For my latest San Francisco Chronicle column, I borrowed a query from a reader of this blog demanding financial disclosure.  This gave me the opportunity to discuss how sources of funding – especially from food companies – raise questions about whom to trust when it comes to nutrition advice.  Thanks to all of you who commented on that original post.  Most interesting.

The column appears in the Food and Wine section.  Although the San Francisco Chronicle, like many newspapers, is ailing badly, this section has just been selected by the Association of Food Journalists to win its award for best section.  I’m proud to be part of it.

On October 6, the American Academy of Family Physicians (AAFP) announced its new partnership with Coca-Cola.  What does AAFP get from this?  A grant “to develop consumer education content on beverages and sweeteners for FamilyDoctor.org.”

The AAFP, says its president, looks forward to

working with The Coca-Cola Company, and other companies in the future, on the development of educational materials to teach consumers how to make the right choices and incorporate the products they love into a balanced diet and a healthy lifestyle.

Coca-Cola must be thrilled with this.  As its CEO explains in an op-ed in yesterday’s Wall Street Journal, soft drinks are entirely benign and have nothing to do with obesity.  Obesity is due to lack of physical activity and eating too much of other foods, not Coke.  His view of the situation is entirely predictable.

But what about the AAFP?  Family practice doctors have been telling me for years that it is not unusual for them to see overweight kids and adults in their practices who consume 1,000 to 2,000 calories a day from soft drinks alone.  The first piece of advice to give any overweight person is to stop drinking soft drinks (or other sugary drinks).

This partnership places the AAFP in embarrassing conflict of interest.  I gather that members were not consulted.  They need to make their voices heard.  I hope AAFP members decide that no matter what Coke paid for this partnership, their loss of credibility is not worth the price.

Addendum: Here’s what a Chicago Tribune blogger has to say about this.

Further addendum, October 10: As noted in the comments, AAFP members were consulted, more or less.  Apparently, they decided Big Food was less of a problem than Big Pharm.  Really?  How about selling out to neither?

In response to the revelations about meat safety (or the lack thereof) in the New York Times comes a letter from J. Patrick Boyle, President and Chief Executive of the American Meat Institute.  Mr. Boyle’s letter is worth reading:

• It contains not a trace of apology.
• It says meat is much safer now due to industry efforts.
• It considers E. coli O157:H7 a “fact of nature” like floods or flu (i.e., unpreventable).
• It blames the USDA for meat safety problems.

Why the USDA?  The USDA will not let meat packers irradiate carcasses to sterilize them.

Is irradiation the key to meat safety?  It kills bacteria, no question.  And it does not make meat radioactive.  But the sterilization is incomplete and temporary and irradiated food must be handled like fresh food.

As I discuss in my book, Safe Food, E. coli O157:H7 most definitely is preventable.  That is why I view irradiation as a late stage techno-fix.  It zaps dirty meat and lets this industry get away with producing dirty meat in the first place.

Nobody ever explained the problem with irradiation better than Carol Tucker Foreman, now at Consumers Federation of America: “sterilized poop is still poop.”

So the New York Times ran a story about early research on the impact of New York City’s calorie labeling postings by fast food restaurants.  The research, done by some of my New York University colleagues, looked at what customers said they were doing and compared what they said to what they actually did.  Oops.  Customers said the labeling made them choose foods more carefully but they actually bought more calories.

So, should we give up on this idea?  No way.  These are preliminary results looking at what happened during the first few weeks of calorie labeling in fast food places in low-income areas of New York City.  In such areas, restaurant choices are few, cheap food is a necessity, and people go to fast food places precisely because they can get lots of calories at low cost.

I can think of several excellent reasons for calorie labeling, none of them addressed by this particular study and all of them supported by considerable observational evidence:

• People do not understand calories very well; calorie labeling can begin the education process especially if accompanied by materials explaining that most people require about 2,000 calories a day.
• Some people – not all, of course – will change their behavior and choose lower calorie items when they realize how many calories are in fast food.
• Fast food places will reduce the number of calories in the items they serve.

This last may be the most important.  Just as labeling the amount of trans fat in processed foods caused food manufacturers to eliminate trans fats from their products, so fast food sellers are looking for ways to reduce the calories in their products.  This is already happening and is the easiest way I can think of to encourage people to eat less: don’t serve as much.

I think we need a whole lot more public outrage about unsafe food.  Maybe the recent front-page articles in the Washington Post and New York Times will do the trick.

Both tell tragic stories of women who developed hemolytic uremia syndrome in response to eating a food contaminated with E. coli O157:H7.  Both reveal the appalling physical and monetary cost of these illnesses.  Recall: we also do not have an effective and affordable health care system.

To me, the most chilling part of the Times investigation had to do with the lack of testing for dangerous pathogens.  No meat packing company wants to test.  Why not?  They know the animals coming into the plant are contaminated.  They know that tests would come up positive.  They know that if they find pathogens, they have to recall the meat.

It’s obvious why meat is contaminated.  The making of hamburger is enough to put anyone off, as the letters to today’s Times attest.  In my book, Safe Food, I discuss a study demonstrating that one pound of commercial hamburger could contain meat from more than 400 cattle.  The Times’ article takes such facts to a personal level.  The 22-year-old woman who ate the tainted hamburger is paralyzed from the waist down and likely never to walk again.

Read these articles and you will understand that meat companies will not do what is needed to produce safe food unless they are forced to.

And it’s not just hamburger that causes problems.  Center for Science in the Public Interest (CSPI) has a new report out on the ten foods that cause the most cases of foodborne illness in America.  Hamburger isn’t even on the list.  Instead, it’s leafy greens, eggs, tuna, oysters, potatoes, cheese, ice cream, tomatoes, sprouts, and berries.  [Addendum October 9: for a critical analysis, see the Perishable Pundit’s comments on the study].

So how come Congress isn’t forcing all food producers to produce safe food?  Could it be because there isn’t enough public outrage to counteract industry pressures and make Congress act?

Bill Marler, who represents both of the victims profiled in those articles, is begging Congress to put him out of business.

His message is clear: get busy and pass meaningful food safety legislation, right now, before it is too late.

I’m hoping these articles and the CSPI report will be seen by senatorial staff who will urge their bosses to support the House bill passed last spring.

Maybe we need hundreds of thousands of people to deluge Congress with appeals to act on food safety, now.

You would like to do this but don’t know how?  Easy.  Find your own representatives online on the House site and your Senator just as easily.  The e-mail addresses are right there waiting to be used.

Addendum: Here’s one rep who is on the job: Rosa de Lauro (Dem-CT).  Take a look at her statement about the Times article.  Where, she wonders, was the USDA while all this was going on?   Doing lots of good things, according to USDA Secretary Tom Vilsack:

No priority is greater to me than food safety and I am firmly committed to taking the steps necessary to reduce the incidence of foodborne illness and protect the American people from preventable illnesses. We will continue to make improvements to reduce the presence of E. coli 0157:H7.

Suggestion: enforce HACCP!

Kim Severson’s piece about school food in last week’s New York Times food section discusses some of the barriers to producing decent and tasty school food: cooking skills!  There are plenty of others, as detailed in Dana Woldow’s terrific 3-minute video detailing the situation in San Francisco’s public schools – as seen by kids in that system.  As the kids put it, “We need better school food!”

On the day the Times piece appeared, I was doing a tour of a couple of New York City school lunch programs.  One was to a small K-to-9th grade school in the low-income Bedford-Stuyvesant area of Brooklyn.   This school may not have had much money, but it had everything else needed to make school food work: a devoted and smart principal, a committed staff, and a school food director who set high standards.  The food looked, smelled, and tasted good and the kids were eating it.

How did this school perform this miracle?  Easy.  Everyone cared that kids got fed and liked what they were eating.

The next stop was Brooklyn Tech.  Same food; different experience.  If caring was present, it didn’t show.

For one thing, the junk-food vending machines were in the lunch room (not a good sign).  Worse, they were open for business (a flat out violation of federal rules).   Even worse, nobody seemed to be doing anything about it, at least as far as I could see.

My conclusion: school food can be really good, even in poor neighborhoods, if everyone involved cares about it.  Can we teach schools to care?  Of course we can.

And officials can make it harder for schools not to care.  The New York City Education Department says schools have to cut way down on bake sales, with exceptions for parent groups, parent-teacher associations, and birthday celebrations.

This policy will undoubtedly elicit complaints, but I don’t have much sympathy for complainers.  School kids are bombarded with junk food from multiple sources all day long.  If they didn’t eat so much of it, they might eat real food and support the school lunch program to a greater degree.  That’s why those open vending machines are so troubling.  The messages they send are “it’s OK to eat junk food in school,” and “it’s OK to disobey federal rules any time we want to.”  Not a good idea.

Well, sort of reveals.  Coca-Cola announces that it will put calories on the front of its packages (so you don’t have to search for and put on glasses to read the Nutrition Facts).  You can see what the label will look like in the story in USA Today.

This sounds good but I view this action as another end run around FDA’s proposed regulations.  In March 2004, the FDA proposed to require the full number of calories to be placed on the front of food packages likely to be consumed by one person, like a 20-ounce soda for example (see figure).  A 20-ounce soda is 275 calories, not 100.

If Coca-Cola followed that FDA proposal, a label of a 2-liter bottle would have to say 800 Calories right on the front of the package.

This idea got stuck in Bush administration but there’s a good chance the new folks at FDA might take it up again.

Is Coca-Cola serious about helping people avoid obesity?  If so, maybe it could send out a press release distancing itself from those consumer-unfriendly ads run by the Center for Consumer Freedom (see previous post).

Here’s another question: Does Coca-Cola fund the CCF directly or indirectly through the American Beverage Assocation or some other industry trade group?  I will believe that they might really have an interest in consumer health when I know they have no connection whatsoever to CCF and its current ad campaigns.

Today’s New York Times carries this full-page ad taking on the New York City Health Department’s campaign against sodas.

Although the ad says it’s paid for by the Center for Consumer Freedom (CCF), it doesn’t take much to guess who paid that group for it.  What better way to fight back than to hide behind this particular public relations agency, which specializes in defending purveyors of unhealthful products.

What CCF is about – and which companies pay for its work – are well known (for starters, see previous post).

I’m guessing the Health Department’s campaign must be having an effect if soft drink companies are so worried that they are willing to fund a group that is so consumer unfriendly.

Addendum:  no wonder they are worried.  According to a new report on soda taxation from Center for Science in the Public Interest, President Obama has said the idea is worth considering.

And thanks to Fred Tripp for giving me yet another CCF ad, this one from the September 30 A.M. New York.   All of this must be making soda companies worried enough to sign on with CCF.  Not a good idea.

Update October 2: I’ve just been send a link to Rachel Maddow’s comments on Rick Berman, the head of CCF.  Look for “Meet Rick Berman.”  It gives an overview of CCF accounts.  I’m not sure when it aired.