I received a flurry of “you should have attended the meeting before you said anything” messages in response to my post yesterday about the FTC forum.  They said the table that I posted did not have footnotes attached and I also had missed a key point about RACC (reference amounts commonly consumed): they are likely to be larger than current FDA serving sizes, meaning that the amounts of sugars and salt will have to be reduced to qualify.

Guilty as charged.  RACC, as I mentioned yesterday, is a new term to me.  This is because – how could anyone have missed this – I was unaware of the FDA’s Federal Register notice of April 4, 2005: “Serving sizes of products that can reasonably be consumed at one eating occasion; Updating of reference amounts customarily consumed; Approaches for recommending smaller portion sizes.”

This notice was the result of concerns about the serving sizes that had been established when the FDA issued final food labeling regulations in 1993.  Then, the FDA established serving sizes for 129 product categories for adult foods and 11 categories for infant and toddler foods.  These were derived from information about amounts commonly consumed reported in food consumption surveys from the late 1970s and late 1980s.

Either people ate a lot less back then or they were lying, or both.  As my former doctoral student, now Dr. Lisa Young, discovered during her doctoral research, standard portion sizes – half a cup of ice cream or one 2 or 3-ounce slice of pizza, for example – are smaller (sometimes much smaller) than what people seem to be actually eating.

The FDA knew this.  In 2003, it appointed an Obesity Working Group to advise the agency about several issues, among them whether to update the RACCs.  The Group filed its report in 2004.  With respect to serving size, it recommended:

* In the short-term, that FDA encourage manufacturers immediately to take advantage of the flexibility in current regulations on serving sizes that allows food packages to be labeled as a single-serving if the entire content of the package can reasonably be consumed at a single-eating occasion.

* In the long-term, that FDA develop two separate ANPRMs [Advance Notice of Proposed Rulemaking].  The first would solicit comment on whether to require additional columns within the nutrition label to list the quantitative amounts and %DV of the entire package on those products and package sizes that can reasonably be consumed at one eating occasion or, alternatively, declare the whole package as a single serving. This ANPRM would also solicit information on products and package sizes that can reasonably be consumed at one eating occasion.  The second ANPRM would solicit comments on which, if any, RACCs of food categories appear to have changed the most over the past decade and therefore need to be updated.

On that basis, the FDA’s 2005 Federal Register notice asked for comments about whether:

• Consumers might “think that an increase in serving size on food labels means more of the food should be eaten.”
• Manufacturers might repackage products in larger sizes to avoid labeling a package as a single serving.
• Manufacturers might reduce the size of single-serving packages to reduce the apparent content of undesirable nutrients.

That was nearly five years ago.  If anything further happened, I cannot find it in the Federal Register. Getting to these questions at last was apparently the point of the FTC forum.

I am told that panelists suggested raising the RACC serving size of kids’ cereals to 50 grams rather than the current 30 grams.  If so, this would require cereal companies to reduce the amount of sugars in their products.   Aha!  That could explain why, as I discussed in a previous post, General Mills chose to put its full-page ads in newspapers promising to drop the sugars to single digits.  General Mills must think changes in the RACC for cereals will require it to lower the sugars in order to be able to advertise to kids under the voluntary guidelines. Given how long the FDA’s processes take, it is understandable why General Mills failed to say when it would implement its promist.  I am also told that the salt cut-point is open for comment.

For those of us who were not at the Forum and prefer to see such things in writing, how about releasing the footnotes to that chart and giving us some examples of the proposed changes to the RACC?  Also, how about setting up a mechanism so interested people can file official comments on the proposals?  Both would help people offer more informed comments on how the FDA should handle the serving size issues.

Update, December 20: Thanks to Ellen Fried for providing a link to some food industry opinion on what all this is about and another an in-the-know source that says the proposed standards are to be published in the Federal Register and opened for further public comment in January.  The project is to be finished by July.  Ellen points out that this procedure seems administratively complicated for standards that are not regulations; they are voluntary. Do the FTC and FDA really have to go through all this to issue what is simply guidance?  Or is something else going on here that I’m not getting?

I could not go to the Federal Trade Commission’s December 15 forum on food marketing to children (see previous post), but from all reports I missed quite a show.

Officials of four federal agencies involved in food and food regulation – FTC, FDA, USDA, and CDC – released the results of their collaborative efforts to set standards for marketing foods to kids through an Interagency Working Group on Food Marketed to Children.  Congress established this group through the 2009 Omnibus Appropriations Act.  It specified that the group was to set up standards for identifying foods that should not be marketed to children and to publish them by July 15, 2010.

And what standards did the four agencies come up with?  Here are the working group’s recommendations:

Take a look at these “Tentative Proposed Standards for Marketing Food to Children 2-17” and decide for yourself whether they are even remotely meaningful.

The Standards are divided into three categories: Standard 1 is real (largely unprocessed) foods with no added sweeteners or functional ingredients.  These could be marketed to children with no further scrutiny.

Foods that do not meet Standard 1 would be required to meet both Standards 2 and 3 in order to be marketed to children.

Standard 2 applies to foods that “must provide a meaningful contribution to a healthful diet” in one of two ways: containing 50% by weight of real foods (Option A), or by containing defined amounts of some useful nutrients per RACC (Option B).  RACC is a new term to me.  Apparently, it means “reference amount customarily consumed.”   I have no idea what these are but let’s call them serving size.

And what about the cut points?  No foods marketed to children can exceed Standard 3 (“nutrients to limit”):

• Saturated fat: 1 gram or less per serving and not more than 15% of calories
• Trans fat: less than half a gram per serving
• Sugar: no more than 13 grams per serving
• Sodium: no more than 200 mg per serving (equivalent to half a gram of salt)

Got that?  It’s enough to make me weep.

Apparently, the agencies did not give examples of products that might qualify or not, so you have to do your own work on this.  So that leaves me with some questions about the tentative proposed standards:

• Which products qualify and which do not?  It looks to me like the criteria will continue to permit the marketing of questionably nutritious products to kids.  Sugary kids’ breakfast cereals should easily qualify; most do not contain more than 13 grams of sugars per serving or more than 200 mg sodium.
• What is the definition of RACC?  I don’t see a definition in the document.  Without a definition, are companies permitted to define serving sizes for themselves and, maybe, reduce the stated serving size to meet the standards?
• Is there any accountability for meeting the standards?  The entire program is voluntary. Alas, we have already had years of experience with industry “self-regulation” and know that it does not work.

This is the best government agencies could come up with?  I see this as further evidence for the need to stop companies from marketing foods to kids.  Period.

Or am I missing something?

A new study from the U.K. suggests that traffic-light labels on food products are not inducing people to choose healthier options.  The study contradicts the results of a previous study by the British Food Standards Agency, which found the traffic-light labels to be preferred by consumers, of use to them, and a stimulant to manufacturers to reformulate products to qualify for more of those little green dots.

While the arguments go on, and the FDA and the Institute of Medicine conduct their own studies of front-of-package labeling, and the FTC establishes its own standards for advertising, I have a suggestion: How about removing ALL health and nutrition claims from junk foods.

How about trying to think about foods as foods, not drugs.  Let food packages carry Nutrition Facts labels and lists of ingredients, but that’s all.  It would save everyone a lot of trouble.  Federal agencies could get back to worrying about more important things.  City and state attorneys could too.  And consumers would no longer be misled by absurd claims that cereals or snacks will make people healthy.

Just a thought.

Ordinarily, concerns about leaching plastics are way down on my list of food safety worries (bacteria are #1), but the evidence against bisphenol A (BPA) continues to pile up.  The latest report says that BPA adversely affects the immunity of the digestive system and causes inflammation.  This, among other considerations, has led the National Institute of Environmental Sciences to invest $30 million to study it.

These and other concerns about its safety hazards have the plastics industry and its users in a tizzy and must also be paralyzing food safety regulators .  The FDA has postponed the release of its report on the safety of BPA.  The report was due out at the end of November but the FDA is not saying when it will be published.  The FDA just says the report is coming soon.  That’s not good enough, say critics who say that the delay is raising questions about the FDA’s credibility.

While all this is happening, United Nations’ agencies are planning a summit on BPS safety to be held in Canada in – don’t hold your breath – October 2010.

What to do?  Avoidance seems prudent.  BPA turns up in plastics coded with numbers 7 (the catchall category) and, sometimes, 3.  Can’t keep the numbers straight?  Try glass?

The research demonstrating the not-so-great effects of sodas just pours in, as it were.  The Robert Wood Johnson Foundation has two new research reports, one on justification for taxation of soft drinks, and the other on the negative effects of soft drinks on kids’ health.

David Ludwig writes in JAMA that artificially sweetened drinks are unlikely to help the situation.  They just make people want sweeter foods.

And the New York City Health Department has put its anti-soda campaign online.   This is its controversial “drinking fat” campaign designed to make the point that excess calories from sugary soft drinks will put on the pounds.  Why controversial?  Take a look at the cute guy demonstrating the drinking-fat point on the YouTube video.

What’s your take on this?

The FTC forum on food marketing to kids takes place tomorrow, December 15.  Recall that the industry-sponsored Children’s Food and Beverage Initiative says the industry doesn’t need regulation, as its self-regulation policies are working just fine.

The research, alas, says otherwise.  According to a report released today, self-regulation is a joke.  An independent investigation of industry marketing-to-kids practices, by Dale Kunkel and his colleagues from the University of Arizona, concludes:

• Most ads for foods produced by self-regulating companies are for junk foods
• Ads for healthy foods are virtually non-existent
• Licensed cartoon characters are increasingly used to market junk foods to kids
• At least a quarter of junk food ads come from companies that do not self-regulate
• Improvements are negligible

Senator Tom Harkin, who has been introducing legislation to restrict children’s food advertising, says he’s disappointed:

The food industry vowed to limit the amount of advertising dollars spent to promote unhealthy foods to children, and focus more on nutritious items.  That’s why I am so discouraged by this report out today.  When private interests work against the public good, government is obliged to act. We need to examine this issue more closely and figure what needs to be done to achieve balance on the airwaves so that we can improve the health and wellness of our children.

Jeffrey Chester, of the Center for Digital Democracy, points out that he, Kathryn Montgomery of the Center for Communications at American University, and Lori Dorfman of the Berkeley Media Studies Group, have been studying the way food companies advertise on the Internet.  Kathryn Montgomery will be presenting their conclusions from a series of papers examining digital advertising, along with some more recent examples of food marketing to kids in action.

The food industry’s job is to sell more food, not less.  Because restrictions on advertising are not in industry’s best interest, it is unreasonable to expect self-regulation to work.  That is why we need government to get in there and establish some checks and balances.  The forum should be interesting.  I’m hoping it will lead to FTC action.  Maybe it will even get some of Harkin’s colleagues to do some real work on this issue.  Fingers crossed!

Update, December 15: Here’s what The FTC released at the forum – standards for the kinds of products that food companies can market to children.  These look good but are voluntary. Good enough? I don’t think so.  And here’s a report on what happened.

While all of that is going on in Copenhagen, the Manhattan Borough President, Scott Stringer, along with Just Food, organized a food and climate change summit today at my university, NYU.  More than one thousand New Yorkers signed up for thirty workshops at the amazing event.  Why amazing?  Because this summit is about advocacy for a more just and sustainable food system, and right now.

My thoughts: the diet that is best for health – more fruits, vegetables, and grains, and less meat, dairy, and junk food – is also the diet that is best for the planet.

Does advocacy for a food system that provides healthy food for everyone constitute a social movement?  Look around the room at the summit.  The answer is an unequivocal YES.  Can one New York City Borough show the way.  YES.

And this one, we will win.

My copy of Thursday’s New York Times business section has a full page ad from General Mills on page B3:

People are talking about sugar in kids’ cereals. General Mills is doing something about it. General Mills commits to reduce the sugar levels in advertised children’s cereals to single digit levels…Today our commitment to further lower sugar levels is among the most aggressive goals in the food industry.  It’s a commitment we’re making in 130 countries around the world.

So that sounds good, no?  But I wondered about two things: WHEN was this going to happen, and WHAT ELSE is in those cereals.

I went to the General Mills website and took a look at its gorgeous pages on “The Benefits of Cereal.” The site is beautifully illustrated with charts showing the changes in sugars per serving during the last couple of years.  Take Lucky Charms, for example.  In 2007, its sugar dropped from 12 to 11 grams per serving, and is now headed for “single digits.”  By when?  It doesn’t say.

General Mills’ press release boasts about all the whole grain its cereals contain:

General Mills’ 2005 whole grain initiative has been called one of the biggest health initiatives in the food industry. The company committed to ensuring that every Big G cereal would help deliver the benefits of whole grain. As a result, every Big G cereal now provides at least 8 grams of whole grain per serving, with many cereals providing 16 grams of whole grain or more.

Maybe, but what about the non-Big G kids cereals?  Lucky Charms, for example again, has only one gram of fiber per serving, making it a low-fiber choice.  It also has 190 mg sodium (half a gram of salt) per serving.

As for the banner on calcium and vitamin D: the cereal contains 10% of the Daily Value per serving, which goes up to 25% if you put milk on the cereal.    As the cereal makers are always assuring me, the point of kids’ cereals (sweet, salty, low-fiber) is to get kids to drink milk.

All of this leads again to that philosophical question: does a reduction of one or two grams of sugars per serving make these cereals a GOOD choice for your kid?   Does a little less sugar turn Lucky Charms into a health food? Is a time-insensitive commitment to reduce sugars a real commitment?

Is this action worth a full-page ad in the New York Times?  General Mills must thing so. But why do I think this is more about marketing than about kids’ health?

You decide.