Search results: a life in food

The 2015 Dietary Guidelines are out.

They are now online in a version that takes up dozens of screens with annoying drop-down boxes.  It’s hard to navigate, and if it’s searchable, I can’t figure out how (OK, it’s searchable but doesn’t work all that well).

First the good news.  These Dietary Guidelines—for the first time—attempt to focus on foods and dietary patterns:

Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. However, people do not eat food groups and nutrients in isolation but rather in combination, and the totality of the diet forms an overall eating pattern.

They almost succeed in this mission.  The Guidelines say:

• Follow a healthy eating pattern across the lifespan [Pattern].
• Focus on variety, nutrient density, and amount [Pattern].
• Limit calories from added sugars and saturated fats and reduce sodium intake [Oops: Nutrients].
• Shift to healthier food and beverage choices [Pattern].
• Support healthy eating patterns for all [Pattern].

A healthy eating pattern, they say:

• Includes foods from various groups [Pattern].
• Limits saturated fats, trans fats, added sugars, and sodium [Oops: Nutrients].

As for (Oops) Nutrients:

• Less than 10% of calories from added sugars [this is new, but consistent with many other reports such as the one from WHO]
• Less than 10% of calories from saturated fats [in the Guidelines since 1990]
• Less than 2,300 mg sodium [no change from 2010]

Why Oops?  Because these Dietary Guidelines, like all previous versions, recommend foods when they suggest “eat more.”   But they switch to nutrients whenever they suggest “eat less.”

In the 2015 Dietary Guidelines,

• Saturated fat is a euphemism for meat.
• Added sugars is a euphemism for sodas and other sugar-sweetened beverages.
• Sodium is a euphemism for processed foods and junk foods.

If the Guidelines really focused on dietary patterns, they wouldn’t pussyfoot.  They would come right out and say:

• Eat less meat [OK, they do but only under the euphemism of “protein” and only for males. “Some individuals, especially teen boys and adult men, also need to reduce overall intake of protein foods (see Figure 2-3) by decreasing intakes of meats, poultry, and eggs and increasing amounts of vegetables or other underconsumed food groups.”  But what about processed meats?  Not a word that I can find.
• Cut down on sugary drinks [OK, it says “drink water instead of sugary drinks,” but good luck finding that statement without knowing where it is].
• Eat less processed and junk food.

Why don’t they?  Politics, of course.

Recall that Congress weighed in with an Appropriations Bill that called for an investigation of the scientific basis of the Guidelines and granted $1 million to the National Academy of Medicine to take them over.

Recall also that the secretaries of USDA and HHS said that the Guidelines would not say anything about sustainability as a rationale for advising eating less meat.

So let’s count the 2015 Guidelines as a win for the meat, sugary drink, processed, and junk food industries.

Other concerns, nutritional and otherwise:

• Calories: The Guidelines deemphasize calories.  They dropped the information about food sources of calories from the 2010 edition, even though calorie balance remains a—if not the—major public health nutrition problem (an Appendix gives calorie needs).
• Portion sizes: the best way to control calorie intake is by eating smaller or moderate portions. If the Guidelines talk about portion size, it must be well hidden.
• Cholesterol: the recommendation to limit cholesterol has been dropped, but the document says, confusingly, that “this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns. As recommended by the IOM, individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern.”  Could the dropping of the limit have anything to do with egg-industry funding of research on eggs, the largest source of dietary cholesterol, and blood cholesterol?  The Physicians Committee for Responsible Medicine has just filed a lawsuit on that very point.
• Protein: My pet peeve.  The Guidelines use this as yet another euphemism for meat.  “Protein” lumps meat together with seafood, poultry, eggs, nuts, seeds, and soy.  But grains and dairy also have protein, so using this term makes no nutritional sense and obfuscates the message to eat less meat.
• Seafood: the document recommends 8 ounces a week of seafood high in omega-3s but low in methylmercury. That pretty much means salmon and sardines (anchovies are too salty).

I might have more to say when I can look at a document that is easier to read.

Full disclosure: I was a peer reviewer on an earlier version of this document.

Documents and commentary

• The HHS press release and the government’s digital press kit
• The Dietary Guidelines Advisory Committee Report
• USDA’s MyWins food guide
• Dietary Guidelines version of MyWins
• My Rogue Dietary Guidelines (with Tamar Haspel)
• CSPI’s press release and materials
• CSPI’s summary of the Guidelines’ major points
• The New York Times take (I’m quoted)
• Politico’s take (I’m quoted)
• Friends of the Earth (with a good summary of public input)
• Julia Belluz in Vox (comparison to Swedish guidelines)
• The official HHS version in JAMA Cardiology
• The Sugar Association’s predictable complaints
• The American Cancer Society’s complaints (no clear guidance on red and processed meats)
• The Distilled Spirits Council’s statement
• Time Magazine’s collection of reactions (including mine)
• The Washington Post on the confusion (I’m quoted)
• Food-Navigator’s take: a marketing opportunity
• The American Beverage Association’s reaction

While we are endlessly waiting for the release of the 2015 Dietary Guidelines, Tamar Haspel and I thought we would jump the gun and write up for the Washington Post what we think most makes sense: How to eat more healthfully, in 6 easy steps.

Here are our Rogue Dietary Guidelines:

Go through the fine print of the omnibus spending bill just passed by Congress, and you’ll see that the 2015 Dietary Guidelines, scheduled for release in — you guessed it — 2015, have been pushed out to 2016. You wouldn’t think that the government’s efforts, every five years, to help Americans eat more healthfully would turn into a political football. But when its appointed scientists reviewed the literature on meat and health, for example, they did something quite radical. They said what they meant with no equivocations: Americans should eat less meat.

As if that were not radical enough — previous committees had pussyfooted with such euphemisms as “choose lean meats to reduce saturated fat” — this committee insisted on an additional reason beyond health: environmental considerations.

The result? Uproar.

Arguments like the ones over the Dietary Guidelines, fueled by lobbyists, politicians and agenda-driven groups, make diet advice seem maddeningly inconsistent, but the fundamentals haven’t changed much at all.

It’s time to take back the process, so we’re going rogue and issuing our own Dietary Guidelines, untainted by industry lobbying, unrestricted by partisan politics. Here, in six easy steps, is our advice for the new year: what we think dietary guidelines ought to say.

1. Eat more plants. You heard it from your grandmother. You heard it from Michael Pollan. Now you hear it from us: Eat your vegetables. Add fruits, beans and whole grains, and the wide-ranging plant category should make up most of your diet. Variety is the key. Plants offer us such an astonishing range of roots, stems, leaves, flowers, buds and seeds that there is bound to be something even the most jaded vegetable skeptic can love.
   Vegetables, fruits, beans and whole grains: Plants should make up most of our diet. (J. Scott Applewhite/Associated Press)
2. Don’t eat more calories than you need. Although on any given day it’s hard to tell whether you’re doing that, over the long term, your scale is a sure-fire indicator. If the pounds are going up, eat less.

Let’s pause here for the good news. If you follow our first two guidelines, you can stop worrying. Everything else is fine-tuning, and you have plenty of leeway.

3. Eat less junk. “And what’s junk?” we hear you asking. We have faith that you know exactly what junk is. It’s foods with lots of calories, plenty of sugar and salt, and not nearly enough nutritional value. It’s soda and sugary drinks. It’s highly processed, packaged foods designed to be irresistible. It’s fast food. You know it when you see it. When you do, don’t eat too much of it.
4. Eat a variety of foods you enjoy. There is research on the health implications of just about any food you can think of. Some — such as fish — may be good for you. You should eat others — such as meat and refined grains — in smaller amounts. The evidence for most foods is so inconsistent that you should never force yourself to eat them if you don’t want to, or deny yourself if you do. If you love junk foods, you get to eat them, too (in moderation, of course). You have bought yourself that wiggle room by making sure the bulk of your diet is plants and by not eating more than you need.

This is an appropriate place to talk about a phrase that has been thrown around a lot in the Dietary Guidelines brouhaha: “science-based.”

As a journalist (Tamar) and a scientist (Marion), we’re very much in favor of science. But in this situation, the food industry’s frequent calls for “science-based” guidelines really mean, “We don’t like what you said.”

Arriving at truths about human nutrition isn’t easy. We can’t keep research subjects captive and feed them controlled diets for the decades it takes many health problems to play out. Nor can we feed them something until it kills them. We have to rely on animal research, short-term trials and population data, all of which have serious limitations and require interpretation — and intelligent people can come to quite different opinions about what those studies mean.

Which is why “eat some if you like it” isn’t a wishy-washy cop-out. It acknowledges science’s limitations. We do know that plants are good, and we do know that junk foods aren’t, but in between is an awful lot of uncertainty. So, eat more plants, eat less junk, and eat that in-between stuff moderately. That is exactly the advice science demands.

What we eat and how we eat go hand in hand. We’ve all been there, sitting in front of a screen and finding that, all of a sudden, that bag, box or sleeve of something crunchy and tasty is all gone. We’re so focused on what to eat that how to eat gets short shrift. So:

5. Find the joy in food. Eat mindfully and convivially. One of life’s great gifts is the need to eat, so don’t squander it with mindless, joyless consumption. Try to find pleasure in every meal, and share it with friends, relatives, even strangers.

6. Learn to cook. The better you cook, the better you eat. There are days when cooking feels like a chore, but there are also days when you find profound satisfaction in feeding wholesome homemade food to people you love. And foods you make at home are worlds apart from foods that manufacturers make in factories. No home kitchen ever turned out a Lunchable.

If you go out in the world armed only with these guidelines, you’ll do great. Sure, there’s much more to know, if you want to know it. We’ve forged careers writing about food and nutrition, and either one of us could talk micronutrients until your eyes glaze over. But these few basics are all you need to make good food decisions. Choose foods you like, cook them and enjoy them.

It really is that simple.

Haspel is the James Beard award-winning writer of Unearthed, a Washington Post column devoted to finding out what’s actually true about food.

Nestle is professor of nutrition, food studies and public health at New York University and is the author, most recently, of “Soda Politics: Taking on Big Soda (and Winning).”

The anthropologist Sidney Mintz has died at the age of 93.  It feels way too soon.

I first heard of him in 1985 when I read a review of Sweetness and Power: The Place of Sugar in Modern History.  I immediately ordered a copy, which he signed it for me much later.

Sweetness and Power used sugar as an entry point into a critical analysis of social institutions, in this case slavery, race, class, and global capitalism.  As he explained, the book continues to be relevant to those concerns as well as to today’s obsession with sugar consumption.

Studying a single food or commodity such as sugar may seem like an incongruous project for an anthropologist who claims to work mostly with living people. Still, it is a rich subject for someone interested in the history and character of the modern world, for its importance and popularity rose together with tea, colonial slavery, and the machine era…How do we get from one child’s sweet tooth to the history of slavery, of war, and of corporate lobbying in the Congress?…These are the kinds of questions that have arisen in recent years. Alongside them are the shacks of the cane cutters, scattered in so many of the earth’s tropical corners, which deserve at least equal attention from anthropologists.

When my colleagues and I started Food Studies programs at NYU, we considered Sweetness and Power to be the seminal work in the field.  So did everyone else.  We polled academics working on food issues about what should be included in a Food Studies “canon”—a list of books that every student ought to master.  Only one book appeared on everyone’s list: Sweetness and Power.

I adored Sid.  Whenever I ran into him at meetings, we talked about how much fun it would be to teach together.  In 2004, we did—in Puerto Rico: The Bitter and the Sweet: Puerto Rico, Sugar, and Caribbean History.  Sid was 82 at the time.

He had done his anthropology field work in Puerto Rico half a century earlier and published this research as Worker in the Cane: A Puerto Rican Life History.  He was still in touch with the children and grandchildren of the cane cutter observed in that book, and he visited with them while we were there.  The University of Puerto Rico honored him.  In Puerto Rico and throughout the Caribbean, he is a national hero.

In 2007, I gave  the Sidney Mintz lecture at Johns Hopkins (here’s my title slide).

I loved visiting with him and his wife Jackie whenever I could.  They were in New York for a speaking engagement early in 2009 and my partner, Mal Nesheim, and I had arranged to take them to dinner at Blue Hill.  What an evening that was.  We had to talk our way through vast crowds and a police barricade around the restaurant.  The newly elected Obamas, it seems, had picked Blue Hill for a date night in New York.  We were seated at the next table (but not introduced).

Whenever I talked to Sid, he told me about his speaking invitations all over the world, his new book projects, and his increasing collection of honors. Here’s Sid in action at NYU in 2012.

I know I’m not the only one who treasured knowing him and will miss him.  But this feels like such a huge loss.

Obituaries

The New York Times

History News Network

Johns Hopkins

The FDA is extending the comment period for the meaning of “natural” on food labels until May 10, 2016.  This, it says, is

In direct response to requests from the public…Due to the complexity of this issue, the FDA is committed to providing the public with more time to submit comments. The FDA will thoroughly review all public comments and information submitted before determining its next steps.

The “complexity of this issue?”  Isn’t it obvious what “natural” means when applied to food—minimally processed with no junk added?

Not a chance.  “Natural” is too valuable a marketing term to forbid its use on highly processed foods.  To wit:

Here, as the agency explains, is what complicates the meaning of “natural”:

The FDA is taking this action in part because it received three Citizen Petitions asking that the agency define the term “natural” for use in food labeling and one Citizen Petition asking that the agency prohibit the term “natural” on food labels.  We also note that some Federal courts, as a result of litigation between private parties, have requested administrative determinations from the FDA regarding whether food products containing ingredients produced using genetic engineering or foods containing high fructose corn syrup may be labeled as “natural.”

Are foods containing genetically modified ingredients or HFCS “natural?”

The FDA says

It has long “considered the term “natural” to mean that nothing artificial or synthetic  (including all color additives regardless of source) has been included in, or has been added to, a food that would not normally be expected to be in that food.

However, this policy was not intended to address food production methods, such as the use of pesticides, nor did it explicitly address food processing or manufacturing methods, such as thermal technologies, pasteurization, or irradiation. The FDA also did not consider whether the term “natural” should describe any nutritional or other health benefit.

Specifically, the FDA asks for information and public comment on questions such as:

• Whether it is appropriate to define the term “natural,”
• If so, how the agency should define “natural,” and
• How the agency should determine appropriate use of the term on food labels.

If you want to weigh in on this, you now have until May 10 to do so.  Go to http://www.regulations.gov and type FDA-2014-N-1207 in the search box.

Here are the background documents:

• Federal Register Notice: Use of the Term “Natural” in the Labeling of Human Food Products; Request for Information and Comments; Extension of the Comment Period.
• “Natural” on Food Labeling

May your holidays be happy, healthy, and natural, of course.

Systematic Review of Pears and Health. Holly Reiland, BS Joanne Slavin, PhD, RD.  Nutrition Today November/December 2015 – Volume 50 – Issue 6 – p 301–305.  doi: 10.1097/NT.0000000000000112.  

• Conclusions: Animal studies with pears suggest that pears may regulate alcohol metabolism, protect against ulcers, and lower plasma lipids. Human feeding studies with pears have not been conducted. In epidemiological studies, pears are combined with all fresh fruits or with apples, because they are most similar in composition. The high content of dietary fiber in pears and their effects on gut health set pears apart from other fruit and deserves study.
• Funding: The authors received a grant from USA Pears in the past. The authors provided their own funding to allow this article to publish as Open Access.
• Comment: Pears are a great fruit but the marketing purpose of this study is evident from this press release from the Pear Bureau Northwest: “While the body of evidence connecting pear intake and health outcomes is still limited, USA Pears has been contributing to research efforts by commissioning independent studies to learn and affirm the heath attributes of pears. Visit www.usapears.org for additional pear research, nutrition resources and recipes.”

Whole Grain Intakes in the Diets Of Malaysian Children and Adolescents – Findings from the MyBreakfast Study.  Norimah AK , H. C. Koo, Hamid Jan JM, Mohd Nasir MT, S. Y. Tan, Mahendran Appukutty, Nurliyana AR, Frank Thielecke, Sinead Hopkins, M. K. Ong, C. Ning, E. S. Tee.  PLoS ONE 10(10): e0138247. doi:10.1371/journal.pone.0138247

• Conclusion: Whole grain is consumed by only a minority of Malaysian children and adolescents and even among consumers, intakes are well below recommendations. Efforts are needed to firstly understand the barriers to whole grain consumption among Malaysian children in order to design effective health promotion initiatives to promote an increase in whole grain consumption.
• Funding: The Nutrition Society of Malaysia received an unrestricted research grant from Cereal Partners Worldwide, Switzerland and Nestleé R&D Center, Singapore. This financial support was provided in the form of salaries for authors but the funders did not have any additional role in the study design, data collection and analysis or decision to publish. Frank Thielecke was an employee of Cereal Partners Worldwide at the time this study was conducted. He now works for Nestec SA. Sinead Hopkins is employed by Cereal Partners Worldwide (CPW), Switzerland and Moi Kim Ong and Celila Ning are employed by Nestleé R&D Center, Singapore….Nestlé and Cereal Partners Worldwide have a commercial interest in breakfast cereals.
• Comment: I learned about this study from a comment on Retraction Watch, which reported that PLoS One had filed a correction to the funding section.  The correction says that the salaries were for research assistants, not authors.

Walnuts Consumed by Healthy Adults Provide Less Available Energy than Predicted by the Atwater Factors.  David J Baer*, Sarah K Gebauer, and Janet A Novotny. J Nutrition First published November 18, 2015, doi: 10.3945/​jn.115.217372.

• Conclusion: Consistent with other tree nuts, Atwater factors overestimate the metabolizable energy value of walnuts. These results could help explain the observations that consumers of nuts do not gain excessive weight and could improve the accuracy of food labeling.
• Funding: This research was funded by the USDA and the California Walnut Commission… DJ Baer was funded by the USDA and the California Walnut Commission.

Cardiorespiratory Fitness, Body Fatness, and Submaximal Systolic Blood Pressure Among Young Adult Women.  Prasad Vivek Kumar, Drenowatz Clemens, Hand Gregory A., Lavie Carl J., Sui Xuemei, Demello Madison, and Blair Steven N.  Journal of Women’s Health, 2015 ahead of print. doi:10.1089/jwh.2015.5307.

• Conclusion: CRF, BF%, and BMI seem to have critical roles in determining SSBP with CRF and BF% being more potent at lower intensity exercise, whereas BMI was more strongly associated at higher intensity exercise.
• Funding for this project was provided through an unrestricted grant from The Coca-Cola Company. The sponsor played no role in the study design, data collection, analysis, and interpretation, or preparation and submission of this article. The authors thank the Energy Balance staff and study participants for their contributions. No competing financial interests exist. 
• Comment: This is one of the papers produced by participants in the now defunct Global Energy Balance Network formerly sponsored by Coca-Cola.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including metaanalyses, of the evidence from human and animal studies. PJ Rogers, PS Hogenkamp, C de Graaf , S Higgs , A Lluch , AR Ness , C Penfold , R Perry , P Putz , MR Yeomans and DJ Mela.  International Journal of Obesity advance online publication, 10 November 2015; doi:10.1038/ijo.2015.177

• Conclusion¨The preponderance of evidence from all human randomized controlled trials indicates that LES [low-energy sweeteners] do not increase EI [energy intake] or BW [body weight], whether compared with caloric or non-caloric (for example, water) control conditions. Overall, the balance of evidence indicates that use of LES in place of sugar, in children and adults, leads to reduced EI and BW, and possibly also when compared with water.
• Conflict: This work was conducted by an expert group of the European branch of the International Life Science Institute (ILSI Europe). The expert group received funding from the ILSI Europe Eating Behaviour and Energy Balance Task Force. Industry members of this task force are listed on the ILSI Europe website at www.ilsi.eu.
• Comment: ILSI is funded by food companies.

Here are another five industry-sponsored studies with results that can be used for marketing purposes (otherwise, what’s the point?).

Effects on childhood body habitus of feeding large volumes of cow or formula milk compared with breastfeeding in the latter part of infancy David Hopkins, Colin D Steer, Kate Northstone, and Pauline M Emmett.  Am J Clin Nutr 2015;102:1096–103.

• Conclusion: “The feeding of high volumes of cow milk in late infancy is associated with faster weight and height gain than is BM feeding. The feeding of bottle-fed infants with high volumes of cow milk in late infancy may have a persisting effect on body habitus through childhood.”  The authors point out “Our findings strengthen the current American Academy of Pediatrics and United Kingdom Department of Health guidelines, which stress the need to not introduce cow milk as a main drink before 12 mo of age. Parents should be advised about the appropriate volume of milk to offer their children once complementary feeding is established.”
• Funding: The research, although specifically funded by Wyeth Nutrition, was carried out independently. DH previously received funding from Pfizer Nutrition Ltd. KN and PME have, from time to time, received research funding, and PME has received consultancy funding from Pfizer Nutrition Ltd., Plum Baby, and Danone Baby Nutrition (Nutricia Ltd.). PME currently receives research funding from Nestlé Nutrition.
• Comment: The study finds that differences between the growth of children fed breast milk or formula disappear by age two.  Infants fed cow milk grew significantly faster than both of the other groups.

Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Liana C Del Gobbo, Michael C Falk, Robin Feldman, Kara Lewis, and Dariush Mozaffarian. Am J Clin Nutr December 2015, vol. 102 no. 6 1347-1356.

• Conclusions: Tree nut intake lowers total cholesterol, LDL cholesterol, ApoB, and triglycerides.
• Funding: LCDG and DM received modest ad hoc consulting fees from the Life Sciences Research Organization (LSRO) in Bethesda, MD, to support this study. MCF, RF, and KL received payment through LSRO (<5% of gross income) to conduct a review of nuts and cardiovascular health outcomes, which was funded through a contract with the International Tree Nut Council (ITNC).

Safety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trial Javier I Ottaviani, Marion Balz, Jennifer Kimball, Jodi L Ensunsa, Reedmond Fong, Tony Y Momma, Catherine Kwik-Uribe, Hagen Schroeter, and Carl L Keen. Am J Clin Nutr December 2015, vol. 102 no. 6 1425-1435

• Conclusion: The consumption of CFs [cocoa flavanols] in amounts up to 2000 mg/d for 12 wk was well tolerated in healthy men and women.
• Funding: Supported in part by an unrestricted gift from Mars Inc. The company also provided the food-grade, standardized test materials and authentic analytical standards as gifts…. JIO, MB, CK-U, and HS are employed by Mars Inc., a company with long-term research and commercial interests in flavanols and procyanidins. CLK has received an unrestricted research grant from Mars Inc. and is the current holder of the Mars Chair in Developmental Nutrition. In addition, CLK has consulted for other food companies and government agencies with an interest in health and nutrition, as well as in phytonutrients, including flavanols and procyanidins.

Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Roger D Gibb,*, Johnson W McRorie Jr., Darrell A Russell, Vic Hasselblad, and David A D’Alessio. Am J Clin Nutr December 2015 , vol. 102 no. 6 1604-1614.

• Conclusion: These data indicate that psyllium would be an effective addition to a lifestyle-intervention program.
• Funding: RDG, JWM, and DAR are full-time employees of P&G, which markets a psyllium product. DAD has received an unrestricted research grant from P&G. VH has received research funding from P&G.

Fresh Pear Consumption is Associated with Better Nutrient Intake, Diet Quality, and Weight Parameters in Adults: National Health and Nutrition Examination Survey 2001-2010.  O’Neil CE, Nicklas TA, Fulgoni VL (2015) J Nutr Food Sci 5: 377. doi:10.4172/2155-9600.1000377

• Conclusion:  Compared to non-consumers [of pears], consumers were 35% less likely to be obese (p<0.05). Fresh pears should be encouraged as a component of an overall healthy diet.
• Funding: Partial support was received from the United States Department of Agriculture/ Agricultural Research Service (USDA/ARS)…Partial support was also received from Pears Bureau Northwest.
• Comment: I’m guessing the same result could be obtained by looking at consumption of any other fruit.  And to prove my point that this is about marketing, here’s the press release.

Let’s take a look at a rare industry-funded study with results contrary to the interests of the funders.

It addresses the question: Is naturally occurring trans fat from meat and dairy products healthier than industrially produced trans fat?

The answer: not really.

The study

Vaccenic acid and trans fatty acid isomers from partially hydrogenated oil both adversely affect LDL cholesterol: a double-blind, randomized controlled trial.  Sarah K Gebauer, Frédéric Destaillats, Fabiola Dionisi, Ronald M Krauss, and David J Baer.  Am J Clin Nutr, November 11, 2015,  doi: 10.3945/ajcn.115.116129.

• Conclusions: Total cholesterol (TC), LDL cholesterol, triacylglycerol, lipoprotein(a), and apolipoprotein B were higher after VA [vaccenic acid] than after iTFA [industrial trans fatty acids]; high-density lipoprotein (HDL) cholesterol and apolipoprotein AI also were higher after VA. Compared with control, VA and iTFA both increased TC, LDL cholesterol, ratio of TC to HDL cholesterol, and apolipoprotein B…VA also increased HDL cholesterol, apolipoprotein AI, apolipoprotein B, and lipoprotein(a)…whereas iTFA did not. c9,t11-CLA [conjugated linoleic acid] lowered triacylglycerol…and had no effect on other lipoprotein risk factors.
• Funding:  Supported by USDA, Dairy Management Inc., Nestlé, and Dairy Australia. The funding organizations had no role in the conduct of the study; collection, management, analysis, and interpretation of the data; or decision to submit the manuscript for publication.

Background

Everyone agrees that hydrogenated fats containing trans fatty acids (industrial trans fatty acids or iTFAs) raise the risk of LDL-cholesterol (the bad one) and, therefore, the risk of coronary artery disease.  But what about the naturally occurring trans fats that occur in meat and dairy products as a result of bacterial hydrogenation of fats in the rumens of ruminant animals (ruminant trans fatty acids or rTFAs)?

Some studies suggest that rTFAs do not raise the risk of coronary disease.  This study tests that hypothesis.  It found that the major rTFA, vaccenic acid, does indeed raise risk factors for coronary artery disease almost or more than do iTFAs.

To make sense of the study, you need to know:

• In iTFAs, the two major trans fats are elaidic acid 25%, and vaccenic acid 10%
• In rTFAs, the trans fats are vaccenic acid 45% and elaidic acid 5%
• Therefore, vaccenic acid is the major trans fat in rTFAs

What about Conjugated Linoleic Acid (CLA, or rumenic acid)?

The study also looked at intake of another rTFA, conjugated linoleic acid, which seems to have more benign properties but is present in such small amounts that it hardly makes a difference.  Although this study found CLA to have no effect on risk factors for coronary heart disease, a study from independently funded investigators judged it to have effects similar to that of other rTFAs.

What took so long to get this study published?

David Baer, who works for USDA, is the senior author on this paper.  I saw a slide presentation he did on this study in 2010.  Its results were already available.

In 2011, his group wrote a review of ruminant trans fats, but did not report these results (they were known, but not published).

In 2012, Dr. Baer wrote about ruminant trans fats, disclosed his dairy industry funding, but also did not report these results.  He concluded:

It is still difficult to draw definitive conclusions about the role of rTFAs in modulating risk of cardiovascular disease as mediated through changes in LDL and HDL cholesterol. Intake of these fatty acids is typically low in the diet.

I heard about this study last summer and wondered whether its funders were holding up publication.  I called Dr. Baer and asked.  He said the funders had nothing to do with the delay.  Instead, life had intervened—collaborators left, he was busy with other things, and was having trouble getting the paper published.

The bottom line

The study was done with purified vaccenic acid, not dairy fat, in amounts higher than those likely to be consumed in diets.  The authors say

Evidence…suggests that VA [vaccenic acid] consumed in amounts and foods typically found in the diet is inversely or not associated with CVD risk.

That’s one possible interpretation, but check the title of the editorial accompanying the paper: “In equal amounts, the major ruminant trans fatty acid is as bad for LDL cholesterol as industrially produced trans fatty acids, but the latter are easier to remove from foods.”

The funders of this study must be disappointed.  It was undoubtedly difficult and expensive to do, since it involved synthesis of pure vaccenic acid and a clinical trial of more than 100 subjects.

The funders must have hoped the study would show vaccenic acid to be as benign or even healthier than conjugated linoleic acid.  They bet wrong on this one.

This brings the score to 80:7 (sponsored studies with results favorable to the sponsor vs. those unfavorable).

In case you haven’t been following this saga, I’ve been collecting studies funded by food companies since last March and posting them according to whether the results do or do not favor the sponsor’s interests.  So far, I’ve reported 80 that do, versus 6 that don’t (although I have a couple more saved up for posting soon).

The point of this exercise is to demonstrate that sponsored studies are far more likely to favor the interests of the sponsor than are studies funded by government agencies or foundations, and to argue for more independent funding of food and nutrition research (see my recent Viewpoint on this topic in JAMA Internal Medicine).

Here are five more examples.

Is consuming yoghurt associated with weight management outcomes? Results from a systematic review. J Eales, I Lenoir-Wijnkoop, S King, H Wood, F J Kok, R Shamir, A Prentice, M Edwards, J Glanville, R L Atkinson. Int’l J Obesity 2015 ahead of print.

• Conclusions: Yoghurt consumption is associated with lower BMI, lower body weight/weight gain, smaller waist circumference and lower body fat in epidemiological studies. RCTs [randomized controlled trials] suggest weight reduction effects, but do not permit determination of a cause/effect relationship. Well-controlled, adequately powered trials in research and community settings appear likely to identify a modest but beneficial effect of yoghurt consumption for prevention of weight gain and management of obesity. The ready availability of yoghurt (a nutrient dense food) and its ease of introduction to most diets, suggests that educating the public to eat yoghurt as part of a balanced and healthy diet may potentially contribute to improved public health.
• Funding: This project was funded by Danone Institute International.
• Conflict of interest statement: York Health Economics Consortium received funding from Danone Institute International to conduct this review. York Health Economics Consortium has received funding from the Global Alliance for Probiotics, Danone and the European Food Safety Agency for projects involving food and health topics. FJK is member of the Scientific Advisory Board Global Dairy Platform, Chicago USA RS is President of Danone Institute International ILW is employed by the Danone Company, France.

Red Meat and Colorectal Cancer: A Quantitative Update on the State of the Epidemiologic Science.  Dominik D. Alexander PhD, MSPHab*, Douglas L. Weed MD, PhDc, Paula E. Miller MPHb & Muhima A. Mohamed M PHd. J Am College Nutrition 2015;34: 521-43.  DOI:10.1080/07315724.2014.992553

• Conclusion:  The state of the epidemiologic science on red meat consumption and CRC [colorectal cancer] is best described in terms of weak associations, heterogeneity, an inability to disentangle effects from other dietary and lifestyle factors, lack of a clear dose-response effect, and weakening evidence over time.
• Funding: This manuscript was partially funded by Meat & Livestock Australia (MLA). MLA did not contribute to the writing, analysis, or interpretation of study findings.
• Comment: The conclusion of this industry-funded study contradicts the findings of the WHO International Agency for Research on Cancer, which finds processed meats to be carcinogenic, and red meat to be a probable carcinogen.

The challenges of nutrition policymaking. Joanne Slavin.  Nutrition Journal (2015) 14:15 DOI 10.1186/s12937-015-0001-8.

• Thrust of paper: As every DGAC [Dietary Guidelines Advisory Committee] wants to be bold and set new direction, nutrition science would support that first we must do no harm with our dietary guidance. Moderation and variety must be kept front and center…A suggestion that all Americans should reduce sodium intakes is not sound and is potentially dangerous. Targeting certain foods and beverages, including chocolate milk, processed meats, added sugars, and even the noble potato as villains in the nutrition wars is not a science-based strategy and may need to be countered on the political front if appointed scientific review committees continue to take this approach.
• Competing interests: In the past 5 years Dr. Slavin has received research grants from Minnesota Beef Council, Minnesota Cultivated Wild Rice Council, Novartis Consumer Health, USA Rice, Nestle Nutrition, Tate and Lyle, General Mills, Inc., USA Pears and American Pulse Association. In the past 5 years Dr. Slavin has received speaking fees from food companies and commodity groups with interests in processed foods, dairy products, meat, pulses, fruits, vegetables, fiber, grains, and carbohydrates. Dr. Slavin has participated in scientific panels and advisory boards that are funded by food companies, ingredient companies, commodity groups, scientific societies, and trade groups. She holds a third interest in the Slavin Sisters LLC, a 119-acre farm in Southern Wisconsin.

Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies PJ Rogers, PS Hogenkam , C de Graaf, S Higgs, A Lluch, AR Ness, C Penfold, R Perry, P Putz, MR Yeomansand DJ Mela.International Journal of Obesity (2015), 1–14 10 November 2015; doi:10.1038/ijo.2015.177

• Conclusions: Overall, the balance of evidence indicates that use of LES [low-energy sweeteners] in place of sugar, in children and adults, leads to reduced EI [energy intake] and BW [body weight], and possibly also when compared with water.
• Conflict of interest: Peter J Rogers has received grants from Sugar Nutrition, UK in support of research on the effects of sugar on human appetite. Cees de Graaf has received grants from the Dutch Sugar Bureau in support of a study on brain responses to sugars and low energy sweeteners. Suzanne Higgs has received a grant from Canderel in support of research on the effects of low-energy sweeteners on human appetite. Anne Lluch and David J Mela are employees and shareholders of companies that manufacture products containing sugars and low-energy sweeteners. Peter Putz is an employee of ILSI Europe.

Walnut ingestion in adults at risk for diabetes: effects on body composition, diet quality, and cardiac risk measures Valentine Yanchou Njike, Rockiy Ayettey, Paul Petraro, Judith A Treu, David L Katz.  . BMJ Open Diabetes Research and Care 2015;3:e000115. doi:10.1136/bmjdrc-2015- 000115.

• Conclusions: The inclusion of walnuts in an ad libitum diet for 6 months, with or without dietary counseling to adjust calorie intake, significantly improved diet quality, endothelial function, total and LDL cholesterol, but had no effects on anthropometric measures, blood glucose level, and blood pressure.
• Funding: Funding for this study has been provided by the California Walnut Commission.
• Competing interests. DLK has been compensated for public speaking by the California Walnut Commission.