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.

I have now had time to look at the full report of the 2010 Dietary Guidelines–all 95 pages of what they are calling “the policy document.”

Oh no!  What happened to the Selected Messages for Consumers that I posted yesterday?  “Enjoy your food” is not in it and neither are any of the other clear, straightforward messages.  This is a big disappointment.

Nevertheless, the document is well worth reading.

It addresses my complaints about the executive summary.  It explains the meaning of the annoying SOFAS (solid fats and added sugars).  It discusses the need to improve the food environment.

Let me share a few thoughts about selected issues.

SOFAS

The report translates its advice (pages 62-68).   It translates  “Cut back on foods and drinks with added sugars,” a nutrition euphemism, as:

Drink few or no regular sodas, sports drinks, energy drinks, and fruit drinks.  Eat less cake, cookies, ice cream, other desserts, and candy.  If you do have these foods and drinks, have a small portion.

But it translates “Cut back on solid fats” in yet another euphemism:  “Select lean meats and poultry, and fat-free or low-fat milk and milk products.”  This, no doubt, is to avoid the politically impossible “eat less meat.”

Added sugars

The report lists synonyms for added sugars that you might find on a food label (page 75).  The 2005 Dietary Guidelines included “fruit juice concentrates” on that list.  The 2010 guidelines do not.  The Table lists “nectars” but not fruit juice concentrates.  How come?  It doesn’t say.

Food group patterns

The report describes healthy patterns for diets ranging from 1,000 to 3,200 calories a day.  For a diet containing 2,000 calories, you are only allowed 258 calories a day from SOFAS.  That’s all? One 20-ounce soft drink contains more than that and so does  one tablespoon of butter and a 12-ounce soft drink.  No wonder the guidelines don’t want to be specific about foods when they mean “eat less.”

Sodium

The recommendation to reduce sodium intake to 2,300 or 1,500 mg per day is addressed to the wrong people.  Individuals cannot do this on their own since most salt is already added in restaurant and processed foods.  The report recognizes this:

• Consume more fresh foods and fewer processed foods that are high in sodium.
• Eat more home-prepared foods, where you have more control….
• When eating in restaurants, ask that salt not be added….
  

Vegetarian and vegan diets

The report includes diet plans for lacto-ovo vegetarians and vegans (pages 81 and 82).  Applause, please.  When I was on the dietary guidelines advisory committee in 1995, we tried to say something useful about vegetarian diets but were forced to add something about the nutritional hazards of such diets, minimal as they are.  Not having to do this is a big improvement.  But you too only get 258 calories for SOFAS.

How about changing the food environment?

The report makes it clear that the food environment strongly influences the food choices of individuals, and it urges efforts to

• Improve access to healthy foods
• Empower people with improved nutrition literacy, gardening and cooking skills
• Develop policies to prevent and reduce obesity
• And for kids, fix school meals, encourage physical activity, and reduce screen time

In short, there is plenty to work with here.  You just have to look hard and dig deep to find it.

What is the food industry’s reaction?

Just for fun, I’ve been tracking some of the industry reactions.  The soy people love it.  The report mentions soy along with nuts and seeds in the USDA’s meal patterns (page 79), and soy has its own category in the vegetarian and vegan diets (page 81 and 82).

The meat people don’t love it so much.  They are a little worried that seafood is pushed more than meat, but the American Meat Institute is giving it a nice spin, pointing out that the overall meat recommendation has not changed since 2005.

And the Salt Institute?  “Dietary Guidelines on Salt Drastic, Simplistic, Unrealistic.”

I rest my case.

The 2010 Dietary Guidelines for Americans were just released.  Here are the take-home messages:

Balancing Calories

• Enjoy your food, but eat less.

• Avoid oversized portions.

Foods to Increase

• Make half your plate fruits and vegetables.

• Switch to fat-free or low-fat (1%) milk.

Foods to Reduce

• Compare sodium in foods like soup, bread, and frozen meals—and choose the foods with lower numbers.

• Drink water instead of sugary drinks.

I’m in shock.  I never would have believed they could pull this off.  The new guidelines recognize that obesity is the number one public health nutrition problem in America and actually give good advice about what to do about it: eat less and eat better. For the first time, the guidelines make it clear that eating less is as priority.

My two quibbles:

Quibble #1: They still talk about foods (fruits, vegetables, seafood, beans, nuts) when they say “eat more.”   But they switch to nutrient euphemisms  (sodium, solid fats and added sugars) when they mean “eat less.”

They say, for example: “limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.”

This requires translation: eat less meat, cake, cookies, sodas, juice drinks, and salty snacks.

That’s politics, for you.

Let’s give them credit for “drink water instead of sugary drinks.”  That comes close. But I listened in on the press conference and conference call and several people pushed federal officials about why they didn’t come out and say “eat less meat.”  The answers waffled.

Quibble #2: This is all about personal responsibility.  What about the “toxic” food environment?  Shouldn’t these guidelines be directed at the food and restaurant industries?  The Dietary Guidelines Advisory Committee made a big point of that.  Apparently, that’s in the full dietary guidelines report but I’ve only seen the executive summary.

For background, see my previous posts, one on the politics of this report, and one on the science of the dietary guidelines.

Overall, the new guidelines aren’t perfect but they are a great improvement.

Next: let’s see what they do to improve the implementation guide—the pyramid or its equivalent.  This, they say will come out in a few months.  Stay tuned.

Michael Taylor, deputy commissioner for food at FDA and long a proponent of food safey, gave a speech on January 27 outlining the FDA’s plans for implementing the new food safety law.

He pointed out that the new law says:

• Food producers and processors must institute preventive controls.
• FDA has new legal powers to ensure that they do.
• FDA can focus efforts on riskiest foods.
• Food importers must meet accountability requirements.

Taylor got right to the point:

So, let me give you a sense of what you can expect from FDA.

First, we’ll hit the ground running…So we embark on implementation with considerable momentum.  

Second, the vast workload that comes with the new law – over 50 new regulations, guidances, programs and reports to Congress – means we have to set priorities for our work…you can expect timely completion of the rulemakings required to set standards for produce safety, preventive controls, and intentional adulteration…And you can count on us giving high priority to building the new import oversight system.

Third, we are absolutely committed to full, transparent engagement with all stakeholders – industry, consumers, public health experts, and other government colleagues – to take advantage of their expertise and diverse perspectives.   

Finally, you can count on FDA to maintain its strong commitment to public health and to achieving the new law’s public health goal in a manner that is in keeping with the consensus that gave rise to the legislation. 

As for the vexing question of how the beleaguered FDA is going to be able to pay for all this?

And, in a world of finite resources, we’ll change how we work to make the best use of every resource we have…Make no mistake, resources will be a continuing issue as we work to build the new food safety system. 

As I hope I’ve made clear there is a lot FDA can and will do to put the new law into action and build the foundation for a new system, but completing the system – fulfilling the Congressional vision embedded in the new law – will require new resources and investment.  

We look forward to working on this issue with our colleagues in industry and the consumer community, and with leaders in Congress. 

Well, good luck with that last one. Members of agricultural appropriations committees have already threatened no new resources for FDA.

Recall: FDA, an agency of the public health service (like NIH or CDC), gets its funding from agricultural appropriations committees—not health committees.  Nobody talks about this bizarre historical anomaly very much but I see it as a huge problem for FDA and one that badly needs fixing.

The fix isn’t likely to happen in this administration but without adequate resources, FDA is severely constrained in what it can do.  Taylor is telling the industry that FDA is not going to wait for resources to get started on its new legal authority to protect public health. 

Let’s hope this works.

In an action long expected, the USDA approved commercial production of genetically modified alfalfa.

The announcement makes it clear that USDA did not do this lightly.  The agency was well aware of the concerns of organic farmers that GM alfalfa could—and will—contaminate their fields.

Secretary Vilsack said:

After conducting a thorough and transparent examination of alfalfa through a multi-alternative environmental impact statement (EIS) and several public comment opportunities, APHIS has determined that Roundup Ready alfalfa is as safe as traditionally bred alfalfa…All of the alfalfa production stakeholders involved in this issue have stressed their willingness to work together to find solutions.

…USDA brought together a diverse group of stakeholders to discuss feasible strategies for coexistence between genetically engineered (GE), organic, and other non-GE stakeholders.

…In response to the request for support from its stakeholders, USDA is taking a number of steps, including:

• Reestablishing two important USDA advisory committees – Advisory Committee on Biotechnology and 21st Century Agriculture, and the National Genetic Resources Advisory Committee.
• Conducting research into areas such as ensuring the genetic integrity, production and preservation of alfalfa seeds entrusted to the germplasm system;
• Refining and extending current models of gene flow in alfalfa;
• Requesting proposals through the Small Business Innovation Research program to improve handling of forage seeds and detection of transgenes in alfalfa seeds and hay; and,
• Providing voluntary, third-party audits and verification of industry-led stewardship initiatives.

USDA seems to think it has brokered “peaceful coexistence” (see previous post).  Skeptics, take note.

The USDA is providing more information about this decision online .  It also has issued a Q and A.  Here’s the Federal Register notice.

Here’s what I’m going to be doing on Monday morning:

INVITATION TO KEY STAKEHOLDERS TO JOIN IN THE NATIONAL RELEASE OF THE 2010 DIETARY GUIDELINES FOR AMERICANS

The U.S. Departments of Agriculture and Health and Human Services Will Release the 2010 Dietary Guidelines for Americans at a Joint Press Conference Monday, January 31, 2011

On Monday, January 31, the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) will hold a joint press a conference at The George Washington University Jack Morton Auditorium to release the new 2010 Dietary Guidelines for Americans.

Agriculture Secretary Tom Vilsack and HHS Secretary Kathleen Sebelius will discuss the Guidelines and provide key insights into the new recommendations. Joining the Secretaries will be Dr. Robert Post, Deputy Director of USDA’s Center for Nutrition Policy and Promotion and Rear Admiral Penelope Slade-Sawyer, HHS Deputy Assistant Secretary for Health Disease Prevention and Health Promotion. Immediately following the presentations, the speakers will entertain questions from the press, stakeholders, students and others in attendance.

 Monday, January 31, 2011, 10 a.m. – 11 a.m. EST

The George Washington University

Jack Morton Auditorium

Media and Public Affairs Building

805 21st Street, NW

Washington, DC 20052

Stakeholders are invited to attend this event in person. Seating is limited and RSVP is required by 5 p.m. on Wednesday, January 26, by registering here.

Stakeholders may also view the event via webcast at www.usda.gov/live

Copies of the 2010 Dietary Guidelines for Americans will be available at www.DietaryGuidelines.gov immediately following the press conference.

Can’t wait!

The FDA announces that it is immediately withdrawing its guidance to the food industry issued in August about how companies should do menu labeling. It will start formal rulemaking instead.  Try some FDA-speak:

As stated in the draft guidance, certain provisions of section 4205 of the Affordable Care Act became requirements immediately upon enactment of the law. FDA also stated that it anticipated issuing the final guidance and enforcement policy in December 2010.FDA received many comments on the draft guidance and on a public docket which FDA opened to solicit comment.

Based, in part, on these comments, FDA now intends to complete the notice and comment rulemaking process for section 4205 before initiating enforcement activities and will not be publishing a final guidance on menu labeling at this time. FDA is required to issue proposed regulations to carry out provisions of section 4205 no later than March 23, 2011. FDA intends to meet this statutory deadline.

FDA believes that the expeditious completion of the rulemaking process for section 4205 will minimize uncertainty and confusion among all interested parties. This approach to implementing section 4205 will most rapidly lead to full and consistent availability of the newly required nutrition information for consumers.

I’m not sure how to translate this.  I think it means that companies currently posting calories should continue to do so.

The FDA still needs time to work out some of the sticky details—calorie ranges like the ones used by Chipotle, for example.  It intends to meet the legislated deadline for issuing rules a year from now.  States and local communities currently requiring calorie labeling should continue to do so but should off on enforcement until then. 

Let’s not hurry these things.

Unsurprisingly, the restaurant industry “supports this approach.”  As The Packer put it, “Don’t sweat menu labeling just yet. Thise just in from the FDA…”

Patience is a virtue.  This willl happen.   Eventually.

I listened in on the conference call at which the Grocery Manufacturers of America and the Food Marketing Institute announced their new Nutrition Keys design for front-of-package labels.

My favorite comment: We are all “singing kumbaya” here.  Nutrition Keys, they said, was the result of a” monumental, historic effort” in which food companies “stepped up to the plate in a big way,” “with 100% support.”

Why did they go to all this trouble?  Because “A healthy consumer makes for a happy consumer.”

Kumbaya, indeed.

The real reason, as I explained yesterday, is to preempt the FDA’s front-of-package food labeling initiatives which might make food companies reveal more about the “negatives” in processed foods.

Here’s what GMA and FMI say the new label will look like:

Four of these things are required: Calories, Saturated fat, Sodium, and Total (not added) sugars.  Packages can also display up to two “nutrients to encourage” picked from this collection:  protein; fiber; vitamins A, C, and D; and potassium, iron, and calcium.

Let’s give these food trade associations credit for listing sugars instead of the Institute of Medicine’s recommendation for trans fat.  Trans fats are already gone from most processed foods.  Everyone cares about sugars.  But these are total sugars, not added sugars, which is what really matters.

And protein?  Since when does protein need to be encouraged in American diets?  We already eat twice the protein we need.  The rationale?  Vegetarians.   I repeat.  Since when don’t vegetarians get enough protein?  Never mind, protein makes the products look better.

Nutrition Keys merely repeats what’s on the Nutrition Facts labels, only worse.  It makes the percent Daily Values practically invisible.  Which is better?  High or low milligrams or grams.  You have to know this, and Nutrition Keys doesn’t help with that problem.

Nutrition Keys, says the industry, is about “more clarity in labeling.”  Really?  Here’s what it will look like on a food package.

I’ve been collecting reactions.

Although GMA and FMI insist they they are doing this in response to the First Lady’s Let’s Move campaign, the White House issued this statement:

The White House, including the First Lady, recognizes these companies for the leadership they have shown in advancing this initiative. We regard their commitment to dedicate space, for the first time, to an industry-wide front-of-pack label as a significant first step and look forward to future improvement. The FDA plans to monitor this initiative closely and will work with experts in the field to evaluate whether the new label is meeting the needs of American consumers and pursue improvements as needed. We will continue to work on seeking solutions for the problem of childhood obesity in America.

Congresswoman Rosa DeLauro was more forthcoming:

The industry’s unveiling today of its front-of-package labeling system is troubling and confirms that this effort should not circumvent or influence FDA’s effort to develop strong guidelines for FOP labels.

Given that negative and positive nutrients will not be differentiated on the package, there is significant risk that these labels will be ignored.  An adequate labeling system must clearly alert consumers about potentially unhealthy foods, and should not mislead them into believing that some foods are healthy when they clearly are not.

Reporters asked tough questions on the conference call about preemption of FDA efforts to do front-of-package labeling in a rational way (see my post from yesterday).  Perhaps space limitations made full accounts impossible:

• USA Today story (I’m quoted)
• Washington Post
• New York Times