Thanks to Matthew Kadey for sending this one.  Matcha is a new one for me.

The study: Matcha green tea beverage moderates fatigue and supports resistance training-induced adaptation.  Shigeta M, et al.  Nutrition Journal volume 22, Article number: 32 (2023)

Methods: Healthy, untrained men were randomized into placebo and matcha groups. Participants consumed either a matcha beverage containing 1.5 g of matcha green tea powder or a placebo beverage twice a day and engaged in resistance training programs for 8 (trial 1) or 12 weeks (trial 2).

Increasingly and more urgently concerned about the effects on children of unrestricted marketing of unhealthy foods and beverages, UNICEF and WHO have produced an invaluable manual on why and how governments must act to curb such marketing.

This is a follow up to the UNICEF report I talked about last week on engagement with food and beverage companies and to the WHO recommendations I posted about yesterday.

WHO and UNICEF are on a roll!

The rationale for this publication:

Food and beverage companies play a significant role in shaping children’s food environments, but their objectives are profit driven rather than child centred. They have a vested commercial interest in increasing sales of their unhealthy products and use highly immersive, engaging – and often unethical – marketing techniques to target children and their caregivers.
We know that food marketing harms children. It negatively affects children’s food preferences, purchase decisions and consumption behaviours, ultimately contributing to childhood obesity and diet-related disease. Food marketing also affects household purchasing decisions and the types of foods that are eaten in the home.

Among this report’s key messages:

• The evidence is clear that food marketing harms children – especially the poorest and most vulnerable.
• Tackling food marketing is challenging: past experience shows that food companies use loopholes and develop new strategies to bypass restrictions.
• Voluntary schemes are ineffective in reducing children’s exposure to foodmarketing.
• Mandatory regulation has the potential to be the most effective path to protecting children from the harmful impact of food
  marketing

Governments must act.  Now.

This exceptionaly timely and important report explains how.

I posted several examples of industry-funded studies this week in part to reduce my backlog but also because of charges that (1) doing so constitites ad hominem (personal) attacks on authors, (2) I should be focusing on the science, not who paid for it, and (3) I have my own ideological biases.

To the first point:

I do not see industry funding of research as a personal matter.  I see it as a systematic problem.

If I see a study titled “Effect of food product X on disease Y,” I can often guess that

• The food’s manufacturer or trade association paid for it
• The study outcome will be favorable to the funder’s commercial interests

This phenomenon is so systematic that it has a name: The Funding Effect.

To the second point

Researchers who study funding effects, and there are many, note that the scientific conduct of the studies is not usually an issue.  Instead, the influence of the funders shows up in the way the research question is framed or the results are interpreted.

The easiest way to explain the research question bias is to cite the requests for research proposals I often receive from food trade associations.  These say: “we have (this much money) for research to demonstrate the benefits of our product on (one or more of these conditions).”

These groups will not fund research proposals unlikely to show benefits.

As for interpretation, industry-funded studies tend to report null results as positive; I posted several such examples this week.

To the third point

Yes, I have ideological or opinion biases and I try to be as clear as I can about them.  All investigators have such biases; otherwise they wouldn’t be doing science.  We all have something we believe in that we would like to prove.  Such biases are not discretionary; everyone has them.  In contrast, industry funding is about selling products, not science and is completely discretionary; investigators can do science without it.

The evidence?

I review the evidence for what I’ve just said here in my book, Unsavory Truth: How Food Companies Skew the Science of What We Eat.

In it, I cite many other books and papers addressing these points.

We all come to the same conclusions:

• Industry funding biases research.  But funded investigators do not recognize the influence, and deny it.
• The statement that accompanies many disclosure statements—“The funder had no influence on the design, conduct, interpretation, or publication of the results,”—is often untrue and must be taken with some degree of skepticism.

I see industry funding of food and nutrition research as a serious problem for public perception.  Even when the research is not conflicted, it appears conflicted.  That alone is a systematic problem.

Nuts are demonstrably good for health.  They have high proportions of fat and, therefore, calories, and the calories can add up quickly.  But a small handful makes a great healthy snack.

Why their trade associations feel they need to produce favorable research is beyond me, but as far as I can tell, they are all competing with each other for market share.

Here are a few examples of nut studies funded by trade associations to convince you to eat more nuts.

The point: Whenever you see a study showing amazing health benefits from one single food, there’s a good chance its trade association paid for it.

NUTS IN GENERAL

The study: Mixed Tree Nuts, Cognition, and Gut Microbiota: A 4-Week, Placebo-Controlled, Randomized Crossover Trial in Healthy Nonelderly Adults.  J. Nutrition.   VOLUME 152, ISSUE 12, P2778-2788, DECEMBER 2022.  DOI:https://doi.org/10.1093/jn/nxac228

Conclusions: These findings indicate a positive effect of nut on cognition following only 4 wk of consumption in a healthy nonelderly sample, as well as upregulation of a microbial taxa associated with gut health. The effects appear to be independent of one another, but further exploration is required in those experiencing cognitive decline and/or gut dysbiosis.

Funding: This study was supported by funding from the INC (International Nut and Dried Fruit Council).

ALMONDS

The study: Almond intake alters the acute plasma dihydroxy-octadecenoic acid (DiHOME) response to eccentric exercise.  Front. Nutr., 09 January 2023. Volume 9 – 2022 | https://doi.org/10.3389/fnut.2022.1042719.

Conclusions: In general, the elevated post-exercise plasma levels of 12,13-DiHOME with almond intake support positive metabolic outcomes for adults engaging in unaccustomed eccentric exercise bouts. Other almond-related benefits for exercisers revealed in this study include reduced feelings of fatigue and tension, better leg-back strength during recovery, and decreased muscle damage during the first day of recovery.

Funding: This work was supported by Almond Board of California, Modesto, CA. The funder had no role in the study design, data collection, analysis and interpretation, the preparation of the manuscript, or in the decision to submit the article for publication.

MACADAMIAS

The study: Macadamia nut effects on cardiometabolic risk factors: a randomised trial  J Nutr Sci. 2023.

Conclusion: Daily consumption of macadamia nuts does not lead to gains in weight or body fat under free-living conditions in overweight or obese adults; non-significant cholesterol lowering occurred without altering saturated fat intake of similar magnitude to cholesterol lowering seen with other nuts.

Funding: This study was funded by Hort Innovation, Sydney, Australia (Project code MC17005).  J. J., K. O. and F. M. – None; J. S., S. R. and C. H. have received research funding through their institution from Hort Innovation, Sydney, Australia.  Note: Hort Innovation is a grower-owned, not-for-profit research and development corporation with the goal of creating value for horticulture growers and those across the horticulture supply chain. It invests more than $120 million in R&D, marketing and trade programs on behalf of industry.

PEANUTS

The study:  Urinary Phenolic Metabolites Associated with Peanut Consumption May Have a Beneficial Impact on Vascular Health Biomarkers. Antioxidants. 2023; 12(3):698. https://doi.org/10.3390/antiox12030698.

Conclusion:  the present study shows for the first time that regular peanut and peanut butter consumption could have a positive impact on vascular biomarkers in healthy young adults.

Funding: This research was supported by funding from the Peanut Institute

Thanks to Arjan van Groningen for this one.

The study:  The Effect of Non-Nutritive Sweetened Beverages on Postprandial Glycemic and Endocrine Responses: A Systematic Review and Network Meta-analysis. Zhang, R.; Noronha, J.C.; Khan, T.A.; McGlynn, N.; Back, S.; Grant, S.M.; Kendall, C.W.C.; Sievenpiper, J.L. Nutrients 2023, 15, 1050. https://doi.org/10.3390/nu15041050.

Conclusions: The available evidence suggests that NNS beverages sweetened with single or blends of NNS have no acute metabolic and endocrine effects, similar to water. These findings provide support for NNS beverages as an alternative replacement strategy for SSBs in the acute postprandial setting.

Funding: This work was supported by an unrestricted grant from the Institute for the Advancement of Food and Nutrition Sciences (IAFNS). The grant was awarded through a competitive request for the proposal process. The sponsor was not involved in the development of the study protocol and design, execution, analyses, interpretation of the data, or decision to publish. The protocol and results were presented to the Low- And No-Calorie Sweeteners Scientific Committee of IAFNS on several occasions with an opportunity for scientific dialogue.

Comment:  IAFNS is the new name for ILSI North America, a classic industry front group.  To its credit, the authors disclose the involvement of IAFNS in this review.  Check out the Conflict-of-Interest declarations from this group; they are legendary.

Conflicts of Interest: J.C.N. has worked as a clinical research coordinator at INQUIS Clinical Research. He has also received research support from Glycemia Consulting Inc. T.A.K. 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 honorariums for lectures from the International Food Information Council (IFIC) and the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America). He is funded by the National Honey Board. N.M., was a former employee of Loblaw Companies Limited, and is a 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. S.M.G. has received honoraria from Dietitians of Canada and Diabetes Canada for the development and delivery of educational resources on the glycemic index in the past five years. C.W.C.K has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), the Almond Board of California, Barilla, the Canadian Institutes of Health Research (CIHR), the Canola Council of Canada, the International Nut and Dried Fruit Council, the 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, the CaliforniaWalnut 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 Barilla, the CaliforniaWalnut Commission, the Canola Council of Canada, General Mills, the International Nut and Dried Fruit Council, the 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, the McCormick Science Institute, and Oldways Preservation Trust. He is a founding member of the International Carbohydrate Quality Consortium (ICQC), the Chair of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD, and is a Director of Glycemia Consulting and the  Toronto 3D Knowledge Synthesis and Clinical Trials foundation. J.L.S. has received research support from the Canadian Foundation for Innovation, the Ontario Research Fund, the Province of Ontario
Ministry of Research and Innovation and Science, the Canadian Institutes of health Research (CIHR),  Diabetes Canada, the American Society for Nutrition (ASN), the International Nut and Dried Fruit Council (INC) Foundation, the National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America), Pulse Canada, the Quaker Oats Center of Excellence, the United Soybean Board (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 which has received contributions from IFF), and the Nutrition Trialists Network 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, the California Walnut Commission, the Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone, Nutrartis, 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, Nutrition Communications, the International Food Information Council (IFIC), the Calorie Control Council, the International Sweeteners Association, and the International Glutamate Technical Committee. 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, the European Association for the study of Diabetes (EASD), the Canadian Cardiovascular Society (CCS), 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), an Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev. R.Z. and S.B. have no conflicts of interest to declare.

I have been sent so many examples of industry-funded studies that I can’t keep up with them.  This is a slow news week and I’m traveling, so how about I post several.  Here’s the first.

My thanks to Katie Iwanowski for sending this one.

The study: The Relationship of Ready-to-Eat Cereal Intake and Body Weight in Adults: A Systematic Review of Observational Studies and Controlled Trials Lisa M. Sanders, Mary R. Dicklin, Yong Zhu, Kevin C. Maki.  Advances in Nutrition, Volume 14, Issue 4, 2023, Pages 671-684.  https://doi.org/10.1016/j.advnut.2023.05.001.

Results:  RTEC[Ready to Eat Cereal] consumers (2 – 4 servings a week), as compared with non- and less frequent consumers have lower BMI, lower prevalence of overweight/obesity, less weight gain over time,  less anthropometric evidence of abdominal adiposity.

Conclusions:

• RTEC may be used as a meal or snack replacement as part of a hypocaloric diet, but this approach is not superior to other options for those attempting to achieve an energy deficit.
• RTEC consumption was not associated with significantly less loss of body weight, or with weight gain, in any of the RCTs.
• RTEC intake is associated with favorable body weight outcomes in adults in observational studies.
• RTEC does not hinder weight loss when used as a meal or snack replacement within a hypocaloric diet.

Funding: This research was funded by Bell Institute of Health and Nutrition, General Mills Inc. The funding sponsor commented on the study design’s early aspects, reviewed the final data, and provided input to the manuscript.

Author disclosures: LMS is a consulting scientist, and MRD and KCM are employees of Midwest Biomedical Research, which has received research funding from General Mills Inc and Kellogg Company. LMS has received funding from Kellogg Company. YZ is an employee of General Mills Inc.

Comment: This cereal study was funded by a cereal company which—this is quite unusual—disclosed its involvement in the study’s design, interpretation, and writing.  The study results are a classic example of interpretation bias.  Basically, breakfast cereals don’t make much difference to body weight (it’s overall calorie balance that counts), but the conclusions are spun positively.  I especially like the double negative, “not associated with significantly less loss….”

The Food and Agriculture Organization of the U.N. released its annual State of Food Security and Nutrition in the World report last week.  Its conclusions are sobering.

Global hunger is still far above pre-pandemic levels. It is estimated that between 690 and 783 million people in the world faced hunger in 2022. This is 122 million more people than before the COVID-19 pandemic. Nonetheless, the increase in global hunger observed in the last two years has stalled and, in 2022, there were about 3.8 million fewer people suffering from hunger than in 2021. The economic recovery from the pandemic has contributed to this, but there is no doubt that the modest progress has been undermined by rising food and energy prices magnified by the war inUkraine. There is no room for complacency, though, as hunger is still on the rise throughout Africa, Western Asia and the Caribbean.

Ultra-processed foods are a critical part of this story.  The word “processed” comes up 264 times in this report; “highly processed” comes up 99 times .  Some examples:

• Healthy diets are essential for achieving food security goals and improving nutritional outcomes. A healthy diet…is based on a wide range of unprocessed or minimally processed foods, balanced across food groups, while it restricts the consumption of highly processed foods and drink products…Eating a healthy diet throughout the life cycle is critical for preventing all forms of malnutrition, including child stunting and wasting, micronutrient deficiencies and overweight or obesity. It also helps reduce the risk of non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes and certain types of cancer.
• The unfinished agendas to reduce stunting, wasting and micronutrient deficiency, along with rising overweight and obesity, represent the current challenge to address multiple forms of malnutrition. Malnutrition in all its forms is related to poor diets, the rise of low-cost
  nutrient-poor foods and the increasing availability of highly processed foods in rural areas.
• Supply-side factors, including globalized technology in food production, transportation and marketing, coupled with an increase in demand for readily available foods, have contributed to a substantial expansion of supermarkets, hypermarkets, food deliveries and other convenience retailers. However, these are also associated with increased supply and spread of energy-dense and highly processed foods.
• However, urbanization has also contributed to the spread and consumption of processed and highly processed foods, which are increasingly cheap, readily available and marketed, with private sector small and medium enterprises (SMEs) and larger companies often setting the nutrition landscape. Cost comparisons of individual food items and/or food groups from existing studies indicate that the cost of nutritious foods – such as fruits, vegetables and animal source foods – is typically higher than the cost of energy-dense foods high in fats, sugars and/or salt, and of staple foods, oils and sugars.
• The dynamics of supply and demand for processed foods, however, are complex. There has been a surge on the supply side, with small and medium enterprises and large private companies alike making massive aggregate investments in all types of processed foods (from minimally to highly processed) in response to demand. At the same time, aggressive marketing and relatively low pricing – and even interference in policies to curb consumption of highly processed foods and sugar-sweetened beverages – are driving up consumption.

The report emphasizes the importance of food processing in contributing to poor diets and health.

What is to be done?  From the Brief summary:

Leveraging connectivity across the rural–urban continuum will require adequate governance mechanisms and institutions to coordinate coherent investment beyond sectoral and administrative boundaries. To this end, subnational governments can play a key role in designing and implementing policies beyond the traditional top-down approach. Approaches to agrifood systems governance should ensure policy coherence among local, regional and national settings through the engagement of relevant agrifood systems stakeholders at all levels.

I read this as saying what’s need is community-based, bottom up approaches at the local level.  That’s a great place to start.  Go for it.

Resources

• The online report
• The  pdf
• The digital report
• The Brief 
• And see Access to food in 2022: filling data gaps. Results of twenty national surveys using the Food Insecurity Experience Scale (FIES)

The British journal, Public Health Nutrition, published a debate about ultra-processed foods this month.

Invited commentaries

CON:  Michael Gibney.  Ultra-processed foods in public health nutrition: the unanswered questions,

Several definitions of the degree of processing have been proposed. However, when each of these is used on a common database of nutritional, clinical and anthropometric variables, the observed effect of high intakes of highly processed food, varies considerably.. Moreover, assigning a given food by nutritional experts, to its appropriate level of processing, has been shown to be variable. Thus, the subjective definitions of the degree of food processing and the coding of foods according to these classifications is prone to error…Another issue that need[s] resolution is the relative importance of the degree of food processing and the formulation of a processed food. Although correlational studies linking processed food and obesity abound, there is a need for more investigative studies.

PRO: Mark Lawrence.  Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets.  Also an addendum: Ultra-processed foods: a fit-for-purpose concept for nutrition policy activities to tackle unhealthy and unsustainable diets.

This commentary describes the UPF concept as being fit-for-purpose in providing guidance to inform policy activities to tackle unhealthy and unsustainable diets. There is now a substantial body of evidence linking UPF exposure with adverse population and planetary health outcomes. The UPF concept is increasingly being used in the development of food-based dietary guidelines and nutrition policy actions. It challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system. Inevitably, there are politicised debates associated with UPF and it is apparent a disproportionate number of articles claiming the concept is controversial originate from a small number of researchers with declared associations with UPF manufacturers.

Letters to the editor

CON: Mark J Messina, John L Sievenpiper, Patricia Williamson, Jessica Kiel, John W Erdman.  Ultra-processed foods: a concept in need of revision to avoid targeting healthful and sustainable plant-based foods

we take issue with his perspective on our recently published article in which we make two fundamental points. First, the common criticisms of ultra-processed foods (UPF) do not apply to soya-based meat and dairy alternatives more so than they do to their animal-based counterparts, meat and cows’ milk, despite the former being classified as UPF and the latter as unprocessed/minimally processed foods. Second, NOVA is overly simplistic and does not adequately evaluate the nutritional attributes of meat and dairy alternatives based on soya….We therefore stand by our opinion that NOVA does a disservice to the public by suggesting that because soya burgers and soyamilk are NOVA-classified as UPF, they should be avoided. These foods can aid in the transition to and maintenance of plant-based diets.

PRO:  Mark Lawrence. The need for particular scrutiny of claims made by researchers associated with ultra-processed food manufacturers.

In this Commentary, I referred to challenges the UPF concept presents to researchers with declared associations with UPF manufacturers. The interplay between nutrition research and commercial interests is a widely recognised phenomenon in the commercial determinants of health literature…UPF-related research has become highly politicised and the integrity of the claims presented by researchers associated with UPF manufacturers demands close scrutiny.

Comment

In his letter, Mark Lawrence noted my having included the paper by Messina et al as one of my “industry-funded studies of the week” on this website.  In it, I reproduced the unusually long conflict of interest declaration of the authors, many of them disclosing ties to companies making ultra-processed foods.  Again, the ultra-processed concept is backed up by an extraordinary amount of research far beyond the point where it can be ignored or dismissed out of hand.

Professor Lawrence explains why there is so much pushback: “It [the UPF concept] challenges many conventional nutrition research and policy activities as well as the political economy of the industrial food system.”