of any kind is not a great idea, which is why there are so many concerns about soft drinks these days.

Q.  I would appreciate some comments about the “Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease.

A.  The study concludes:  

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD [coronary heart disease] or CVD [cardiovascular disease]. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat.

This is a review of previous epidemiological studies (not clinical trials).  These fail to find a correlation between consumption of saturated fat and heart disease.  This could be because there is no correlation or there is one but they can’t find it.  My interpretation: even if there is one, it is likely to be small.

I am increasingly convinced that studies of single nutrients – sugar, fructose, saturated fat, or even omega-3s – will give complicated results when removed from their dietary context.  People who eat foods containing a lot of sugars or animal fats eat and behave differently than people who do not, but not so differently that health differences will show up in the kinds of studies scientists are currently able to do.

Keep in mind: nutrition science is exceedingly difficult to do because there are so many factors in foods that affect health and so many behavioral, economic, and social factors that affect what people eat.

All of this is why I find nutrition so interesting but I can understand why others might find it frustrating.

Dec 27 2009

FDA warns Nestlé: Juicy Juice misbranded!

I’ve been fretting about the immunity and brain claims on Nestlé’s Juicy Juice for quite some time now, but completely missed the FDA’s December 4 warning letter about them.  Thanks to Hemi Weingarten at Fooducate for keeping track of such things.

JuicyJuice

If you give these products a moment’s thought, you can quickly figure out that feeding DHA- or antioxidant-fortified juice drinks to kids is unlikely to have much effect on how smart they are or whether they can resist colds or swine flu.  But never underestimate the power of food marketers.   Adding a little DHA or a few antioxidants to juices sells products.  Health claims, as I keep pointing out, are about marketing, not health.

In warning the company to cease and desist, however, The FDA did not take on the health issues.  Instead, it invoked labeling regulations:

The Food and Drug Administration (FDA) has reviewed the labeling for several Nestlé Juicy Juice products…Based on our review, we have concluded that these products are misbranded…. because [their] labeling includes unauthorized nutrient content claims. Except for statements that describe the percentage of a vitamin or mineral in relation to a Reference Daily Intake (RDI), a nutrient content claim cannot be made for a food intended for use by infants and children less than 2 years of age….On October 30, 2009. we also reviewed your website….The labeling found on your website makes an additional unauthorized nutrient content claim, which further misbrands the product. The website claims that Juicy Juice Brain Development Fruit Juice Beverage is “naturally lower in sugar”…[but] no nutrient content claims can be made for a food intended specifically for use by infants and children less than 2 years of age unless specifically permitted by FDA regulations.

Additionally, we have reviewed the labeling of your Nestle Juicy Juice All Natural 100% Juice Orange Tangerine and Nestle Juicy Juice All Natural 100% Juice Grape products. These products are misbranded…because their labels are misleading. The label of the Orange Tangerine product is designed to imply that the product is 100% orange/tangerine juice, and the label of the Grape product is designed to imply that product is 100% grape juice…neither orange/tangerine juice nor grape juice is the predominant juice in the products….

Nestlé (alas, no relation) is the largest food company in the world with $102 billion in sales last year.  It should know better.

Just for the record, the misbranded products are still displayed on the Juicy Juice website.

The FDA also warned Nestlé that its Boost Kids Essentials products are misbranded. Why?  Because their labeling does not follow the rules for medical foods, those aimed at alleviating specific conditions – in this case “failure to thrive.”   Oops.  The Boost Kids Essentials website is now under revision.

Dec 7 2009

Saving the earth: Coca-Cola?

I greatly admire the work of Jared Diamond.  His book, Guns, Germs, and Steel: The Fate of Human Societies, is as clear an explanation as you will ever get of how the inequitable distribution of favorable geography, climate, and natural resources affects the development and maintenance of human societies.

But here he is, incredibly, in the Sunday New York Times writing a fan letter to corporate social responsibility for protecting those favorable environments.  He writes:

There is a widespread view, particularly among environmentalists and liberals, that big businesses are environmentally destructive, greedy, evil and driven by short-term profits. I know — because I used to share that view.  But today I have more nuanced feelings…I’ve discovered that while some businesses are indeed as destructive as many suspect, others are among the world’s strongest positive forces for environmental sustainability.

And which corporations does he include as “strongest positive forces?”  Chevron, Walmart, and Coca-Cola.   I’ll leave discussion of Chevron and Walmart to others, but Coca-Cola?

Coca-Cola, Diamond says, is protecting the world’s water supplies.  The company needs clean water in the 200 countries in which it operates.  This, says Diamond:

compels it to be deeply concerned with problems of water scarcity, energy, climate change and agriculture. One company goal is to make its plants water-neutral, returning to the environment water in quantities equal to the amount used in beverages and their production. Another goal is to work on the conservation of seven of the world’s river basins, including the Rio Grande, Yangtze, Mekong and Danube — all of them sites of major environmental concerns besides supplying water for Coca-Cola. These long-term goals are in addition to Coca-Cola’s short-term cost-saving environmental practices, like recycling plastic bottles, replacing petroleum-based plastic in bottles with organic material, reducing energy consumption and increasing sales volume while decreasing water use.

Please note the future tense.  These are things Coke says it plans to do.  As for what the company is doing now, Diamond does not say.  His piece does not mention Coke’s negotiating with officials in developing countries to buy water at rates significantly below those charged to local communities, a topic under much discussion when I was in India last year.  It does not mention campaigns in India to hold Coke accountable for its abuse of local water rights or any of the similar campaigns in other countries.

Diamond’s piece does not talk about the efforts Coke puts into selling bottled water at the expense of local water supplies.  As described by Elizabeth Royte in her book, Bottlemania, companies like Coke exhibit every one of of the characteristics formerly deplored by Diamond in attempting to secure plentiful and reliable sources of cheap local water: in his words, “environmentally destructive, greedy, evil and driven by short-term profits.”

Diamond says he sits along side and has gotten to know and appreciate the motives of many corporate executives.  Me too.  Personally, many of them mean well and wish that they could do more to be socially responsible.  But they work for businesses that are required, by law, to make short-term profit their reason for existence.  This means that corporate social responsibility is necessarily limited to actions that bring visible – and immediate – returns on investment.

We need some critical thinking here.  If Diamond gave any thought at all to what Coca-Cola produces – bottled water and sodas – he would surely have to agree that less of both would be good for our own health and that of the planet.

Nov 25 2009

The latest on too much salt

The British Medical Journal has a new meta-analysis of 13 studies of the health effects of high salt intake.  Its conclusion:

High salt intake is associated with significantly increased risk of stroke and total cardiovascular disease. Because of imprecision in measurement of salt intake, these effect sizes are likely to be underestimated. These results support the role of a substantial population reduction in salt intake for the prevention of cardiovascular disease.

In commentary, the authors insist that regulation is needed.  The effects of salt are large:

a 5 g reduction in salt intake at the population is associated with a 23 per cent difference in stroke rates, and a 17 per cent difference in total cardiovascular disease….eating less salt could avert 1.25 million deaths from stroke and almost 3m deaths from cardiovascular disease – and these projections are…conservative because of imprecision in assessing salt intake.

Why regulation?  Because nearly 80% of salt enters the diet through processed and pre-prepared foods.  The rest is about equally divided between naturally occurring salt in foods and salt added at the table.   To reduce salt, food manufacturers and restaurants need to cut down, and all of them have to do it.

This is because the taste for salt depends on how much is eaten.  On a low salt diet, even lightly salted foods taste salty.  But if you are used to eating a lot of salt, it takes even more to taste salty.  So the object needs to be to reduce salt in the diet across the board.

I’m hearing a lot these days about how federal agencies are getting interested in the salt issue.  Stay tuned on this one.

And have a safe, healthy, delicious, and lightly salted thanksgiving!

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