Food Politics

by Marion Nestle
May 1 2023

American Society for Nutrition commissions highly conflicted meta-analysis

I was surprised to see a press release from the American Society for Nutrition (ASN—of which I am a member) announcing publication of a research paper the Society had commissioned and published on sugars and body weight: Important food sources of fructose-containing sugars and adiposity: a systematic review and meta-analysis of controlled feeding trials.

The paper, the press release said, “Illustrate[s] The Need for Nuance in Public Health Guidance Related to Consumption of Sugars: Findings call into question recommendations that imply all sources of fructose-containing sugars carry the same risk.

The press release notes that “this comprehensive review is timely as the 2025 Dietary Guidelines Advisory Committee currently assesses the latest science to inform updated evidence-based recommendations,” and it quotes the lead author: “There is an opportunity for more food-based guidance around sugars to help ensure Americans don’t inadvertently eat less health-promoting foods containing fructose – especially at a time when most people don’t eat enough of all forms of fruit, which offer significant health benefits.”

Uh oh.  This is an easily misinterpreted message.

My immediate question:  Who wrote the paper ?

No surprise.: authors with extensive conflicts of interest.

I’ve written about some of these authors’ conflicts of interest disclosures previously.  See, for example. this, this, and this.

Just for fun, I’ll post this particular statement of the conflicted interests at the end of this post.

Basically, these authors do not understand the difference between a conflict of interest (financial ties, which are discretionary) and non-discretionary viewpoints (all researchers have them).  In this case, consulting for a sugar company is a conflict; being a vegan or avoiding sugar-sweetened beverages is not.

My second question: Why did ASN commission this paper, and from these particular authors no less?

I contacted John Courtney, the long-time executive director of the ASN.  He said this was a leftover from an initiative started ten years ago.  Since then, the ASN has decided not to commission papers on controversial topics and this will not happen again.

Good.  It shouldn’t.  Commissioning papers like these make the ASN look like an arm of the food industry.  The ASN should avoid even teh appearance of conflicts of interest as much as it possibly can.

You don’t believe this is a problem?  Take a look at this conflict of interest statement.  Enjoy!

Conflict of Interest

JLS is a member of the Journal’s Editorial Board and played no role in the Journal’s evaluation of the manuscript.

LC was a Mitacs-Elevate postdoctoral fellow jointly funded by the Government of Canada and the Canadian Sugar Institute (September 2019–August 2021). She was previously (2010–2018) employed as a casual clinical coordinator at INQUIS Clinical Research, Ltd. (formerly Glycemic Index Laboratories, Inc.), a contract research organization.

AC and AA have received funding from a Toronto 3D MSc Scholarship award.

SA-C was funded by a Canadian Institutes of Health Research (CIHR) Canadian Graduate Scholarships Master’s Award, the Loblaw Food as Medicine Graduate Award, the Ontario Graduate Scholarship, and the CIHR Canadian Graduate Scholarship Doctoral Award. She avoids consuming NSBs and SSBs and has received an honorarium from the international food information council (IFIC) for a talk on artificial sweeteners, the gut microbiome, and the risk for diabetes.

NM was a former employee of Loblaw Companies Limited and current employee of Enhanced Medical Nutrition. She has completed consulting work for contract research organizations, restaurants, start-ups, the International Food Information Council, and the American Beverage Association, all of which occurred outside of the submitted work.

TAK has received research support from the Canadian Institutes of Health Research (CIHR), the International Life Science Institute (ILSI), and the National Honey Board. He has taken honorarium for lectures from International Food Information Council (IFIC) and Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America).

FA-Y is a part-time Research Assistant at INQUIS Clinical Research, Ltd., a contract research organization.

DL reports receiving a stipend from the University of Toronto Department of Nutritional Sciences Graduate Student Fellowship, University of Toronto Fellowship in Nutritional Sciences, University of Toronto Supervisor’s Research Grant—Early Researcher Awards, and Dairy Farmers of Canada Graduate Student Fellowships; a scholarship from St. Michael’s Hospital Research Training Centre, and a University of Toronto School of Graduate Studies Conference Grant.

AZ is a part-time Research Associate at INQUIS Clinical Research, Ltd., a contract research organization, and has received funding from a BBDC Postdoctoral Fellowship. She has received consulting fees from the GI found.

RJdS has served as an external resource person to the World Health Organization’s Nutrition Guidelines Advisory Group on transfats, saturated fats, and polyunsaturated fats. The WHO paid for his travel and accommodation to attend meetings from 2012–2017 to present and discuss this work. He has also performed contract research for the CIHR’s Institute of Nutrition, Metabolism, and Diabetes, Health Canada, and the World Health Organization for which he received remuneration. He has received speaker’s fees from the University of Toronto and McMaster Children’s Hospital. He has held grants from the Canadian Foundation for Dietetic Research, Population Health Research Institute, and Hamilton Health Sciences Corporation as a principal investigator and is a co-investigator on several funded team grants from the CIHR. He has served as an independent director of the Helderleigh Foundation (Canada). He serves as a member of the Nutrition Science Advisory Committee to Health Canada (Government of Canada) and is a co-opted member of the Scientific Advisory Committee on Nutrition Subgroup on the Framework for the Evaluation of Evidence (Public Health England).

TMSW was previously a part owner and now is an employee of INQUIS and received an honorarium from Springer/Nature for being an Associate Editor of the European Journal of Clinical Nutrition.

CWCK has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada, Almond Board of California, Barilla, CIHR, Canola Council of Canada, International Nut and Dried Fruit Council, International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd, the Peanut Institute, Pulse Canada, and Unilever. He has received in-kind research support from the Almond Board of California, Barilla, California Walnut Commission, Kellogg Canada, Loblaw Companies, Nutrartis, Quaker (PepsiCo), the Peanut Institute, Primo, Unico, Unilever, and WhiteWave Foods/Danone. He has received travel support and/or honoraria from the Barilla, California Walnut Commission, Canola Council of Canada, General Mills, International Nut and Dried Fruit Council, International Pasta Organization, Lantmannen, Loblaw Brands, Ltd., the Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, the Peanut Institute, Pulse Canada, Sun-Maid, Tate & Lyle, Unilever, and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, the International Pasta Organization, McCormick Science Institute, and Oldways Preservation Trust. He is a founding member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes, is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD and is a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation.

DJAJ has received research grants from Saskatchewan & Alberta Pulse Growers Associations, the Agricultural Bioproducts Innovation Program through the Pulse Research Network, the Advanced Foods and Material Network, Loblaw Companies, Ltd., Unilever Canada and Netherlands, Barilla, the Almond Board of California, Agriculture and Agri-food Canada, Pulse Canada, Kellogg’s Company, Canada, Quaker Oats, Canada, Procter & Gamble Technical Centre, Ltd., Bayer Consumer Care, Pepsi/Quaker, International Nut & Dried Fruit Council, Soy Foods Association of North America, the Coca-Cola Company (investigator initiated, unrestricted grant), Solae, Haine Celestial, the Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Soy Nutrition Institute (SNI), the Canola and Flax Councils of Canada, the Calorie Control Council, the CIHR, the Canada Foundation for Innovation and the Ontario Research Fund. He has received in-kind supplies for trials as a research support from the Almond Board of California, Walnut Council of California, the Peanut Institute, Barilla, Unilever, Unico, Primo, Loblaw Companies, Quaker (Pepsico), Pristine Gourmet, Bunge Limited, Kellogg Canada, and WhiteWave Foods. He has been on the speaker’s panel, served on the scientific advisory board and/or received travel support and/or honoraria from Nutritional Fundamentals for Health (NFH)-Nutramedica, Saint Barnabas Medical Center, The University of Chicago, 2020 China Glycemic Index International Conference, Atlantic Pain Conference, Academy of Life Long Learning, the Almond Board of California, Canadian Agriculture Policy Institute, Loblaw Companies, Ltd., the Griffin Hospital (for the development of the NuVal scoring system), the Coca-Cola Company, Epicure, Danone, Diet Quality Photo Navigation, Better Therapeutics (FareWell), Verywell, True Health Initiative, Heali AI Corp, Institute of Food Technologists, SNI, Herbalife Nutrition Institute, Saskatchewan & Alberta Pulse Growers Associations, Sanitarium Company, Orafti, the International Tree Nut Council Nutrition Research and Education Foundation, the Peanut Institute, Herbalife International, Pacific Health Laboratories, Barilla, Metagenics, Bayer Consumer Care, Unilever Canada and Netherlands, Solae, Kellogg, Quaker Oats, Procter & Gamble, Abbott Laboratories, Dean Foods, the California Strawberry Commission, Haine Celestial, PepsiCo, the Alpro Foundation, Pioneer Hi-Bred International, DuPont Nutrition and Health, Spherix Consulting and WhiteWave Foods, the Advanced Foods and Material Network, the Canola and Flax Councils of Canada, Agri-Culture and Agri-Food Canada, the Canadian Agri-Food Policy Institute, Pulse Canada, the Soy Foods Association of North America, the Nutrition Foundation of Italy, Nutra-Source Diagnostics, the McDougall Program, the Toronto Knowledge Translation Group (St. Michael’s Hospital), the Canadian College of Naturopathic Medicine, The Hospital for Sick Children, the Canadian Nutrition Society, the American Society of Nutrition, Arizona State University, Paolo Sorbini Foundation, and the Institute of Nutrition, Metabolism and Diabetes. He received an honorarium from the United States Department of Agriculture to present the 2013 W.O. Atwater Memorial Lecture. He received the 2013 Award for Excellence in Research from the International Nut and Dried Fruit Council. He received funding and travel support from the Canadian Society of Endocrinology and Metabolism to produce mini cases for the Canadian Diabetes Association. He is a member of the ICQC. His wife, Alexandra L Jenkins, is a director and partner of INQUIS Clinical Research for the Food Industry. His 2 daughters, Wendy Jenkins and Amy Jenkins, have published a vegetarian book that promotes the use of the foods described in this study, The Portfolio Diet for Cardiovascular Risk Reduction (Academic Press/Elsevier 2020 ISBN:978-0-12-810510-8). His sister, Caroline Brydson, received funding through a grant from St. Michael’s Hospital Foundation to develop a cookbook for 1 of his studies. He is also a vegan. JLS has received research support from the Canadian Foundation for Innovation, Ontario Research Fund, Province of Ontario Ministry of Research and Innovation and Science, Canadian Institutes of health Research (CIHR), Diabetes Canada, American Society for Nutrition (ASN), International Nut and Dried Fruit Council (INC) Foundation, National Honey Board [the US Department of Agriculture (USDA) honey “Checkoff” program], Institute for the Advancement of Food and Nutrition Sciences (IAFNS), Pulse Canada, Quaker Oats Center of Excellence, The United Soybean Board (the USDA soy “Checkoff” program), The Tate and Lyle Nutritional Research Fund at the University of Toronto, The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), The Plant Protein Fund at the University of Toronto (a fund that has received contributions from IFF), and The Nutrition Trialists Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received food donations to support randomized controlled trials from the Almond Board of California, California Walnut Commission, Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone, Nutrartis, Soylent, and Dairy Farmers of Canada. He has received travel support, speaker fees, and/or honoraria from ASN, Danone, Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Comité Européen des Fabricants de Sucre, Nutrition Communications, International Food Information Council, Calorie Control Council, the International Sweeteners Association, the International Glutamate Technical Committee, Phynova, and Brightseed. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Phynova, and INQUIS Clinical Research. He is a former member of the European Fruit Juice Association Scientific Expert Panel and a former member of the Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes, Canadian Cardiovascular Society, and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves or has served as an unpaid member of the Board of Trustees and an unpaid scientific advisor for the Carbohydrates Committee of IAFNS. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group of the EASD, and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev.

XYQ, SB, NM, VH, EL, SBM, VLC, and LAL declare no competing interests.

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Apr 28 2023

Weekend reading: “Henfluence” for the love of chickens

Tove Danovich.  Under the Henfluence: Inside the World of Backyard Chickens and the People Who Love Them.  Agate, 2023 (223 pages).

I’ve followed Tove Danovich’s career with great interest, not least because she took a course with me in the Food Studies master’s program at NYU some years ago.

This is her first book, a nonfiction account of the chickens she raises, each named and identified, the contrast between the welfare of chickens raised in backyards as opposed to industrial batteries, and her love for chickens in general and hers in particular.

During the first year of the pandemic, chicken watching became my main hobby. (Not that there were many other options.)  When the news got to be too overwhelming, watching the chickens was how I reset  Obviously, I’m not the first one to discover the therapeutic power of chickens..Some people pour themselves a glass of wine; others stare at chickens. (p. 107)

She adopts two checkens rescued from factory farms and names them Thelma and Louise.

Some of Thelma’s and Louise’s natural behaviors came back as soon as they were given the chance to express them—dust bathing, foraging, laying in the sun—but their bodies and minds took longer to heal  A year after they were rescued, the hens’ feathers were almost completely regrown with the exception of their still sparse tail feathers.  Some things won’t change.  They will probabl always sleep on the floor of the coop.  Their beaks will never grow back.  But they’ve found a place for themselves in the flock and with me.  (p. 193)

The book has plenty to say about the political, economic, and animal-welfare aspects of factory farmed chicken raising, but mostly it’s a personal account of her enjoyment of raising backyard chickens.

She eats their eggs.  She does not eat the hens.

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Apr 27 2023

Sugarcane juice is a health food!

Thanks to Jill Richardson who spotted this at the Sugarcane Juice Bar, St Louis Galleria.

Sugarcane juice is delicious but, as I keep saying, you can’t make this stuff up.

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Tags:
Apr 26 2023

The latest sugar recommendation

The latest review of sugars and health has created quite a stir.

  • The study:  Dietary sugar consumption and health: umbrella review.  BMJ 2023381 doi: https://doi.org/10.1136/bmj-2022-071609 (Published 05 April 2023).
  • Method:  The authors evaluated 73 meta-analyses that included 8601 studies, most of them observational (meaning they indicate associations but not necessarily causation).
  • Findings: Significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic) were detected.
  • Implications: Low-quality evidence linked each additional serving of a sugar-sweetened beverage per week with a 4% higher risk of gout. Each extra cup per day of a sugar-sweetened drink was associated with a 17% and a 4% higher risk of coronary heart disease and all-cause mortality, respectively.
  • Recommendations: (1) Reduce the consumption of free sugars or added sugars to below 25 g/day (this translates to about 6 teaspoons daily). (2) Limit sugar-sweetened beverages to less than 1 a week.

Here’s the headline about the stir:

Experts recommend 6-teapsoon limit to added sugar following BMJ review, industry weighs in:  Recently published research in The BMJ is providing fresh concerns about sugar consumption levels, as some industry stakeholders disagree with the conclusion and CPG brand look to innovate in the low- and no-sugar space…. Read more

And one of the quotes from an industry representative:

…This is a review of existing evidence, and even a well-executed systematic review is only as good as the studies that are inputted. Essentially, garbage in equals garbage out, and it is known that added sugars literature suffers from significant variability when it comes to definitions, intake measurements and control of energy and other diet and lifestyle variables.

Comment: The six-teaspoon recommendation is consistent with World Health Organization guidelines to reduce daily intake of free sugar to less than 10% of their total energy intake, and preferably 5 percent.  The authors admit the evidence is not strong.  But there’s just so much of it, and it’s not going away.

When it comes to sugars, less is better, alas.

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Apr 25 2023

Menopause is a food marketing opportunity!

If you thought yesterday’s post about blueberries as a means to reduce hypertension in menopausal women seemed far-fetched, you are missing the point.

The food industry views menopause as a marketing opportunity.

‘We need the food industry to recognise this opportunity and step up to the plate’: Campaigner urges more NPD to embrace the menopause: The menopause represents a significant untapped opportunity for food and beverage brands, FoodNavigator’s Positive Nutrition Summit hears…. Read more

The menopause hits at a life stage when many women are particularly busy and time-poor and it is, at best, an inconvenience…This audience is now demanding more from brands – they don’t want to have to struggle and search to find items that support their symptoms. GenM research shows that 78% of women would be happy to shop for products labelled as menopause-friendly, while a further 90% of menopausal women want brands to be more inclusive to menopause. We need the food industry to recognise this opportunity and step up to the plate.

And then there’s this one:

Marketing sports nutrition products for menopausal women:  A variety of products are geared toward youth and seniors, but where do women in their 50s fit?… Watch now

Alexis Collins, director of product and brand strategy, Stratum, said one ingredient stands out to her most: NEM, the company’s flagship, branded eggshell membrane. Our ingredient is natural eggshell membrane also known as NEM and NEM is a joint health ingredient that has been specifically clinically researched in postmenopausal women to show fast exercise recovery.

Eggshell membrane.  Why didn’t I think of that?

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Apr 24 2023

Industry-funded study of the week: blueberries and menopause

NutraIngredients, a newsletter I read daily, caught my eye with this headline:

Blueberries benefit postmenopausal women with high blood pressure: Study:  Daily blueberry consumption improves endothelial function in postmenopausal women with high blood pressure, according to a recent study…. Read more

I looked it up, of course.

  • The study: Daily blueberry consumption for 12 weeks improves endothelial function in postmenopausal women with above-normal blood pressure through reductions in oxidative stress: a randomized controlled trial. Food Funct., 2023,14, 2621-2641
  • Objective: “to examine the efficacy of blueberries to improve endothelial function and blood pressure in postmenopausal women with above-normal blood pressure, and to identify potential mechanisms for improvements in endothelial function.”
  • Method: Postmenopausal women with elevated blood pressure or hypertension were given 22 g/day of freeze-dried highbush blueberry powder or placebo powder for 12 weeks.
  • Findings: The sum of plasma (poly)phenol metabolites increased in the blueberry group compared to baseline, and were higher than the placebo group.  Increases in several plasma flavonoid and microbial metabolites were also noted. No major differences were found for blood pressure, arterial stiffness, blood biomarkers, or endothelial cell protein expression following blueberry consumption (my emphasis).
  • Conclusion: “These findings suggest daily consumption of freeze-dried blueberry powder for 12 weeks improves endothelial function through reduced oxidative stress in postmenopausal women with above-normal blood pressure”
  • Conflicts of interest: There are no conflicts to declare.
  • Acknowledgements: This research was funded by the US Highbush Blueberry Council, the USDA National Institute of Food and Agriculture [Grant No. 2020-67017-30833/Project Accession No. 1021875], and the College of Health and Human Sciences at Colorado State University.

Comment: Yes there is a conflict of interest, but the authors don’t seem to recognize it.  This is a classic case of interpretation bias; the study didn’t show much of anything but the authors conclude that blueberry powder does some good.

High marks to NutraIngredients for disclosing the funding source right at the top of the article:

Published in the journal Food and Function, the study was supported by the US Highbush Blueberry Council and the USDA National Institute of Food and Agriculture.

 

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.

 

Apr 21 2023

Weekend reading: Resilient Kitchens

Gleissner P, Kashdan HE, eds.  Resilient Kitchens: American Immigrant Cooking in a Time of Crisis.  Rutgers University Press, 2023.   

I enjoyed reading this book and did a blurb for it:

Resilient Kitchens collects the deeply personal accounts of immigrant chefs, writers, and scholars of how their experience as “other” informed their use of food and cooking to stay centered during the COVID-19 pandemic.  Their stories are vastly different but all bear on why food matters to much to personal identity.

Rutgers University Press describes it this way:

Resilient Kitchens: American Immigrant Cooking in a Time of Crisis is a stimulating collection of essays about the lives of immigrants in the United States before and during the COVID-19 pandemic, told through the lens of food. It includes a vibrant mix of perspectives from professional food writers, restaurateurs, scholars, and activists, whose stories range from emotional reflections on hardship, loss, and resilience to journalistic investigations of racism in the American food system. Each contribution is accompanied by a recipe of special importance to the author, giving readers a taste of cuisines from around the world. Every essay is accompanied by gorgeous food photography, the authors’ snapshots of pandemic life, and hand-drawn illustrations by Filipino American artist Angelo Dolojan.

Contributions by Reem KassisStephanie JollyKrishnendu RayTien NguyenBonnie Frumkin MoralesMayukh SenGeetika AgrawalFernay McPhersonAntonio TahhanSangeeta LakhaniKeenan DavaTim FloresAngelo DolojanGuillermina Gina Núñez-MchiriHarry Eli KashdanPhilip Gleissner

Apr 20 2023

USDA’s latest charts

Every now and then the USDA puts out a collection of its latest charts.

These provide lots of information at a glance.  Here are three quick examples:

  1.  What’s happened to farms in the US over the past 200 years.  The number of farms has gone way down; the size has gone way up.

2. This one is about sweeteners in the food supply (not amounts actually eaten).The peak year was around 2000. The overall trend tracks with corn sweeteners.

3. More than half of food expenditures are now on food eaten in restaurants or institutions—where meals are higher in calories.

Enjoy!

*******

For 30% off, go to www.ucpress.edu/9780520384156.  Use code 21W2240 at checkout.