Serge Hercberg, who originated the NutriScore front-of-package labeling system used in France and several other European countries send me a link to this review by several Italian investigators.   To refresh memory, this is how NutriScore works.

It’s a bit complicated but this paper is even more so.  Its writing seems obfuscating, but judge for yourself.

The review: Uncovering the Effect of European Policy-Making Initiatives in Addressing Nutrition-Related Issues: A Systematic Literature Review and Bibliometric Analysis on Front-of-Pack Labels.  Nutrients2022, 14(16), 3423; https://doi.org/10.3390/nu14163423

Conclusions: “The most recent goal of EU policy-makers is to find a harmonized and universal labelling system to adapt in all European countries. However, observing the structure of the extant literature, there might be two current risks that should be avoided. The first risk is to outline a labelling scheme that is not fully supported by converging evidence as derived from multiple different constructs. The second one refers to the risk of implementing a labelling scheme grounded on valid results and high levels of citations, supported by a network of authors, but overlooking the fragmentation of other valid positions in the literature that together contribute to depicting an environment in which the different and still valid results reflect the diversity of alternatives that are equally effective, but less supported. In conclusion, the right choice of FoPL would benefit both consumers and the food industry, but there are still additional knowledge and usage gaps that must be fulfilled to define the proper universal option that supports consumers toward healthier and more informed food choices.”

Funding: The research received non-conditional funding from Federalimentare.

Conflicts of Interest: The authors declare no conflict of interest.

Comment: Federalimentare is the Federazione Italiana dell’Industria Alimentare, the major Italian food trade association.  It strongly opposes use of NutriScorre (no surprise).  The authors do have a conflict of interest, but either do not recognize it or are denying it.

I think what they are saying that NutriScore and other front-of-pack systems are not “fully supported by converging evidence,” suggesting that better alternatives would “benefit both consumers and the food industry.”

But what’s really going on here is that front-of-pack labels discourage puchases of ultra-processed foods.  It is understandable that the food industry dislikes them.

This paper is part of a concerted effort by the Italian food industry to discredit NutriScore.

Serge Hercberg, a professor of nutrition at the University of Paris, is under intense personal attack from Italian Twitter trolls, who have been posting insulting and threatening anti-Semitic tweets about his background (Polish Jewish) and his work with NutriScore.

Nutri-Score is not perfect (no such scheme can be) but the only explanation for these attacks must be that it is working.  The attacks are strong evidence for its effectiveness.

Who would ever imagine that a front-of-package food label would elicit anti-semitic vitriol.

Tough times, these.

I’m just getting caught up on reports.  Here’s one from The Food Foundation, an “independent charity working to address challenges in the food system in the interests of the UK public.”

Its report: The Broken Plate 2022: The State of the Nation’s Food System  “documenting the health of our food system, how it impacts on our lives, and why we must change the food environment so that it delivers healthy and sustainable diets for everyone, everywhere.”

Three things about this report make it of special interest: comprehensiveness, clarity of presentation, and forthright statements about what needs to happen.

For example:

The report covers issues such as price and affordability, food availability (in schools and shopping areas), and health and environmental effects (chidren’s weight and growth, diabetes amputations, life expectancy, climate change).

This one comes from Great Britain.

Whew.  I was worried about potatoes.  What a relief!

I thought it was a spoof, but it’s not.  ASDA (formerly Associated Dairies) is a Walmart subsidiary in Great Britain.

It offers other products labeled the same way.   In case you were worried.

The Task Force on Hunger, Nutrition, and Health released its comprehensive report yesterday.

The report’s purpose is to inform the upcoming White House Conference on Hunger, Nutrition, and Health.  If so, it’s going to leave the White House in a quandary.

The report has lots of useful information, beautifully presented, and does all it should on adddressing hunger.

But as I read it, the report, titled Ambitious, Actionable Recommendations to End Hunger, Advance Nutrition, and Improve Health in the United States,” is not nearly ambitious enough when it comes to nutrition and health.

It makes far too many recommendations—30.  That’s always a bad sign (too many to do).  .

Really, only 2 recommendations are needed.  These should establish or expand federal agriculture, food, and nutrition policies to ensure:

1.  Adequate, affordable food and nutrition for everyone.
2.  Healthy diets for everyone, meaning those that follow Dietary Guidelines and are largely plant-based, balanced in calories, and low in undesirable fats, sugars, and salt (i.e., ultra-processed foods).

The hunger recommendations do the job: they call for ensuring benefits sufficient to meet households’ basic needs.

But the second?  A mess.

Here is the most obvious example [my comments follow] .

Recommendation #9: “Reduce the marketing of foods that do not align with the latest DGA and increase the marketing of foods that align with the latest DGA to children and populations with disproportionate rates of diet-related chronic conditions” [Good! But not through the recommended voluntary methods by industry.  That won’t work; it requires legislation]

But here’s Recommendation #25: “Increase the ability of food companies to communicate with consumers about the evidence for healthfulness of certain food products and nutrients.”  [Uh oh]

This comes with three action items:

1. FDA should expeditiously update its definition of the word “healthy” [good] and incentivize food companies to use the terminology and/or associated symbol in their food packaging and marketing [Yikes!] and increase the proportion of products on the market that meet the “healthy” definition [OK, as long as they are not gaming the system].
2. Congress and/or FDA should improve and streamline the process for application, review, approval, and use of health claims and qualified health claims on food packages. [No!  If it’s one thing we don’t need, it’s more misleading health claims]. 
3. Congress and/or FDA should create a new process for communicating about foods, nutrients, and other bioactive ingredients that may prevent or treat disease through label claims. [No!  We do not need more claims for the benefits of ultra-processed food products].

What’s missing from this report?

• Anything about ultra-processed foods and their effects on calorie intake and overall health.  The term is mentioned once, but only in the context of ‘more research needed’ (Recommendation #19).
• A clear statement of the benefits of soda taxes in reducing consumption of sugar-sweetened beverages.  Why isn’t there one?  A box explains: “Task Force members voiced diverse perspectives on this topic.”
• A clear statement about making SNAP align with Dietary Guidelines.  This is mentioned, but only in the context of pilot research (recommendation #2), and therefore contradicts recommendations #3 and #5.  #3:  Increase nutrition security by promoting dietary patterns that align with the latest Dietary Guidelines for Americans (DGA) through federal nutrition programs.  #5:  Leverage the federal nutrition programs’ power in economic stimulus to support food systems that promote foods that align with the latest DGA.”
• Firm calls on Congress to pass legislation to do what is needed.

What happened?  One member of the committee explained to me that its membership included everyone from anti-hunger advocates to food industry representatives, and too many vested interests were at stake.  Members could not agree on anything that would make a real difference to policy.  Anything substantive met strong resistance.

When it comes to public health policy, which this most definitely is, the food industry has no business being at the table.

This was a recommendation of the 2019 Lancet Commission on the Global Syndemic of Obesity, Undernutrition, and Climate Change.  Read that report.  It explains why including the food industry in policy recommendations that might reduce sales is not a good idea.

If I had been a member of this Task Force, I would have called for a minority report on policies for reducing consumption of sugary drinks and ultra-processed foods.  But that, of course, is why I’m no longer appointed to such committees.

• Read the Executive Summary
• Read the Full Report
• Read the Press Release
• Register here for the Webinar hosted by the co-chairs: Wednesday, Aug. 31 at 2:00 p.m. ET.

USDA has finally proposed new rules to try to make the current poultry farming system a bit more fair to the people who actually raise the chickens.

Under the current system, the big poultry producers get the benefits while the chicken farmers take all the risks.  The companies supply the chicks; the farmers pay for the houses, equipment, and management—and take on immense debt to do so.

They are paid according to a tournament system.  Farmers who produce the most amount of chicken using the least amount of feed are paid the most; others get less.  But the farmers do not control the quality of the chicks they receive.  They also sell to only one buyer, a system with its own name, monopsony.

John Oliver did a synopsis of the tournaent system in 2015.

Hence the new rule: Transparency in Poultry Grower Contracting and Tournaments.  This does not get rid of the tournament system, unfortunately, but it does require poultry companies to disclose key information to growers about realistic outcomes before making important contracting decisions such as capital investments, and about key inputs.

The point is to enable growers to understand the terms of their contracts so as to have a better chance to compete.

• USDA is seeking comments on this proposed rule and also on additional steps it could take to enhance fairness and address concerns about the tournament system.  Poultry Growing Tournament Systems: Fairness and Related Concerns is available for comment until Sept. 6, 2022, at www.regulations.gov.
• For more information, see Agricultural Competition: A Plan in Support of Fair and Competitive Markets.

Also see:

• Government Accountability Project whistleblower complaints against the tournament system
• Johns Hopkins Center for a Livable Future — Letter to State Attorneys General on Protecting Contract Chicken Farmers from Unfair Business Practices.
• Survey Results: Marylanders Support a Fair Poultry Industry and Stronger Government Oversight
• Civil Eats op-ed on ending the tournament system

According to Politico, advocates for a fairer system are complaining that the largest poultry companies are pressuring farmers to oppose the USDA’s proposed rule and providing them with form letters to send in.

The USDA acknowledged these complaints when it announced an extension of the public comment period.

USDA is taking these steps to help ensure the integrity of the Federal rulemaking process and to ensure all parties have the opportunity to fully comment.

“There is fear throughout the meat and poultry industry as we saw earlier this year at two separate Congressional hearings where witnesses did not testify due to concerns of retaliation,” Vilsack said. “But it is still critical that we hear the full story, so we are highlighting the option for comments to be provided anonymously.”

Politico says that as of Aug. 18, the USDA had received at least 350 public comments.  According to its analysis, at least 200 of public comments support the rule, though some supporters have significant reservations and are imploring USDA to go further.

Today’s Dietitian  sent this e-mail blast to members of the Academy of Nutrition and Dietetics on behalf of the National Pork Board, one of its sponsors.

The National Pork Board is seeking to build strong and meaningful partnerships with the Registered Dietitian profession. When it comes to up-to-date nutrition information, cooking techniques, continuing education and future collaborations, Pork is getting ready to give you the resources you value most. But first, we want to hear from you!

We invite you to take this survey for a chance to win one of fifteen $100 Amazon gift cards!*

The survey should take less than 15 minutes to complete. Your responses are voluntary and confidential. Responses will not be identified by individual but will be compiled and analyzed in aggregate.

Fifteen winners will be chosen at random to receive a $100 Amazon gift card. To be eligible, respondents must share their email address at the end of the survey.

Please click here to take the survey by August 22, 2022* Giveaway is subject to Official Rules.

If you want to know how meat trade associations encourage dietitians to promote their products, here’s an example.

Thanks to Dr. Lisa Young for alerting me to this one.

The Government Accountability Office has produced a “snapshot” on Healthy Eating: Government-wide solutions for promoting healthy diets, food safety, and food security.  It’s only two pages; take a look.

As of July 2022, many of our recommendations for developing strategies on healthy eating have not yet been addressed.

1. Strategy Needed to Address Diet-Related Chronic Health Conditions
Three diet-related chronic health conditions (cardiovascular diseases, diabetes, and cancer) were among the 10 leading causes of death in 2018, according to CDC. Men, Black or African Americans, and people living in southern states had disproportionately higher mortality rates from diet related conditions. Dietary changes could have prevented some of these deaths.

Additionally, in 2018, about three in four adults in the U.S. had excess weight, which can be associated with poor diet and lead to cardiovascular diseases, diabetes, and cancer.

The GAO recommends that the federal government establish leadership for strategies:

• On diet-related efforts
• Food-safety oversight
• Nutrition assistance programs to respond to emergencies

Excellent suggestions.  If only they could be implemented.

For those of us who have observed the Dietary Guidelines since they first came out in 1980, everything about them is a source of endless fascination, if not exhausting.  They engender enormous fuss, but the basic dietary advice stays the same, year after year.  It just gets presented in ways that are increasingly lengthy and complicated.

I have a vested interest in all this.  I was a member of the 1995 Dietary Guidelines Advisory Committee.

Critics of the 2015 guidelines got Congress to order a review of the process by the National Academies of Sciences, Engineering, and Medicine (NASEM), which produced two reports.  The 2017 report recommended seven improvements to the process.  Congress then mandated an evaluation of how well USDA and HHS had implemented the recommendations.

NASEM has just published the first of what will be two evaluation reports: Evaluating the Process to Develop the Dietary Guidelines for Americans, 2020-2025: A Midcourse Report.  This one responds to the first of three questions and part of the second.

• Question #1: How did the process used to develop the Dietary Guidelines for Americans, 2020–2025, compare to the seven recommendations included in the 2017 National Academies report?
• Question #2: Did the criteria used to include scientific studies used to inform the Dietary Guidelines for Americans, 2020–2025, ensure that the evidence base was current, rigorous, and generalizable or applicable to public health nutrition guidance?

My reading of this report is that the agencies and their advisory committee did a pretty good job of producing the 2020-2025 guidelines, given the tight time schedule, the lack of resources, and the fundamental difficulties of producing solid evidence for the effects of diet on disease risk.  The report’s conclusion (p. 106):

Finally, the committee identified many instances of partial implementation of the recommendations from the 2017 National Academies report. Some of these (e.g., recommendation 6) were minor concerns. Many other concerns that might, individually, seem minor represent a more substantial concern  when considered together. For example, the many seemingly small deviations from committee-identified practices for systematic reviews together reduce the quality and utility of this important element of the evidence used to develop the DGA. Moreover, the combined effect of recommendations for which there were substantial concerns with those that were not implemented at all represents a continuing risk to the integrity of the DGA process.

The report, by the way, is 295 pages.

Do we really need all this?  The guidelines stay pretty much the same from edition to edition: eat more fruits and vegetables (plant foods); don’t eat much salt, sugar, saturated fat; maintain healthy weight.  Or, as Michael Pollan famously put it, “Eat food.  Not too much.  Mostly plants.”

The food industry has the biggest stake in dietary guidelines, which is why we have to go through all this.

As I like to put it, I’ve made a career of criticizing dietary guidelines, and I’m not the only one.  I’m ready to move on.  If only.