Search results: food strategy

Several readers have asked me to comment on legislative proposals to refocus SNAP on nutrition quality.

Their requests were triggered by an editorial in The Hill,  America’s food program for the poor should focus on nutrition, by two former USDA Secretaries, Dan Glickman and Ann Veneman, who co-chair the Bipartisan Policy Center’s Food and Nutrition Security Task Force.

They have several suggestions for improving SNAP:

To start, they should make diet quality a core, statutory focus of SNAP. Legislation from Sens. Cory Booker (D-N.J.) and Marco Rubio (R-Fla.) — the SNAP Nutrition Security Act of 2023 — would not only provide a statutory focus on nutrition within SNAP but craft a robust data collection strategy to identify opportunities to improve nutrition in the program.

The Booker/Rubio bill is clear about its purpose:

Food programs administered by the Department of Agriculture  should simultaneously combat food insufficiency and diet related chronic diseases, including obesity, diabetes, hypertension, heart disease, and cancer, which cause immense suffering, significantly increase already high health care spending, increase poverty, and undermine military readiness.

The bill calls for a report from the USDA Secretary that includes:

• An analysis of the food and nutrition security of participants and non-participants in SNAP
• Changes in SNAP aimed at improving food and nutrition security and diet quality
• An analysis of the effectiveness of those changes
• Recommendations for additional authority for the USDA Secretary to improve food and nutrition security and diet quality.

The core of this bill is store-level data collection.

The bill authorizes the USDA to study “the specific food items acquired with [SNAP] benefits by eligible households.”

Good idea, and about time too.  I was on the SNAP to Health commission which made similar recommendations in 2012.

I hope Congress passes it.  Here are the organizations that endorse the bill so far (as of July 14, 2023).

For the record: if we were starting from scratch on poverty reduction, my strong preference is for income support, not SNAP.  It worked splendedly during the pandemic.

Given that SNAP is what we’ve got, my preference is for the WIC model, or would be if all of these questions weren’t so politicized.

Thanks to Arjan van Groningen for this one.

The study:  The Effect of Non-Nutritive Sweetened Beverages on Postprandial Glycemic and Endocrine Responses: A Systematic Review and Network Meta-analysis. Zhang, R.; Noronha, J.C.; Khan, T.A.; McGlynn, N.; Back, S.; Grant, S.M.; Kendall, C.W.C.; Sievenpiper, J.L. Nutrients 2023, 15, 1050. https://doi.org/10.3390/nu15041050.

Conclusions: The available evidence suggests that NNS beverages sweetened with single or blends of NNS have no acute metabolic and endocrine effects, similar to water. These findings provide support for NNS beverages as an alternative replacement strategy for SSBs in the acute postprandial setting.

Funding: This work was supported by an unrestricted grant from the Institute for the Advancement of Food and Nutrition Sciences (IAFNS). The grant was awarded through a competitive request for the proposal process. The sponsor was not involved in the development of the study protocol and design, execution, analyses, interpretation of the data, or decision to publish. The protocol and results were presented to the Low- And No-Calorie Sweeteners Scientific Committee of IAFNS on several occasions with an opportunity for scientific dialogue.

Comment:  IAFNS is the new name for ILSI North America, a classic industry front group.  To its credit, the authors disclose the involvement of IAFNS in this review.  Check out the Conflict-of-Interest declarations from this group; they are legendary.

Conflicts of Interest: J.C.N. has worked as a clinical research coordinator at INQUIS Clinical Research. He has also received research support from Glycemia Consulting Inc. T.A.K. has received research support from the Canadian Institutes of Health Research (CIHR), the International Life Science Institute (ILSI), and the National Honey Board. He has taken honorariums for lectures from the International Food Information Council (IFIC) and the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America). He is funded by the National Honey Board. N.M., was a former employee of Loblaw Companies Limited, and is a current employee of Enhanced Medical Nutrition. She has completed consulting work for contract research organizations, restaurants, start-ups, the International Food Information Council, and the American Beverage Association, all of which occurred outside of the submitted work. S.M.G. has received honoraria from Dietitians of Canada and Diabetes Canada for the development and delivery of educational resources on the glycemic index in the past five years. C.W.C.K has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), the Almond Board of California, Barilla, the Canadian Institutes of Health Research (CIHR), the Canola Council of Canada, the International Nut and Dried Fruit Council, the International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd., the Peanut Institute, Pulse Canada, and Unilever. He has received in-kind research support from the Almond Board of California, Barilla, the CaliforniaWalnut Commission, Kellogg Canada, Loblaw Companies, Nutrartis, Quaker (PepsiCo), the Peanut Institute, Primo, Unico, Unilever, and WhiteWave Foods/Danone. He has received travel support and/or honoraria from Barilla, the CaliforniaWalnut Commission, the Canola Council of Canada, General Mills, the International Nut and Dried Fruit Council, the International Pasta Organization, Lantmannen, Loblaw Brands Ltd., the Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, the Peanut Institute, Pulse Canada, Sun-Maid, Tate & Lyle, Unilever, and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, the International Pasta Organization, the McCormick Science Institute, and Oldways Preservation Trust. He is a founding member of the International Carbohydrate Quality Consortium (ICQC), the Chair of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD, and is a Director of Glycemia Consulting and the  Toronto 3D Knowledge Synthesis and Clinical Trials foundation. J.L.S. has received research support from the Canadian Foundation for Innovation, the Ontario Research Fund, the Province of Ontario
Ministry of Research and Innovation and Science, the Canadian Institutes of health Research (CIHR),  Diabetes Canada, the American Society for Nutrition (ASN), the International Nut and Dried Fruit Council (INC) Foundation, the National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America), Pulse Canada, the Quaker Oats Center of Excellence, the United Soybean Board (USDA soy “Checkoff” program), the Tate and Lyle Nutritional Research Fund at the University of Toronto, the Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), the Plant Protein Fund at the University of Toronto (a fund which has received contributions from IFF), and the Nutrition Trialists Network Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received food donations to support randomized controlled trials from the Almond Board of California, the California Walnut Commission, the Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone, Nutrartis, and Dairy Farmers of Canada. He has received travel support, speaker fees and/or honoraria from ASN, Danone, Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, the International Food Information Council (IFIC), the Calorie Control Council, the International Sweeteners Association, and the International Glutamate Technical Committee. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Phynova, and Inquis Clinical Research. He is a former member of the European Fruit Juice Association Scientific Expert Panel and a former member of the Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, the European Association for the study of Diabetes (EASD), the Canadian Cardiovascular Society (CCS), and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves or has served as an unpaid member of the Board of Trustees and an unpaid scientific advisor for the Carbohydrates Committee of IAFNS. He is a member of the International Carbohydrate Quality Consortium (ICQC), an Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev. R.Z. and S.B. have no conflicts of interest to declare.

In February, the USDA proposed rules for sugars in school meals.  These meant:

Flavored milks would be limited to no more than 10 grams of added sugars per 8 fluid ounces for milk served with school lunch or breakfast. For flavored milk sold outside of the meal (as a competitive beverage for middle and high school students), the limit would be 15 grams of added sugars per 12 fluid ounces.

The International Dairy Foods Association says it can and will do this as part of an effort “to preserve flavored milk options as part of the National School Lunch and Breakfast programs. USDA currently has proposed one option to provide only unflavored milk for school-aged children grades K-8.”

Among milk options available in schools, low-fat flavored milk is the most-consumed beverage for students regardless of grade, IDFA says. Flavored milk products such as chocolate milk offered in schools today contain an average of just 8.2 grams of added sugar per serving.

The Sugar Association, no surprise, supports continued use of sugary milk in schools—for its own particular reason.

As the ‘Healthy School Milk Commitment’ moves forward, it is important that alternative sweeteners are not encouraged or deployed as a frontline sugar reduction strategy for flavored milk served in schools.

The use of low- and no- calorie sweeteners in products intended primarily for both children and adults has increased by 300% in recent years, and their presence in food products is easily cloaked from consumers because of FDA’s arcane and outdated food labeling requirements.

As the health effects of sugar substitutes on children are not adequately studied, we should proceed cautiously when it comes to initiatives that incentivize the use of these ingredients.

We support flavored milk products, which provide important nutrients and are always a fan-favorite among school students in our nation’s schools, and caution against the use of sugar substitutes to meet sugar reduction commitments in the milk consumed by our nation’s school children.

That is a new argument (to me, at least).  Here are some old ones (with my comments):

• Chocolate milk has lots of nutrients (it also has lots of sugar).
• Kids won’t drink plain milk (they will, actually)
• Kids won’t get those nutrients if they don’t drink milk (they can get them from other foods).

But New York City has a handout on why plain milk is preferable.  It’s worth a look.

The FDA is under siege these days.  Two reasons why.

• Its failure to follow the advice of experts on how to reorganize the agency to give greater prominence and authority to food as opposed to drugs.
• Its failure to get on top of the safety and supply problems with infant formula.

As usual, Bill Marler gets right to the point.

Two top  food officials at the FDA have retired recently.

Food and Drug Administration Director of the Center for Food Safety and Applied Nutrition (CFSAN) Susan Mayne announced that she will retire on May 31, 2023. Dr. Mayne has served as Director of CFSAN since January 2015. Another retirement among FDA leadership occurred earlier this year when FDA Deputy Commissioner of Food Policy and Response Frank Yiannas retired on February 24, 2023.

Frank Yiannis, formerly deputy commissioner for food policy at the FDA, testified to Congress:

Yiannas said that the FDA’s structure and culture exacerbated delays and that the agency had no data system in place to monitor key food supply chains. While Abbott is responsible for the safety and testing of its own powdered formula, he said, the sickened children and months-long shortage “was all a preventable tragedy” had FDA acted more urgently.

To deal with the uproar about infant formula, the FDA has just released:

• Status Update on FDA’s Infant Formula Response Activities
• Strategy to Help Prevent Cronobacter sakazakiiIllnesses Associated with Consumption of Powdered Infant Formula
• Letter to the Infant Formula Industry
• Enforcement Discretion to Manufacturers to Increase Infant Formula Supplies
• Press Release: FDA Outlines Immediate National Strategy to Further Increase the Resiliency of the U.S. Infant Formula Market

But this will not be enough.

Helena Bottemiller Evich’s most recent Politico report is titled “‘Lessons have not been learned’: FDA knew of positive test months before latest infant formula recall.”

And another recall of infant formula occurred more recently.

All of this increases the urgency of the calls on FDA to pay more attention to food issues.

Congress:  Act now!

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A report, Science Education in an Age of Misinformation, from Stanford University and written by a distinguished group of scientists addresses a question I get asked all the time: how do you know whom to trust when reading articles about food and nutrition.

It presents a decision tree for evaluating information sources.

Although most of the report is focused on other science topics, it includes one nutrition example (Example 3, pages 34 and 35).

Example 3 presents two websites, one from the Partnership for a Healthier America, the other from ILSI, the International Life Sciences Institute.

The suggested lesson asks students to use the decision tree to evaluate the credibility of the information on the websites.

For this example,

if students search for ‘Partnership for a Healthier America,’ they will find that one of the first links to appear in the search results is from Wikipedia…they may decide to start with the Wikipedia page to get a broad sense of what other information is available about the organization. There students will read that PHA is a nonprofit organization focused on health and nutrition. Its president and CEO is Nancy Roman, who has years of experience working for world food programs, food banks, and nutrition non-profit organizations.

On the other hand, when students apply the same strategy to the ISLI web page, they are also likely to begin with the Wikipedia entry. This tells a very different story. While ISLI is also a nonprofit organization, the Wikipedia entry shows it was funded by a Coca-Cola executive and has numerous ties to food and chemical companies, such as McDonald’s and Pepsi. Such ties represent a clear conflict of interest and would strongly suggest that ISLI is not a credible source of information.

A good start?  I think yes.  Take a look and decide for yourself.

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The World Health Organization has taken a major step: it calls on member countries to tax sugar-sweetened beverages.

“Taxes on sugar-sweetened beverages can be a powerful tool to promote health because they save lives and prevent disease, while advancing health equity and mobilizing revenue for countries that could be used to realize universal health coverage,” said Dr Ruediger Krech, Director of Health Promotion at WHO.

SSB, tobacco, and alcohol taxes have proven to be cost-effective ways of preventing diseases, injuries, and premature mortality. SSB tax can also encourage companies to reformulate their products to reduce sugar content.

More than that, WHO has produced a manual on how to develop and implement SSB taxation policies.

This tax manual is a practical guide for policy-makers and others involved in SSB tax policy development to promote healthy diets and populations. It features summaries and case studies of SSB global taxation evidence, and provides support on the policy-cycle development process to implement SSB taxation — from problem identification and situation analysis through policy design, development and implementation to the monitoring and evaluation phase. Additionally, the manual identifies and debunks industry tactics designed to dissuade policy-makers from implementing these taxes.

SSB taxes can be a win-win-win strategy: a win for public health (and averted health-care costs), a win for government revenue, and a win for health equity.

The manual summarizes everything anyone needs to know to justify taxes and to craft policy.  Get to work!

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The USDA is at long last giving some attention—a small but significant first step—to reducing Salmonella contamination of poultry products.

Salmonella is a big problem in poultry and eggs.  For decades, food safety advocates have called on the USDA to declare Salmonella an adulterant.  Adulterated food is illegal to sell.

The poultry industry has resisted, arguing that chicken gets cooked before it is eaten; cooking kills Salmonella.

It does, but you don’t want toxic forms of Salmonella in your kitchen where they can get into other foods.  For background all this, see my book, Safe Food: The Politics of Food Safety.

In a press release, the USDA’s Food Safety and Inspection Service (FSIS) announces that it

is considering a regulatory framework for a new strategy to control Salmonella in poultry products and more effectively reduce foodborne Salmonella infections linked to these products…The most recent report from the Interagency Food Safety Analytics Collaboration estimates that over 23% of foodborne Salmonella illnesses are attributable to poultry consumption—almost
17% from chicken and over 6% from turkey.

The proposed Salmonalla framework has three components:

What FSIS is actually doing:

We will publish a proposed notice of determination to declare Salmonella an adulterant in NRTE [not ready to eat] breaded and stuffed chicken products in 2022, and we intend to publish additional proposed rules and policies implementing this strategy in 2023, with the goal of finalizing any rules by mid-2024.

The adulterant consideration only applies to breaded and stuffed chicken or turkey products that are likely to be microwaved but not necessarily thoroughly cooked.  It does not apply to plain, unbreaded and unstuffed poultry.

Consumer Reports finds lots of poultry to be contaminated with Salmonella.  Consumer Reports says Salmonella is “lethal but legal.”

Currently, a chicken processing facility is allowed to have salmonella in up to 9.8 percent of all whole birds it tests, 15.4 percent of all parts, and 25 percent of ground chicken. And producers that exceed these amounts are not prevented from selling the meat. If salmonella became an adulterant, even in some poultry products, it would help reduce the amount of contaminated meat that hits the market.

As might be expected, the National Chicken Council opposes the USDA’s proposed framework: “lacks data, research.”

the facts show that the Centers for Disease Control and FSIS’s own data demonstrate progress and clear reductions in Salmonella in U.S. chicken products.  “Increased consumer education about proper handling and cooking of raw meat must be part of any framework going forward…Proper handling and cooking of poultry is the last step, not the first, that will help eliminate any risk of foodborne illness. We’ll do our part to promote safety.”

As a follow up to the White House Conference on Hunger, I’ve been collecting fact sheets (my version of what happened at the conference is here)

Official information is available on the conference website.   You can even watch it; links to videos of the sessions are posted here.

Note that everything in the fact sheets refers to the conference “Pillars.”  As a reminder, these are:

1. Improve Food Access and Affordability
2. Integrate Nutrition and Health
3. Empower Consumers to Make and Have Access to Healthy Choices
4. Support Physical Activity for All
5. Enhance Nutrition and Food Security Research

Fact sheet #1: The Biden-⁠Harris Administration Announces More Than $8 Billion in New Commitments as Part of Call to Action for White House Conference on Hunger, Nutrition, and Health

These [commitments] range from bold philanthropic contributions and in-kind donations to community-based organizations, to catalytic investments in new businesses and new ways of screening for and integrating nutrition into health care delivery. At least $2.5 billion will be invested in start-up companies that are pioneering solutions to hunger and food insecurity. Over $4 billion will be dedicated toward philanthropy that improves access to nutritious food, promotes healthy choices, and increases physical activity.

Fact sheet #2: From Senate Agriculture Committee Chairwoman Debbie Stabenow:   Anti-Hunger and Healthy Food Successes

As long as we have hunger and food insecurity in America, we have work to do…We’ve put policies in place that take big steps to strengthen the food safety net, incentivize purchases of healthy fruits and vegetables, and provide more resources for food banks and other organizations to address hunger and nutrition issues in their communities.

Fact sheet #3: From USDA’s Food and Nutrition Service (FNS): Leveraging the White House Conference to Promote and Elevate Nutrition Security.

FNS’s work aligns closely with the National Strategy, which outlines steps the government will take, while calling on the public and private sector to address the intersections between food, hunger, nutrition, and health.

It is fair to ask what the conference will produce and how government and private agencies will be held accountable for their commitments.  For that we must wait and see.

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