I just got off a subway car adorned with posters advertising the New York City Health Department’s “Are you pouring on the pounds?” campaign.  They are riveting.

They make a simple point, but one that is not always understood:  Soft drinks contain sugar, and lots of it.

Lots of sugar—all those packets—will make you fat.

The campaign also includes a tough video.

New York City’s Health Department is taking on the city’s high rates of heart disease and type 2 diabetes in every way it can.

Take a look.  What do you think?  Will this work?

I’ve been asked repeatedly this week to comment on the huge press outcry about a study that links diet sodas to an increased risk of stroke and heart disease.

I have not seen the study and neither has anyone else. It is not yet published.

It was presented at the American Stroke Association’s International Stroke Conference 2011.  The American Heart Association has a short summary on its website.  And Rosie Mestel has an excellent account in the Los Angeles Times.

Here’s what I can glean from the limited information available:

• The study started in 2003.  It was designed to determine risk factors for heart disease and stroke in a multi-ethnic New York City population.
• It used a food frequency questionnaire to ask about 2,500 people how often they drank diet sodas (among many other questions).
• Nine years later, it assessed rates of stroke and heart disease.
• The result: people who said they habitually drank diet sodas had a 60% higher rate of stroke and heart attacks.
• They had a 48% higher rate when the data were controlled for contributing factors: age, sex, race, smoking, exercise, alcohol, daily calories, and metabolic syndrome.

That is all we know.

Does this study really mean that “diet soda may not be the optimal substitute for sugar-sweetened beverages for protection against vascular outcomes,” as the lead author is quoted as saying?

As Rosie Mestel puts it:

It’s worth noting, as some scientists did, that this is a link, not proof of cause and effect. After all, there are many things that people who slurp diet sodas every day are apt to do – like eat a lousy diet — and not all of these can be adjusted for, no matter how hard researchers try. Maybe those other factors are responsible for the stroke and heart attack risk, not the diet drinks. (Those who drink daily soda of any stripe, diet or otherwise, are probably not the most healthful among us.)

Leaving questions about the accuracy of dietary information obtained by questionnaire, the study raises more important questions:

1. Could this finding simply be a statistical result of a “fishing expedition?”  The food frequency questionnaire undoubtedly asked hundreds of questions about diet and other matters.  Just by chance, some of them are going to give results that look meaningful.  The increase in stroke risk seems astonishingly high and that also suggests a need for skepticism.
2. What is the mechanism by which diet sodas lead to stroke or heart disease?  I can’t think of any particular reason why they would unless they are a marker for some known risk factor for those conditions.

Please understand that I am no fan of diet sodas.  I don’t like the metallic taste of artificial sweeteners and they are excluded by  my “don’t eat” rule: never eat anything artificial.

But before I believe that this study means that artificial sweeteners cause cardiovascular problems, I want to see a study designed to test this particular hypothesis and a plausible biological reason for how diet sodas might cause such problems.

The 2010 edition of the dietary guidelines appeared on January 31.  Since then, FoodNavigator-USA, an online daily newsletter for the food industry, says it has been gathering reactions and taking a look at how the guidelines are likely to affect food and beverage companies.   Here are its reports.

‘Eat less’: A difficult message for industry: The new dietary guidelines give the food industry the clearest map yet of what is necessary for a healthy diet – but no one is fooled by assertions that industry is already in line.

2010 Dietary Guidelines: Opportunity for continued industry innovation: In this guest article, Melissa Musiker of the Grocery Manufacturers Association says that the 2010 Dietary Guidelines are an opportunity for industry to find better ways to innovate, as part of a collective responsibility to improve American diets.

How the 2010 guidelines affect food technologists:  The 2010 Dietary Guidelines’ new focus on reducing energy intake will present major reformulation challenges for food technologists, says the Institute of Food Technologists’ (IFT) president-elect.

Politics too influential in new Dietary Guidelines, says nutrition expert [that would be me]:  The new Dietary Guidelines for Americans are still too heavily influenced by political interests – but the initial consumer messaging was ‘fantastic’, according to nutrition and public policy expert Marion Nestle.

‘Total diet’ in the 2010 Dietary Guideline: The latest version of the Dietary Guidelines for Americans includes a new focus on the importance of total diet. FoodNavigator-USA spoke to Cynthia Harriman of Oldways to get the perspective of the organization behind the Mediterranean diet pyramid.

USDA releases 2010 Dietary Guidelines for Americans: The US Department of Agriculture (USDA) has updated the Dietary Guidelines for Americans for the first time since 2005, with a number of small changes that could make a big difference for the food industry.

Industry welcomes USDA Dietary Guidelines supplements shift: The US dietary supplements industry has welcomed the 2010 Dietary Guidelines for Americans which demonstrated a thawing in attitude toward supplements use from a Guidelines committee that has previously balked at recommending them.

Mrs. Obama’s Let’s Move campaign is one year old and people are asking me whether it has accomplished anything.  I think it has.

• It has brought childhood obesity to public attention, as never before.
• The choice of action areas—fixing school food and getting supermarkets into inner city food deserts—makes excellent sense.  Both are doable and both can make a real difference to kids and their families.
• Encouraging the makers of packaged foods to reduce salt and sugar and to stop blatant marketing to kids brings attention to their worst practices.
• And now, according to the New York Times, Mrs. Obama is talking to restaurant companies about serving healthier foods, especially to kids.

This last one warms my heart.  Six or seven years ago, I was invited to speak to a small group of owners of restaurant chains, Applebee’s, Darden’s, and the like.  I went with a three-point agenda:

• Make healthy kids’ meals the default.
• Give a price break to encourage people to order smaller portions (charge 70% for a 50% portion, for example).
• And stop funding the Center for Consumer Freedom (an aggressive PR firm that does the dirty work for restaurant and other industries).

The response?  Ballistic. “What are you trying to do, put us out of business?”

Well, times have changed.  Some of those chains are actually doing some of these things.  And now the First Lady is urging them to do the first two points on my agenda, at least.

Mrs. Obama has no legislated power.  She only has the power of leadership and persuasion.  I’m glad she’s using it to promote action on childhood obesity, challenging as that is.

Happy birthday!

I write a monthly first-Sunday column for the San Francisco Chronicle. This one is on the latest Dietary Guidelines.

Dietary Guidelines try not to offend food industry

Sunday, February 6, 2011

Q: What do you think of the new Dietary Guidelines that were announced earlier this week? Is there anything very new or different? And how important are these guidelines, anyway?

A: I was stunned by the first piece of the 2010 Dietary Guidelines for Americans that I saw online (dietaryguidelines.gov): “Enjoy your food, but eat less.”

Incredible. The federal government finally recognizes that food is more than just a collection of nutrients? It finally has the nerve to say, “Eat less?”

But this statement and others directed to the public do not actually appear in the guidelines. That document repeats the same principles that have appeared in dietary guidelines for decades.

The 2010 guidelines just state them more clearly. (For the news story on the guidelines, go to sfg.ly/gdgsc0.)

Obesity prevention

Its 23 recommendations are aimed at obesity prevention. They focus on eating less and eating better. “Eat better” guidelines suggest eating more vegetables, fruits, whole grains, low-fat milk, soy products, seafood, lean meats and poultry, eggs, beans, peas, nuts and seeds – all are foods.

But the “eat less” advice is about nutrients: sodium, saturated fat, cholesterol and trans fats. The guidelines even coin a new term for the “eat less” nutrients of greatest concern: “solid fats and added sugars,” annoyingly abbreviated as SoFAS.

Here is one SoFAS guideline: “Limit consumption of … refined grain foods that contain solid fats, added sugars, and sodium.”

Nutrient-based guidelines require translation. You have to delve deeply into the 95-page document to find the food translations. Eat fewer solid fats? This means cakes, cookies, pizza, cheese, processed and fatty meats, and, alas, ice cream. Less sugar? The major sources are sodas, sports drinks, energy drinks and fruit drinks.

Why don’t the guidelines just say so? Politics, of course.

Official policy

Dietary guidelines are an official statement of federal nutrition policy. They influence everything the government says and does about food and nutrition. The guidelines determine the content of school meals, the aims of food assistance programs and the regulation of food labeling and advertising.

But their most powerful effect is on the food industry.

Why? Because advice to eat less is very bad for business.

Banal as their recommendations may appear, dietary guidelines are hugely controversial. That is why I was so surprised by “Enjoy your food, but eat less.”

Consider the history. In 1977, a Senate committee chaired by George McGovern issued dietary goals for the United States. One goal was to reduce saturated fat to help prevent heart disease. To do that, the committee advised “reduce consumption of meat.”

Those were fighting words. Outraged, the meat industry protested and got Congress to hold hearings. The result? McGovern’s committee reworded the advice to “choose meats, poultry and fish which will reduce saturated fat intake.”

This set a precedent. When the first dietary guidelines appeared in 1980, they used saturated fat as a euphemism for meat, and subsequent editions have continued to use nutrients as euphemisms for “eat less” foods.

Then came obesity. To prevent weight gain, people must eat less (sometimes much less), move more, or do both.

This puts federal agencies in a quandary. If they name specific foods in “eat less” categories, they risk industry wrath, and this is something no centrist-leaning government can afford.

Eat less, move more

So the new guidelines break no new ground, but how could they? The basic principles of diets that protect against chronic disease do not change. Stated as principles, the 2010 dietary guidelines look much the same as those produced in 1980 or by the McGovern committee.

In my book, “What to Eat,” I summarize those basic principles “eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.” Michael Pollan manages this in even fewer words: “Eat food. Mostly plants. Not too much.”

Everything else in the guidelines tries to explain how to do this without infuriating food companies that might be affected by the advice. And the companies scrutinize every word.

The soy industry, for example, is ecstatic that the guidelines mention soy products and fortified soy beverages as substitutes for meat and as protein sources for vegetarians and vegans.

The meat industry is troubled by the suggestion to increase seafood, even though the guidelines suggest meal patterns that contain as much meat as always.

The salt recommendation – a teaspoon or less per day, and even less for people at risk for high blood pressure – is unchanged since 2005, but stated more explicitly. The salt industry reacted predictably: “Dietary guidelines on salt are drastic, simplistic and unrealistic.”

In a few months, a new food guide will replace the old pyramid. Thanks to a law Congress passed in 1990, dietary guidelines must be revisited every five years. Expect the drama over them to continue.

But for now, enjoy your food.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

This article appeared on page H – 3 of the San Francisco Chronicle

I’ve been asked to explain my brief appearance on the Colbert Report (so brief, that if you blinked, you missed it).  On February 1, Colbert did a “Thought for Food” piece about Walmart’s recent food initiatives.

What was I doing there?  Colbert used a clip from an ABC News interview from January 20.  I was away from NYU that day and taped the interview in a studio at Cornell University.

And once again, here’s my NPR interview with Robert Siegel on All Things Considered about the Walmart announcement.

I’m eager to see how the Walmart promises get put into action.

Enjoy the weekend!

I’m still trying to understand how it happened that USDA’s plan for peaceful coexistence among growers of alfalfa—genetically modified (GM), industrial (but not GM), and organic (definitely not GM))—failed so miserably.  It was the first time that USDA seemed to be recognizing the legitimacy of complaints that GM crops are contaminating organic crops.  I thought this was a food step forward.

But the USDA ended up approving GM alfalfa with no restrictions—just promises to study the matter.

I’ve now seen some explanations that not only make sense, but also shed considerable light on how agricultural politics works in Washington these days.

Sam Fromartz, author of Organic, Inc, writes on his blog that after USDA’s decision:

The only appeasement the USDA offered were panels on studying ways to prevent contamination from occurring in the future. But this seems akin to studying ways to protect a forest after loggers have been allowed to cut down the trees.

The decision was a stunning reversal of a more measured approach that Vilsack appeared to be taking in December, when the USDA talked about considering the impact of the GM crop on other sectors of agriculture. But that was before he faced an uproar by the GM industry and the editorial page of the Wall Street Journal for playing nice with organic farmers.

Gary Hirshberg, in response to heavy criticism that he sold out to Monsanto, writes on the Huffington Post:

Stonyfield is absolutely and utterly opposed to the deregulation of GE crops. We believe that these crops are resulting in significantly higher uses of toxic herbicides and water, creating a new generation of costly “super” weeds, pose severe and irreversible threats to biodiversity and seed stocks, do not live up to the superior yield claims of their patent holders and are unaffordable for small family farmers in the US and around the world.

We believe that organic farming methods are proving through objective, scientific validation to offer far better solutions. We also believe that unrestricted deregulation of GE crops unfairly limits farmer and consumer choice.

…From the outset of these stakeholder discussions, it was clear that GE alfalfa had overwhelming political, legal, financial and regulatory support, and thus the odds were severely stacked against any possibility of preventing some level of approval, just as has been the case with GE cotton, soy, canola and corn.

Keep in mind that, according to Food and Water Watch, biotech has spent more than half a billion dollars ($547 million) lobbying Congress since 1999. Their lobby expenditures more than doubled during that time. In 2009 alone they spent $71 million. Last year they had more than 100 lobbying firms working for them, as well as their own in-house lobbyists.

In an interview with Food Chemical News (Feb 3), Andrew Kimbrell, executive director of the Center for Food Safety,  one of the groups leading the opposition to GM alfalfa:

describes USDA’s promises as a “stale gesture” toward organic and other industry groups that had worked with the department on its proposed option for partial deregulation of RR alfalfa. He speculates that USDA was prepared to go down the partial deregulation route but was “shot down at the White House level….

“It’s not about organic and GMOs,” Kimbrell continues. “The real losses are not with organic crops but with conventional crops,” such as rice commingled with Bayer’s authorized LibertyLink 601 variety and corn commingled with the StarLink variety. “The growers can’t sell their crops to Europe or Asia. The issue is how do we keep GMOs from contaminating conventional crops such as rice, corn and now alfalfa?”

Food and Water Watch, another leading group on this issue and the source of the lobbying data in Hirshberg’s comments,  points out that the USDA’s decision to allow unrestricted planting of GM alfalfa is not likely to be an isolated case.  The FDA is currently considering approval of GM salmon, and its decision is expected soon.

Both organizations are organizing protests on their websites, but this is how agricultural politics works these days.

In an article about fast food marketing, the Los Angeles Times explains as clearly as could be why Dietary Guidelines matter so much.  The article is titled “Eat less, U.S. says as fast-food chains super-size their offerings.”

Why would fast food chains want to offer hot dogs, hamburgers, and burritos ranging from 800 t0 1,600 calories each?  How’s this for a candid answer:

The bottom line is we’re in the business of making money, and we make money off of what we sell,” said Beth Mansfield, spokeswoman for CKE Restaurants Inc., which owns the Carl’s Jr. and Hardee’s chains. “If we wanted to listen to the food police and sell nuts and berries and tofu burgers, we wouldn’t make any money and we’d be out of business.

You want to help people stay healthy?  That makes you food police.

If you care about public health, you can expect to be called names.  But that shouldn’t stop you from trying to create a healthier food system.

And thanks to Sheila Viswanathan of the GoodGuide for sending the article.