Here’s another one that several readers have asked me about: Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial.  Authors: Lok-Kin Yeung, Daniel M. Alschuler, Melanie Wall, Howard D. Sesso, JoAnn E. Manson, Adam M. Brickman.  American Journal of Clinical Nutrition. DOI:https://doi.org/10.1016/j.ajcnut.2023.05.011

The study: “Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y.”  Primary outcome measure: change in episodic memory (immediate recall performance on the ModRey test, after 1 y of intervention).  Secondary outcome measures: changes in episodic memory over 3 y of follow-up,  and in performance on neuropsychological tasks of novel object recognition and executive function over 3 y.

Results: “Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes…we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change.”

Conflict of interest: HDS, JEM, and AMB received investigator-initiated grant support to their institutions from Mars Edge. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. HDS received investigator-initiated grants from Pure Encapsulations and Pfizer Inc and honoraria and/or travel for lectures from the Council for Responsible Nutrition, BASF, NIH, and the
American Society of Nutrition during the conduct of the study. No funding sources had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Funding: This work was supported by an investigator-initiated grant from Mars Edge, a segment of Mars Inc dedicated to nutrition research. Pfizer Consumer Healthcare (now Haleon) provided support through the
partial provision of study pills and packaging.

Comment:  This study continues to surprise me.  As I’ve written before, it is part of the COSMOS trial, which is also supported by grants from NIH and a private foundation.  In my previous post on it, I noted that despite being funded by Pfizer (which makes Centrum Silver multivitamin supplements), the study did not show benefits of the supplement for prevention of cardiovascular disease or cancer—a rare exception to the rule that industry-funded studies tend to favor the sponsor’s interests.  But here we go again, this time with an equally surprising result but for a different reason: most multivitamin studies have shown no benefits whereas this one says if you take Centrum Silver, it will give you another three years of no loss in memory.  Wow!  I’ll be Pfizer is thrilled.

Here’s what the NIH National Center for Complementary and Integrative Health says about multivitamins:

I’m just getting to this report from Food and Water Watch: The Economic Cost of Food Monopolies: Dirty Dairy Racket

Food & Water Watch took a look at what’s happening to the U.S. dairy industry.  Its conclusions are not surprising if you have been following these trends.

• Big dairies have driven out small.  Only about 30 percent of all U.S. milk is produced on family-scale farms.
• Dairy is not profitable.  “Thanks to the gutting of federal supply management policy,” overproduction and increased production costs gave caysed milk prices to plummet.
• Consolidation doesn’t help.  Three dairy coops control 83 percent of milk sales: DFA (Dairy Farmers of America), Land O’ Lakes, and California Dairies, Inc.).

Here’s one comparison: Dairy association CEP salaries as compared to dairy farmer income.

The next Farm Bill could help fix some of this by:

• Restoring supply management
• Stopping proliferation of factory dairy farms
• Reforming the farm safety net
• Setting fair prices

The American Beverage Association, which represents Big (and also Medium) Soda, is now advertising in Politico.

America’s leading beverage companies – The Coca-Cola Company, Keurig Dr Pepper and PepsiCo – are bringing consumers more choices with less sugar. From sparkling, flavored and bottled waters to zero sugar sodas, sports drinks, juices and teas, consumers have more options than ever. In fact, nearly 60% of beverages sold today have zero sugar. Americans are looking for more choices to support their efforts to find balance, and America’s beverage companies are delivering. Explore choices at BalanceUS.org.

Ultra-processed foods—defined operationally as industrially produced foods formulated to be irresistably delicious that can’t be made in home kitchens (because you don’t have the machinery or the ingredients—are by now well established to be associated with weight gain and weight-related chronic diseases.

Evidence now suggests the association is causal.  Ultra-processed diets induce people to eat more calories without realizing it.

Alas for food companies.  Ultra-processed products are among their most profitable.

The British Nutrition Foundation to the rescue!

• It has issued a position statement on ultra-processed foods.   It complains that:
• The classification system omits foods the Foundation considers healthy.
• It implies that expensive artisanal products are superior for health (advice to reduce UPF raises questions of equity).
• The research is largely observational.
• The food environment is a key driver of poor health.
• Making products that are not ultra-processed may have unintended consequences.
• Demonizing ultra-processed foods could foster feelings of guilt and stigma.
• Messages to avoid UPF might discourage industry from reformulation.
• Food processing plays a releant role in food system sustainability and food security.

When I read things like this, I have the usual question: Who paid for this?

The British Nutrition Foundation says:

BNF’s funding comes from: membership subscriptions; donations and project grants from food producers and manufacturers, retailers and food service companies; contracts with government departments; conferences, publications and training; overseas projects; funding from grant providing bodies, trusts and other charities.

If it lists its corporate sponsors, I can’t find it.

But PowerBase says:

The British Nutrition Foundation (BNF) is the key food industry front group in the UK. The BNF promotes itself as a source of impartial information, but it does not always make its links with industry clear.

The BNF is hard at work on behalf of food companies who wish the entire UPF concept would just disappear.  See, for example, “How do we differentiate not demonise –Is there a role for healthier processed foods in an age of food insecurity? Proceedings of a roundtable event” published in the Nutrition Bulletin.  The themes that emerged from the conference:

• problems with the use of definitions for UPF,
• the lack of causal evidence and defined mechanisms linking processing per se with poor health outcomes,
• advice that may result in consumer confusion.
• misalignment of UPF foods with dietary guidelines
• unintended consequences for vulnerable groups

Comment: 

OK, the food industry is fighting back.  I think it’s a losing battle.  The UPF concept has so much evidence backing up its usefulness.  But I will say one thing about the point about unintended consequences.   It’s OK for rich people to avoid UPF but OK for poor people to eat them?  I think the food industry is in trouble on this one.  It has gotten away with pushing junk food for way too long.  The British Nutrition Foundation would be much more crredible if it put public health first.

Mexico has issued new dietary guidelines.

https://www.gob.mx/cms/uploads/attachment/file/826673/Gui_as_Alimentarias_2023_para_la_poblacio_n_mexicana.pdf

1. Breastfeed babies for the first 6 months and then continue until age 2 along with other nutritious foods.
2.  Eat more vegetables and fruits.
3. Eat beans.
4. Choose whole grains.
5. Eat less beef and processed meats.
6. Avoid ultra-processed foods.
7. Drink water.
8. Avoid alcohol.
9. Be physically active.
10. Enjoy meals with family and friends.

I’m looking forward to reading a case study on how the public health institute got these through the political process.

If people follow these guidelines, these industries will be in trouble:

• Infant formula
• Beef
• Processed meats
• Ultra-processed foods
• Sugar-sweetened beverages
• Alcohol

People will be healthier!  These industries will also be in trouble.

• Pharmaceutical drugs
• Private medicine
• Insurance companies? (you might think they would benefit, but they make so much money on illness—this one is complicated)

I hope the new U.S. Dietary Guidelines will find these inspiring.

Thanks to Bradley Flansbaum for sending this one from a journal not on my usual reading list: “In persons with constipation or IBS-C, kiwifruit vs. psyllium increased spontaneous bowel movements.”

I like the way this press release gets right to the point.

An industry-funded randomized trial assessed the effect of daily consumption of kiwifruit versus psyllium on GI function and comfort in 184 adults who were healthy, had functional constipation (FC), or met Rome III diagnostic criteria for constipation-predominant irritable bowel syndrome (IBS-C).

The study: Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort—Results of an International Multicenter Randomized Controlled Trial.  The American Journal of Gastroenterology ():10.14309/ajg.0000000000002124, January 9, 2023. | DOI: 10.14309/ajg.0000000000002124.

Authors: Gearry, Richard MD, PhD; Fukudo, Shin MD, PhD; Barbara, Giovanni MD; Kuhn-Sherlock, Barbara PhD; Ansell, Juliet PhD; Blatchford, Paul PhD; Eady, Sarah MSc; Wallace, Alison PhD; Butts, Christine PhD; Cremon, Cesare MD; Barbaro, Maria Raffaella PhD; Pagano, Isabella MD; Okawa, Yohei PhD; Muratubaki, Tomohiko PhD; Okamoto, Tomoko PhD; Fuda, Mikiko MS; Endo, Yuka MD; Kano, Michiko MD, PhD; Kanazawa, Motoyori MD, PhD; Nakaya, Naoki PhD; Nakaya, Kumi PhD; Drummond, Lynley BTech (Hons)

Summary of the study

Methods: Participants included healthy controls (n = 63), patients with functional constipation (FC, n = 60), and patients with constipation-predominant irritable bowel syndrome (IBS-C, n = 61) randomly assigned to consume 2 green kiwifruits or psyllium (7.5 g) per day for 4 weeks, followed by a 4-week washout, and then the other treatment for 4 weeks. The primary outcome was the number of complete spontaneous bowel movements (CSBM) per week.

Results: Consumption of green kiwifruit was associated with a clinically relevant increase of ≥ 1.5 CSBM per week (FC; 1.53, P < 0.0001, IBS-C; 1.73, P = 0.0003) and significantly improved measures of GI comfort (GI symptom rating scale total score) in constipated participants (FC, P < 0.0001; IBS-C, P < 0.0001).

Conclusion: This study provides original evidence that the consumption of a fresh whole fruit has demonstrated clinically relevant increases in CSBM and improved measures of GI comfort in constipated populations. Green kiwifruits are a suitable dietary treatment for relief of constipation and associated GI comfort.

Financial support: Zespri International Ltd. was the principal sponsor and reviewed, approved, and funded the study design. The New Zealand study center trial was jointly funded by a grant from the New Zealand government (Contract C11X1312) and the sponsor company, Zespri International Ltd. In Italy and Japan, Zespri International Ltd. was the sole funder for each study center trial. The funder did not contribute to the study design or data analysis.

Potential competing interests: J.A. and P.B. are employed by Zespri International who part-funded the study. R.G. and L.D. sit on the Science Advisory Board, have received travel and research grants from Zespri International. SF and GB have received research travel grants from Zespri International.

Comment:  Can you guess what Zespri International sells?  Go on.  Take a wild guess.  I’ll admit it.  I’d go for kiwi over psyllium every time.  But we are talking here about an average improvement of 1.5 bowel movements a week, which may or may not be clinically meaningful..  I do give the authors credit for claiming a benefit for “fresh whole fruit,” not specifically kiwifruit.  The study didn’t compare kiwi to other fruits (and why would it, given the kiwi fruit sponsor).  But overall, this is yet another study done for marketing far more than scientific purposes.

Welcome to New York City ‘s new “Eat A Whole Lot More Plants” campaign “to put scrumptious sprouts and piquant produce on New Yorkers’ menus.”

The Health Department launched a new campaign that urges New Yorkers to put plants on their plates and adopt a healthy balanced diet full of whole foods. Whole and minimally processed plant foods like fruits, vegetables, whole grains, beans, and nuts are good for health as they are high in fiber, vitamins, and minerals and don’t come packaged with high amounts of sodium, added sugar, or unhealthy fats. The campaign titled “Eat A Whole Lot More Plants” highlights how eating a diet with lots of plants is one way to improve health and can help manage and reduce risk of type 2 diabetes.

The campaign begins with video ads.

It includes  ideas to increase intake of tasty shrub grub, like fruits, vegetables, beans, nuts, and whole grains.

It “builds on the Mayor’s commitment to improve the food environment and combat climate change throughout New York City. ”

The campaign includes:

• Plant-powered Fridays in public schools.
• Updated NYC Food Standards for Meals and Snacks Purchased and Served and for Food, Vending Machines on City Property.
• Plant-based meals in public hospitals.
• Commitment to reduce absolute carbon emissions from food purchases across city agencies by 33% by 2030.
• A new partnership with the American College of Lifestyle Medicine (ACLM) to provide every New York City health care practitioner with free introductory training in lifestyle medicine with a special focus on plant-based nutrition.
• An expansion of NYC Health + Hospitals’ (H+H) groundbreaking lifestyle medicine services at six new sites across all five boroughs to provide patients living with chronic diseases such as type 2 diabetes and high blood pressure the tools, support, and guidance to treat and prevent common conditions using lifestyle interventions including a plant-predominant eating pattern.

I hope it also includes an evaluation.  Let’s try it and see if it works!

There’s a lot of new product development going on in the plant-forward arena: chocolate, cheese, and anything else you can think of.

Which of these products will survive?  You get to decide that one.

• • Hershey debuts plant-based Reese’s and chocolate bar: The confections, which will hit shelves in March and April, are made with oats. This will be the first time the company offers permanent products in the category.<
  • Inside Lovo’s quest to rethink plant-based milk chocolate:  The new brand from the founders of Pascha makes almond, oat, coconut and hazelnut milk the star ingredients, leaning into what consumers love about the popular alternatives.
  • ‘We were told this was impossible’: Meet FÆRM, the start-up that plans to revolutionize plant-based cheese:  The Danish company says it’s among the first to successfully adapt traditional cheesemaking techniques in the manufacture of plant-based cheese. Now, FÆRM has joined the Venture Lab accelerator program in a bid to commercialize its patented technology…. Read more
  • Cargill embraces ‘smarter’ fats to perk up plant-based options in Europe: The ingredients supplier has joined forces with Spanish food tech start-up Cubiq Foods aimed at accelerating healthier, more sustainable and better-tasting plant-based food solutions…. Read more
  • Dairy alternatives: “We have to be realistic about the growth outlook,” warns Rabobank analyst:  The plant-based dairy market may be reaching maturity while the cell-based and precision fermentation dairy segments are just getting started…. Read more
  • 23 New Plant-Based Foods Coming to Market in 2023: Even if they don’t go fully vegan or vegetarian, research indicates a growing number of people are adding more plant-based foods to their diet.
  • 14 Best Vegan Products to Try in 2023: Vegans these days have it easy thanks to the brave souls that paved the way before us: Early vegans drank rice milk and ate soy patties so that we could enjoy JUST Eggs and Impossible burgers. There’s a new wave of veganism and consumers have put out a cry for tastier options.