I’ve just turned in the copy-edited manuscript of Why Calories Count: From Science to Politics (pub date March 2012) and now have time to catch up on some questions:

Q. I was recently given to read a book titled “The China Study” which is based on research conducted in 1970’s in China by Dr. Colin Campbell. His main conclusion is that eating dairy and meat causes cancer. His resolution is that a plant-based diet (i.e. vegan) is the (only?) healthy diet for humans. This book has made strong enough of a point to convince several of my friends to “convert” to a vegan diet in order to save their health. Could you share some comments on the validity of the research and conclusions this book presents with regards to detrimental effects of dairy and meat on human health?

A. Campbell makes a forceful argument based on his interpretation of the research and on case studies of people whose diseases resolved when they became vegans. And yes I’ve seen Dr. Campbell’s new movie, Forks over Knives. The first half is a terrific introduction to how the current food environment promotes unhealthy eating.  The second half promotes Dr. Campbell’s ideas about the hazards of meat and dairy foods.

Whether you agree with these ideas or not, the film is well done and worth a look.

Some scientists, however, interpret the research as demonstrating that people are healthier when they eat dairy foods.  For example, the enormous consensus report on diet and cancer risk from the American Institute for Cancer Research and the World Cancer Research Fund concluded in 2007 that eating lots of red meat and processed meat is convincingly associated with an increased risk of colorectal cancer (but no others).

On the other hand, they found dairy foods to be associated with a decrease in the risk of colorectal cancer.  They found limited and less convincing evidence that dairy foods might decrease the risk of bladder cancer but increase the risk of prostate cancer.

How to make sense of this?  These are two food groups in the diets of people who consume many kinds of foods and who do many things that might increase or decrease cancer risk.  Given this complexity, one food or food group seems unlikely to have that much influence on cancer when considered in the context of everything else people eat and do.

Nutrition research, as I am fond of saying, is difficult to do and requires interpretation. Intelligent people can interpret the studies differently depending on their point of view.

The new Dietary Guidelines say to cut down on saturated fats. Those are most plentiful in meat and dairy foods (plant foods have them, but in smaller amounts). Pretty much everyone agrees that plant-based diets promote health/  But whether they have to be 100% plant-based is highly debatable.

The new USDA MyPlate food guide suggests piling plant foods—fruit, vegetables, and grains—on 75% of your plate so the argument is really about what goes on the remaining 25%, what USDA calls the  “Protein” section. You can put beans in that quarter if you don’t want to eat red meat, poultry, or fish.

Q. I’d love to hear your take on the recent walnut flap [accusations that the FDA now considers walnuts to be drugs].  I suspect walnuts got caught with such offenders as Pom, Froot Loops, and Juicy-Juice, but I’d love to find out what the FDA actually said about this. For some odd reason I don’t believe the article is presenting the whole truth.

A. This is a health claims issue. The FDA is not saying walnuts are drugs. It is saying that Diamond Walnut is claiming walnuts as drugs on package labels. How so?

The labels say the omega-3 fatty acids in walnuts may help lower cholesterol; protect against heart disease, stroke and some cancers (e.g. breast cancer); inhibit tumor growth; ease arthritis and other inflammatory diseases; and even fight depression and other mental illnesses. These are disease claims for which the FDA requires scientific substantiation.

The company’s petition did not provide that substantiation so the FDA issued a warning letter. In general, you should be skeptical any time you see a nutritional factor advertised for its ability to prevent or treat such a broad range of problems.

Q. A question about sugar and how it is counted: My books say: 4 g = 1 teaspoon = 15 calories. My Illy Caffe says 10 g of sugar, but 50 calories. Ingredients: coffee, sugar, potassium bicarbonate, potassium citrate. If the drink is 50 calories, shouldn’t it say 12 g or more for the sugar listing?

A. Sugar should be the only ingredient that has calories in this coffee but I’ve seen calorie lists that say 5 calories per gram for sugars. Food companies have some leeway in the way they compute calories. Illy may be using a method that gives 5 rather than 4. But the difference between 40 and 50 is hardly measurable and I wouldn’t worry about amounts this small, annoying as imprecise figures may seem.

 My monthly (first Sunday) Food Matters column is in answer to a question about the deeper meaning of the fuss over McDonald’s “healthier” Happy Meals.

Q: Wouldn’t it be the best form of activism to encourage people to buy McDonald’s slightly-less-bad-for-you Happy Meals? If the new formulation flops, do you really think McDonald’s will take more baby steps in the same direction? Aren’t you letting perfect be the enemy of the good?

A: The question, for those of you ignoring national media, refers to McDonald’s announcement that it plans to restructure its Happy Meals for kids by adding fruit, downsizing the fries and reducing calories by 20 percent and sodium by 15 percent.

Skeptic that I am, I took a look at McDonald’s lengthy press release. The company does not claim to be making healthier changes. It says it is offering customers improved nutrition choices. This is something quite different.

At issue is the default meal – the one that gets handed to you without your having to ask for anything. Plenty of research shows that although customers can request other options, most take the default. So the default is what counts.

McDonald’s says its new default will include a quarter cup of apple slices (how many slices can that be?), less sodium and 1 ounce less of french fries (thereby reducing calories and fat). These are steps in the right direction, but tiny baby steps.

The rest is up to you: hamburger, cheeseburger or McNuggets.

As for beverage, the press release says, “McDonald’s will automatically include produce or a low-fat dairy option in every Happy Meal.”

This sounds great. “Automatically” makes me think the default Happy Meal will come with low-fat milk. No such luck. It’s up to you to choose from soda or low-fat chocolate or plain milk.

Want something healthy? You have to ask for it. And the meal still comes with a toy, although the meal isn’t healthy enough to qualify for a toy under the San Francisco’s nutrition standards, which are scheduled to go into effect in December.

The McNuggets meal meets the San Francisco standard for sodium, overall calories and for saturated fat – if you choose low-fat white milk. It fails the other criteria. Fat provides about 40 percent of the calories (the standard is 35 percent), and fruit misses the mark by 50 percent. The hamburger and cheeseburger meals fare worse. And even if french fries count as a vegetable, they don’t reach the three-quarter-cup standard. Sodas, of course, have too much sugar.

No toy for you, San Francisco kids.

So let’s get back to the underlying question: Isn’t perfect the enemy of the good? Aren’t baby steps like these in the right direction and, therefore, deserving of support?

I don’t think so. McDonald’s proposed changes are a reason to ask a different question: Is a better-for-you Happy Meal a good choice? Wouldn’t your child be better off eating something healthy, not just slightly healthier?

Couldn’t McDonald’s, the largest fast-food maker in the world, come up with something genuinely healthy that also tastes good?

“Better for you” is a marketing ploy, and McDonald’s must need help. Although its annual sales are $24 billion from its 14,000 outlets in the United States, Happy Meals have not been doing well.

Business analysts attribute declining sales since 2003 to the unsophisticated toys. Toys are the only reason kids want Happy Meals, but more parents are ordering adult meals and splitting them with the kids. But what if Happy Meals appear healthier?

Let’s be clear: McDonald’s is not a social service agency. It is a business. Its business interests come first. This means selling more food to more people more often, viewing food choice exclusively as a matter of personal responsibility and pretending that the company’s $1.3 billion annual marketing expenditure has no effect on consumer choice.

I suspect McDonald’s actions are attempts to appease Michelle Obama’s healthy eating campaign and perhaps to attract health-minded families to its outlets.

But surely the changes are also part of a calculated public relations effort to discourage other communities from enacting nutrition standards like those in San Francisco.

What McDonald’s actions make clear is the need for federal action to make it easier for people to make healthier choices for their kids. This means putting some curbs on marketing below-standard foods to kids and insisting that default kids menus be healthy.

If McDonald’s were serious about promoting kids’ health, it would offer default Happy Meals that meet San Francisco’s nutrition standards and advertise them to the hilt. Until the company does that, I’m reserving applause.

Marion Nestle is the author of “Food Politics,” among other books, and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com.

This article appeared on page G – 4 of the San Francisco Chronicle

I got several calls this week about a new study from the University of Washington arguing that because of the way foods are subsidized, it will cost everyone nearly $400 a year to follow the recommendations of the government’s MyPlate food guide. 

The Seattle group calculates the cost of food per calorie.  By this measure, the price of fruits and vegetables is exceedingly high compared to the cost of junk food.  Fruits and vegetables do not have many calories for their weight.

The Commerce department tracks the indexed price of foods.  Its data show that the indexed price of fresh produce increased by 40% ince 1980 whereas the price of sodas and processed foods has declined by 10-30%.  (The easiest place to see their charts is in New York Times articles from a couple of years ago.  Click here and also here).

USDA economists have produced a similar chart:

 

Other USDA economists, however, argue that price trends for fruits, vegetables, and junk foods are really no different, and that the data shown in the figure overstate the apparent difference.

Nevertheless, the Seattle paper got a lot of attention, and rightly so.  One of my calls was from David Freeman of CBS News who said he was hearing lots of complaints that the study promoted a “nanny state” because it blamed bad eating habits on the government.  My quotes:

“It’s a common misconception that food choices are solely a matter of personal responsibility,” Dr. Marion Nestle, professor of nutrition, food studies, and public health at New York University and an outspoken critic of the fast food industry, told CBS News. “People are hugely influenced by the price of food. If you don’t have any money and go into the store to buy some fresh fruits, you might decide that it’s cheaper to have a couple of fast food hamburgers.”

And those who can afford healthy food may lack the time or the necessary food-preparation skills, Dr. Nestle said.

Government-sponsored cooking classes and kitchen equipment may not be in the offing. But Dr. Monsivais and Dr. Nestle agreed that federal agriculture policies could do more to encourage healthy eating. For example, some of the federal farm subsidies now directed to producers of corn, soybeans, and other crops used to make fast and processed foods could be redirected to growers of fruits and vegetables.

“What’s the matter with that?” Dr. Nestle said. “I can’t think of a thing.”

I’m in the midst of working on the copy-edited manuscript of my forthcoming book with Malden Nesheim Why Calories Count: From Science to Politics (University of California Press, March 2012) and spending every minute I have on it.  So I’m going to take some shortcuts on the blog this week and deal with some questions I’ve been asked recently.

One is right on the topic of the book:

Q.  Could you address the 2,000 calorie a day number (both its history and speculate on how an individual can arrive at a more personalized amount)? Short of metabolic testing (and I read conflicting opinions on that, too), it seems rather difficult to figure out how much I should be eating.

A.  Nothing could be easier, and here’s a preview of the kind of thing that will be in this book (with footnotes, of course):

If you look at  a food label, you will see ingredient contents compared to a 2,000-calorie average diet: “Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.”

Here’s the history of where that came from:

The FDA wanted consumers to be able to compare the amounts of saturated fat and sodium to the maximum amounts recommended for a day’s intake—the Daily Values.  Because the allowable limits would vary according to the number of calories consumed, the FDA needed benchmarks for average calorie consumption, even though calorie requirements vary according to body size and other individual characteristics.

From USDA food consumption surveys of that era, the FDA knew that women typically reported consuming 1,600 to 2,200 calories a day, men 2,000 to 3,000, and children 1,800 to 2,500. But stating ranges on food labels would take up too much space and did not seem particularly helpful. The FDA proposed using a single standard of daily calorie intake—2,350 calories per day, based on USDA survey data. The agency requested public comments on this proposal and on alternative figures: 2,000, 2,300, and 2,400 calories per day.

Despite the observable fact that 2,350 calories per day is below the average requirements for either men or women obtained from doubly labeled water experiments, most of the people who responded to the comments judged the proposed benchmark too high. Nutrition educators worried that it would encourage overconsumption, be irrelevant to women who consume fewer calories, and permit overstatement of acceptable levels of “eat less” nutrients such as saturated fat and sodium. Instead, they proposed 2,000 calories as:

• consistent with widely used food plans
• close to the calorie requirements for postmenopausal women, the population group most prone to weight gain
• a reasonably rounded-down value from 2,350 calories
• easier to use than 2,350 and, therefore, a better tool for nutrition education

Whether a rounding down of nearly 20 percent is reasonable or not, the FDA ultimately viewed these arguments as persuasive. It agreed that 2,000 calories per day would be more likely to make it clear that people needed to tailor dietary recommendations to their own diets. The FDA wanted people to understand that they must adjust calorie intake according to age, sex, activity, and life stage. It addressed the adjustment problem by requiring the percent Daily Value footnote on food labels for diets of 2,000 and 2,500 calories per day, the range of average values reported in dietary intake surveys.

 As to how many calories you personally need, I think they are too difficult for most people to count accurately to bother.  The bottom line: If you are eating too many, you will be gaining weight.   

The best advice I can give is to get a scale and use it.  If your weight starts creeping up, you have to eat less.

The book will go into far more explanation of such issues but for that you will have to wait until March.

The Wall Street Journal says you can.  If a Murdoch paper says so, it must be true.  I’ve got ripe tomatoes on my terrace.  But here’s serious urban farming in the Bronx.  Is local food a fad?  I don’t think so.

The Berkeley group that organized a contest to redesign the food label has picked its top choices from among 24 entries.   Take a look at them on that site and vote for your favorite by midday Sunday.

Tara Parker-Pope has a nice summary on her New York Times blog along with interviews with the judges.  Lily Mihalik, cocreator of the project explains:

We asked food thinkers and design minds to come together and give advice on how they might rethink the food label and bring some insight into how design impacts choice…There are a lot of things right with the current label, but at the same time people are confused. The question is whether a new nutrition facts label could help people make more educated decisions.

Good question.  My take is that most of the entries are even more complicated than the current Nutrition Facts label and leave out a lot of useful things you might like it to do:

• State the content of calories per serving
• State the serving size
• State the content of nutrients of interest per serving (opinions can vary as to which are worth listing)
• Compare those levels to standards for daily intake
• Explain how those levels apply to a typical day’s diet
• Indicate how the food fits into diets that vary in calorie intake
• List ingredients
• List allergens
• Be accurate, noticable, understandable, and usable

Overall, the label is supposed to help consumers make more healthful food choices.  It also has to fit on food packages.

As several of the entries suggested, it would also be helpful if the label could indicate the degree of processing.  Actually, you can figure that out now by looking at the ingredient list.  Count the ingredients, see if you can pronounce them, and make sure they are recognizable as food.

If anything, this project demonstrates how difficult it is to develop a design that addresses all of these issues.   The January 6, 1993 Federal Register notice that announced the Nutrition Facts label takes up nearly 900 pages.

That notice reviewed the research that led to the current label.  The review makes it clear that nobody understood any of the available design options.   The FDA, under great pressure to meet a deadline set by Congress, chose the design that was least poorly understood.

Hence the FDA’s web pages devoted to explaining how to read and interpret the Nutrition Facts label, and its even lengthier web guide to the food industry on how to create the labels.

The FDA is currently doing the preparatory work for an eventual revision of the label, so these designs come at an opportune time.  Take a look and see what you think of them. 

The designers were brave to take this on. 

And so is the FDA.

I have received numerous complaints from readers about the increasingly hostile, aggressive, rude, and uncivil tone of some of the comments to this site.

I have not been censoring comments because I would like the site to be a forum for a wide range of opinions about matters related to food politics.  I know that people are passionate about their beliefs, and I do not take comments personally.

And for reasons of time and technical challenge, I have been reluctant to intervene.

But because I now understand that the tone of the comments is adversely affecting readers, I am calling for civility.

Societies set rules for civil behavior for a reason.  Lack of civility leads to hate and undermines democracy.

I do not want this site to contribute to the uncivil discourse that has become so common in our society.

No matter how strongly you feel about food politics issues, I expect your comments–whether aimed at me, other readers, or anyone else—to be offered thoughtfully, respectfully, and with an appropriate degree of civility.

I will delete comments that do not adhere to this expectation.

I thank all of you who have weighed in with your concerns about this and other issues.  Keep talking, please.

 

 

 

McDonald’s sent out a press release yesterday to announce “healthier” changes to its Happy Meals.

Healthier?  Not quite.  The company is announcing a “Commitment to Offer Improved Nutrition Choices” [my emphasis].

The comprehensive plan aims to help customers — especially families and children — make nutrition-minded choices whether visiting McDonald’s or eating elsewhere.

Menu changes underway include the addition of more nutritionally-balanced choices that meet McDonald’s reputation for great taste and affordability, along with an increased focus on providing nutrition information that enable customers and employees to make simple, informed menu decisions.

McDonald’s says that by the end of this year it will automatically include produce or a low-fat dairy option in every Happy Meal.  It will:

• Automatically include both produce (apple slices, a quarter cup or half serving)
• Automatically include a new smaller size French fries (1.1 ounces)
• Automatically reduce the sodium by 15% or more

I emphasize “automatically” because it means the default. If you order a Happy Meal, that’s what you get.   Research shows that most people stick with the default. If the default is a healthy meal, kids have a better chance of getting one.

Everything else is your choice:

• Hamburger, Cheeseburger or Chicken McNuggets.
• “Beverage, including new fat-free chocolate milk and 1% low fat white milk”

The press release says: “McDonald’s will automatically include produce or a low-fat dairy option in every Happy Meal.”

Doesn’t that sound like the Happy Meal will come with low-fat milk?

Wrong.

The meal comes with a choice of a soda or low-fat chocolate or white milk.  Soda remains an option.  And the meal still comes with a toy.

So all the fuss—and McDonald’s has gotten huge press over this—is about 3 or 4 small slices of apples, one ounce less of French fries, and less sodium.

The New York Times’ summary:

These may be steps in the right direction, but I’d call them tiny baby steps.

So what’s going on here? Much of this is about responding to Michelle Obama’s call for action on childhood obesity.

But according to the Wall Street Journal, business matters may also be at stake. Happy Meals account for less than 10% of McDonald’s U.S. sales, but sales have been declining since 2003 for a funny reason: “gadgets for children have become more sophisticated and the toys less desirable.”  Of course the only reason kids want Happy Meals is for the toys.

But kids have to eat.  Instead of Happy Meals, parents have been

ordering adult-size items off the ‘dollar menu’ and splitting them between two children rather than buying two kids’ meals.

Kids’ meal orders at fast-food restaurants have declined 15% since 2006 to just under a billion, while dollar-menu items ordered by or for kids have increased 29% in the last five years.

The Wall Street Journal quotes a restaurant consultant who comments that

Making [apples] a forced decision is a pretty unusual thing for a restaurant to do…If they can get to a place where parents associate them with healthy offerings in a world of increasing fast casual options that are perceived as healthier, that will be good for them.

But will it? McDonald’s tested healthier meals with disappointing results.  So this has to be about McDonald’s trying to appear to do something to promote kids’ health. In reality, it can’t. McDonald’s is a business and its business interests come first.

If McDonald’s were serious, it could offer a truly healthier Happy Meal as the default and back it up with marketing dollars.  When the company does that, I’ll cheer.  Until then, as I told the Times, “I’m not impressed.”