by Marion Nestle

Search results: natural

May 3 2022

RIP Senator Orrin Hatch

The New York Times’ obituary for the late Utah Senator Orrin Hatch, “Orrin Hatch, Seven-Term Senator and a Republican Force, Dies at 88,” filled an entire page of the newspaper.  That’s how important he was.

I was surprised that the obituary said not one word about Senator’s Hatch’s responsibility for the Dietary Supplement Health and Education Act of 1994 (DSHEA, pronounced d’shay).  The purpose of this act was to boost the supplement industry, which is well represented in Utah, by taking it out from under the regulatory authority of the FDA.

As a reminder, DSHEA:

  • Assumed that dietary supplements were safe.
  • Essentially deregulated them by weakening the FDA’s regulatory power.
  • Permitted structure/function health claims on supplements, (e.g., supports a healthy immune system), regardless of level of scientific substantiation.
  • Labeled supplements with Supplement Facts rather than Nutrition Facts.
  • Forced the FDA to take manufacturers to court if agency regulators had concerns about safety, misleading claims, or inconsistent contents.
  • Caused the FDA to lose court cases on First Amendment grounds.

The results:

  • The supplement industry expanded rapidly, achieving DSHEA’s purpose.
  • You cannot be sure that what you are buying is actually waht the label says you are buying.
  • You cannot be sure that claimed benefits have any science behind them.
  • Food manufacturers demanded the right to make struture/function claims.
  • Use of the First Amendment to protect commercial (rather than personal, political, or religious) speech has gotten stronger.

We have Orrin Hatch to thank for turning the supplement industry into one based on faith, not science.

Why would he do this?

The obituary suggests one possibility:

During the opioid crisis in 2015, he introduced a bill to narrow the authority of government regulators to halt the marketing of drugs by predatory pharmaceutical companies. It later emerged that he had received $2.3 million in donations from the drug industry over 25 years.

For a more direct explanation, check out this article about Senator Hatch from the New York Times in 2011, “Support Is Mutual for Senator and Utah Industry.

“Senator Hatch — he’s our natural ally,” said Marc S. Ullman, a lawyer for several supplement companies. Mr. Hatch, who credits a daily regimen of nutritional supplements for his vigor at 77, has spent his career in Washington helping the $25-billion-a-year industry thrive….Mr. Hatch has been rewarded with hundreds of thousands of dollars in campaign contributions, political loyalty and corporate sponsorship of his favorite causes back home.  His family and friends have benefited, too, from links to the supplement industry.

Hatch’s efforts to deregulate supplements did no good for public health or trust in science.  As the obituary said,

But there were no political repercussions. The senator was re-elected in 1982, 1988, 1994, 2000, 2006 and 2012, averaging nearly 65 percent of the vote.

Requiescat in pace.

Apr 29 2022

Weekend reading: The politics of protein

IPES-Food, the International Panel of Experts on Sustainable Food Systems, has a new report: The politics of protein: Examining claims about livestock, fish, “alternative proteins” and sustainability 

The report contains a deep analysis of the strengths and weaknesses of these eight claims.

The report’s argument is that the focus on protein is overblown.

For decades, the perceived need for more protein has led to distractions and distortions in development programs, flawed marketing and nutritional campaigns, and calls to increase the production and trade of meat, dairy, and protein-enriched foods.

Today, the evidence clearly shows that there is no global ‘protein gap’: protein is only one of many nutrients missing in the diets of those suffering from hunger and malnutrition, and insufficiency of these diets is primarily a result of poverty and access.

The report displays data to back up its arguments in attractive and easily understood charts.  Its conclusions are clearly marked.  Example:  part of the conclusion for Claim #5: Alternative proteins are a win-win.

In conclusion, there are too many uncertainties and data gaps, and too much variation between systems, to make a definitive statement on whether ‘alternative proteins’ are more environmentally sustainable than animal source foods as a whole. Bold and categorical claims about ‘alternative proteins’ being a ‘win-win-win’ are therefore likely to be misleading…The validity of claims about ‘alternative proteins’ (and the purported benefits of these products) ultimately comes down to how foods are produced, what food systems we consider to be desirable and viable, how we weigh up trade-offs ….

Sensibly, the report makes only three recommendations:

Comment:  I think this report is well done, well written, and well presented.   But here’s where this nutritionist gets cranky: Why title it Protein?  Protein is a nutrient, not a food.  Using protein to stand for foods that contain it is an example of “nutritionism,” the reduction of  the benefits of a food to its single components.

I had to search the report for an explanation of what IPES means by protein.  As far as I can tell, its writers assume you know what it means.  But sometimes the report refers to meat and protein, implying that meat means beef, and protein means protein-containing animal foods other than beef.  At other times, the report uses protein to include beef as well as poultry, fish, dairy, and insects.   But what about vegetables and grains?  They have protein too.  Legumes are particularly good sources; grains have nourished entire civilizations.

I realize that protein—a chefs’ term—is widely understood to stand for all foods, particularly from animals, that contain protein, but that’s nutritionally incorrect because basically every naturally occurring food contains some protein (OK, lettuce doeesn’t have much).

I wish everyone would find a better term, one that calls meat meat, if that’s what’s meant.

Apr 18 2022

Research giggle of the day: Popeye was right?


 

The study:  A 12-Week Randomized Double-Blind Placebo-Controlled Clinical Trial, Evaluating the Effect of Supplementation with a Spinach Extract on Skeletal Muscle Fitness in Adults Older Than 50 Years of Age. Pérez-Piñero, S.; Ávila-Gandía, V.; Rubio Arias, J.A.; Muñoz-Carrillo, J.C.; Losada-Zafrilla, P.; López-Román, F.J. Nutrients 2021, 13, 4373. https:// doi.org/10.3390/nu13124373

Purpose: to assess the effect of daily supplementation with a natural extract of Spinacia oleracea L. (4 × 500 mg capsules/day; total 2 g per day) combined with a moderate-intensity training program (1 h session/3 times a week) on skeletal muscle fitness in adults over 50 years of age.

Conclusion: In subjects over 50 years of age, moderate-intensity strength training combined with daily supplementation for 12 weeks with a natural extract of Spinacia oleracea L. improved muscle-related variables and muscle quality. Maintaining muscle health is a key component of healthy aging

Comment: Muscle function improved significantly at the end of the study as compared with baseline both in the experimental and the placebo groups, but the magnitude of improvements was higher in the experimental group.

Really?  The paper doesn’t even mention Popeye.  I consider this an egregious oversight.

According to a Popeye fan site (yes, such things exist)

In most media featuring Popeye, it is used as a last-minute device in which the hero, in danger, pulls out a can of spinach from his shirt or otherwise acquires the vegetable and eats it. This gives his already extraordinary strength a tremendous boost, helping him withstand his enemies’ attacks and all kinds of adverse situations.

Eat your spinach, everyone.

Apr 1 2022

Weekend reading: agriculture and climate change

The Intergovernmental Panel on Climate Change (IPCC) has released its 6th report.  

The news gets worse with each successive report.

Human-induced climate change is causing dangerous and widespread disruption in nature and affecting the lives of billions of people around the world, despite efforts to reduce the risks. People and ecosystems least able to cope are being hardest hit…The world faces unavoidable multiple climate hazards over the next two decades with global warming of 1.5°C (2.7°F). Even temporarily exceeding this warming level will result in additional severe impacts, some of which will be irreversible. Risks for society will increase, including to infrastructure and low-lying coastal settlements.

One paragraph (C.2.2) deals with the effects of agriculture on climate change, and the strength of the associations.

  • Effective adaptation options, together with supportive public policies enhance food availability and stability and reduce climate risk for food systems while increasing their sustainability (medium confidence).
  • Effective options include cultivar improvements, agroforestry, community-based adaptation, farm and landscape diversification, and urban agriculture (high confidence).
  • Institutional feasibility, adaptation limits of crops and cost effectiveness also influence the effectiveness of the adaptation options (limited evidence, medium agreement).
  • Agroecological principles and practices, ecosystem-based management in fisheries and aquaculture, and other approaches that work with natural processes support food security, nutrition, health and well-being, livelihoods and biodiversity, sustainability and ecosystem services (high confidence).
  • These services include pest control, pollination, buffering of temperature extremes, and carbon sequestration and storage (high confidence).
  • Trade-offs and barriers associated with such approaches include costs of establishment, access to inputs and viable markets, new knowledge and management (high confidence) and their potential effectiveness varies by socioeconomic context, ecosystem zone, species combinations and institutional support (medium confidence).
  • Integrated, multi-sectoral solutions that address social inequities and differentiate responses based on climate risk and local situation will enhance food security and nutrition (high confidence).
  • Adaptation strategies which reduce food loss and waste or support balanced diets (as described in the IPCC Special Report on Climate Change and Land) contribute to nutrition, health, biodiversity and other environmental benefits (high confidence).

Here are the documents:

The previous IPCC reports

Mar 21 2022

Industry-funded study of the week: Cocoa flavanols

I learned about this one from a PR tweet from @Brigham Research: “Dr. JoAnn Manson…& colleagues report the main findings of the first ever randomized trial of a cocoa flavanol supplement on cardiovascular disease endpoints.”

Its spectacular results:  Supplementation with cocoa flavanols led to a 27% reduction in deaths from cardiovascular disease among all participants taking the supplement, and a 39% reduction in those deaths when they excluded participants who did not take the pills properly.

From taking cocoa flavanol supplements?

Who paid for this?

Bingo.

The study (still in preprint): Effect of Cocoa Flavanol Supplementation for Prevention of Cardiovascular Disease Events: The COSMOS Randomized Clinical Trial.  Sesso HD, et al.  American Journal of Clinical Nutrition, nqac055, https://doi.org/10.1093/ajcn/nqac055

Conclusion: “Cocoa extract supplementation did not significantly reduce total cardiovascular events among older adults but reduced CVD death by 27%….

Funding: “The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging…[and other sources].

Conflicts of interest: Drs. Sesso and Manson reported receiving investigatorinitiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, for infrastructure support and donation of COSMOS study pills and packaging,
Pfizer Consumer Healthcare (now part of GSK Consumer Healthcare) for donation of COSMOS study pills and packaging during the conduct of the study. Dr. Sesso additionally reported receiving 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 American Society of Nutrition during the conduct of the study. No other authors reported any conflicts of interest.

Comment: Déjà vu all over again.

Mars, as I described in detail in Unsavory Truth, has been trying to make you think that chocolate is a health food (M&Ms!) for decades. It created a special brand, CocoaVia, for this purpose.  Here is an excerpt:

In 1982, Mars established a chocolate research center in Brazil.[i]  Its scientists were particularly interested in cocoa flavanols, a category of flavonoids with antioxidant, anti-inflammatory, and other heart-healthy effects.  Through the 1980s and 1990s, Mars’ scientists produced studies suggesting such benefits.

Alas, cocoa flavanols come with complications.  They taste bitter (dark chocolate contains more of them).  They are present in such small amounts that you would have to eat a quarter to a full pound of chocolate a day to achieve cardiovascular benefits.[ii]  Worse, they are destroyed by traditional chocolate processing.[iii]  The losses may explain why a Hershey-funded clinical trial failed to find neuropsychological or cardiovascular benefits from eating dark chocolate when compared to a placebo.[iv]

But to return to CocoaVia: Mars developed a process to preserve the cocoa flavanols during processing, and combined the rescued flavanols with cholesterol-lowering plant sterols to make chocolate bars and chocolate-covered almonds.  By 2002, the company decided that it had enough research to promote CocoaVia candies as heart-healthy.[v]  As the New York Times put it, Mars was on a “corporate quest to transform chocolate into a healthy indulgence.”[vi]  Mars marketed the candy bars—two a day, no less—as a means to increase blood flow, lower blood pressure, and reduce the risk for heart disease.

The FDA takes a dim view of unproven claims like “chocolate prevents heart disease.”  In 2006, the agency sent Mars a warning letter complaining that claims like “promotes a healthy heart” and “now you can have real chocolate pleasure with real heart health benefits,” were false, misleading, and easily misinterpreted…Chocolate, the FDA pointed out, is high in saturated fat (it didn’t mention sugar).   Furthermore, the claim “Cocoa Via Chocolate Bars contain natural plant extracts that have been proven to reduce bad cholesterol (LDL) by up to 8%,” meant that Mars was advertising chocolate as a drug.  If Mars wanted to make drug claims, it would need to conduct clinical trials to prove that eating CocoaVia chocolate bars prevented heart disease.[vii]

Rather than run the financial and scientific risk of doing that, Mars gave up on candy bars and began marketing CocoaVia in pills and powder as a “daily cocoa extract supplement.”  In doing this, Mars could take advantage of the more lenient marketing claims allowed by the Dietary Supplement Health and Education Act (DSHEA) of 1994. This act permits “structure/function” claims, those proposing that a supplement is good for some structure or function of the body.  Under DSHEA, the labels of CocoaVia are allowed to say that these supplements “promote a healthy heart by supporting healthy blood flow.”

To convince people to take CocoaVia supplements, Mars funds research.  In 2015, it funded studies demonstrating that cocoa flavanols are well tolerated in healthy men and women,[viii] support healthy cognitive function in aging,[ix] can reverse cardiovascular risk in the healthy elderly,[x] and improve biomarkers of cardiovascular risk.[xi]

Lest the “eat more chocolate” implications of these studies be missed, Mars issued a press release: “Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.”[xii]  The company followed this announcement with a full-page ad in the New York Times quoting a dietitian: flavanols “support healthy blood flow…which allows oxygen and nutrients to get to your heart more easily.”  …The ad directed readers to more information on a paid ad on the Times’ Website.  You have to look hard in these ads to discover that Mars owns CocoaVia; the company’s name only appears in barely legible print as part of the trademark.[xiii]

But Mars, which already has funded “more than 150 peer-reviewed scientific papers and [has] approximately 100 patents globally in the field of cocoa flavanols”[xiv] has more ambitious research plans.  In 2014, the company announced that in partnership with the National Heart, Lung, and Blood Institute it would provide “financial infrastructure support “ for an ambitious placebo-controlled, randomized trial of the effects of cocoa flavanols alone or in combination with vitamin supplements, on heart disease and cancer risk in 18,000 men and women over the age of 60.[xv]  The five-year trial, called the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), has evolved somewhat since then.  It now lists Brigham and Women’s Hospital in Boston as the sponsor, and Mars as a “collaborator” along with the Fred Hutchinson Cancer Research Center in Seattle and Pfizer. NIH seems no longer to be involved.[xvi]

We now have the result of this trial.  Even though cocoa flavanol supplements did not reduce cardiovascular events, Mars got its money’s worth from what must have been a very expensive study.

Tomorrow: a second report from this trial, with surprising results.

References

[i] Mars, Inc.  The history of CocoaVia.  CocoaVia.com

https://www.cocoavia.com/how-we-make-it/history-of-cocoavia

[ii] Vlachojannis J, Erne P, Zimmermann B, Chrubasik-Hausmann S.  The impact of cocoa flavanols on cardiovascular health.  Phytother Res.  2016;30(10):1641-57.

[iii] Andres-LaCueva C, Monagas M, Khan N, et al.  Flavanol and flavonol contents of cocoa powder products: influence of the manufacturing process.  J Agric Food Chem. 2008;56:3111-17.

[iv] Crews WD, Harrison DW, Wright JW.  A double-blind, placebo-controlled, randomized trial of the effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health: clinical findings from a sample of healthy, cognitively intact older adults.  Am J Clin Nutr. 2008;87(4):872-80.

[v] Meek J.  Chocolate is good for you (or how Mars tried to sell us this as health food).  The Guardian, Dec 23, 2002.

https://www.theguardian.com/uk/2002/dec/23/research.highereducation

[vi] Barrionuevo A.  An apple a day for health?  Mars recommends two bars of chocolate.  NY Times, Oct 31, 2005.

The FDA considers candy bars to be foods labeled with Nutrition Facts panels.  Supplements are labeled with Supplement Fact panels.

[vii] FDA.  Inspections, compliance, enforcement, and criminal investigations.  Warning letter to Mr. John Helferich, Masterfoods USA.  FDA, May 31, 2006.  http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2006/ucm075927.htm

[viii] Ottaviani JI, Balz M, Kimball J, et al. Safety and efficacy of cocoa flavanol intake in healthy adults: a randomized, controlled, double-masked trial.  Am J Clin Nutr. 2015;102(6):1425-35.

[ix] Necozione S, Raffaele A, Pistacchio L, et al.  Cocoa flavanol consumption improves cognitive function, blood pressure control, and metabolic profile in elderly subjects: the Cocoa, Cognition, and Aging (CoCoA) Study—a randomized controlled trial  Am J Clin Nutr. 2015; 101:538-48.

[x] Heiss C, Sansone R, Karimi H, et al.  Impact of cocoa flavanol intake on age-dependent vascular stiffness in healthy men: a randomized, controlled, double-masked trial.  Age. 2015;37:56.

[xi] Sansone R, Rodriguez-Mateos A, Heuel J, et al.  Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.  Brit J Nutr. 2015;114(8):1246-55.

[xii] Mars Center for Cocoa Health Science.  Press release: Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people.  MarsCocoaScience.com, Sep 9, 2015.  http://www.marscocoascience.com/news/cocoa-flavanols-lower-blood-pressure-and-increase-blood-vessel-function-in-healthy-people.

[xiii] CocoaVia.  Cocoa’s past and present: a new era for heart health.  NY Times, Sep 27, 2015.  http://paidpost.nytimes.com/cocoavia/cocoas-past-and-present-a-new-era-for-heart-health.html?_r=0

[xiv] Mars Symbioscience.  Explore Mars Symbioscience.  Mars.com.

http://www.mars.com/global/brands/symbioscience

[xv] Mars.  Largest nutritional intervention trial of cocoa flavanols and hearth (sic) health to be launched.  MarsCocoaScience.com, Mar 17, 2014.

http://www.marscocoascience.com/news/largest-nutritional-intervention-trial

[xvi] The trial is registered at COcoa Supplement and Multivitamin Outcomes Study (COSMOS).    ClinicalTrials.gov.

https://clinicaltrials.gov/ct2/show/NCT02422745

[xvii] ASRC (Advertising Self-Regulatory Council).  NAD recommends Mars modify certain claims for CocoaVia cocoa extract.  ASRCReviews.org, Aug 11, 2016.

http://www.asrcreviews.org/nad-recommends-mars-modify-certain-claims-for-cocoavia-cocoa-extract/

Mar 14 2022

Industry funded opinion of the week: animal protein

This is another example of my seeing the title of a paper and wondering right away who paid for it.  The paper is displayed as a research article, but reads more like an analytical opinion piece.

The paper: Nutritionism in a food policy context: the case of ‘animal protein’.  Frédéric Leroy, Ty Beal, Pablo Gregorini, Graham A. McAuliffe, and Stephan van Vliet. Animal Production Science –   Published online: 21 February 2022

The rationale: Reductionist approaches to food focus on isolated nutritional criteria, ignoring the broader physiological and societal benefits and trade-offs involved…Among our present-day array of issues is the disproportionate stigmatisation of animal-source foods as harmful for human and planetary health.

The problem: “…animal-source foods (reduced to the notion of ‘animal protein’) are represented as an intrinsically harmful food category that needs to be minimised, thereby falsely assuming that ‘proteins’ are nutritionally interchangeable.

The solution: “…we suggest referring to said foods as ‘protein-rich foods’, while acknowledging the expanded pool of non-protein nutrients that they provide and their unique capabilities to support a much broader range of bodily functions. Several essential or otherwise beneficial nutrients are generally more bioavailable in animal-source foods than in plant-source foods.

The overall solution: “A more appropriate way forward would consist of combining and integrating the best of animal and plant solutions to reconnect with wholesome and nourishing diets that are rooted in undervalued benefits such as conviviality and shared traditions, thus steering away from a nutrient-centric dogma.”

Funding: FL acknowledges financial support of the Research Council of the Vrije Universiteit Brussel, including the SRP7 and IOF3017 projects, and in particular the Interdisciplinary Research ProgramTradition and naturalness of animal products within a societal context of change’ (IRP11). GM is funded by Soil to Nutrition (S2N), Rothamsted Research’s Institute Strategic Programme supported by UK Research and Innovation (UKRI) and Biotechnology and Biological Sciences Research Council (BBSRC) (BBS/E/C/000I0320). SvV grant support by SvV reports grant support from USDA-NIFA-SARE (2020-38640-31521; 2021-67034-35118), the North Dakota beef commission, the Turner Institute of Ecoagriculture, the Dixon Foundation, and the Greenacres Foundation for projects that link agricultural production systems (including livestock and crops) to the nutritional/metabolite composition of foods and human health. PG and FL acknowledge financial support of the project ‘Grazing for environmental and human health’ funded by the New Zealand Royal Society’s Catalyst Seeding Fund.

Conflicts of interest: FL is a non-remunerated board member of various academic non-profit organisations including the Belgian Association for Meat Science and Technology (President), the Belgian Society for Food Microbiology (Secretary), and the Belgian Nutrition Society. On a non-remunerated basis, he also has a seat in the scientific committee of the Institute Danone Belgium, the Scientific Board of the World Farmers’ Organization, and the Advisory Commission for the ‘Protection of Geographical Denominations and Guaranteed Traditional Specialties for Agricultural Products and Foods’ of the Ministry of the Brussels Capital Region. PG is an Associate Editor of Animal Production Science but was blinded from the peer-review process for this paper. SvV reports financial renumeration for academic talks, but does not accept honoraria, consulting fees, or other personal income from food industry groups/companies. All authors consume omnivorous diets.

Comment: I too am an omnivore, do not disagree with much of it, and could have written a lot of this myself, particularly the concerns about nutritionism (the use of nutrients to stand for the foods that contain them) and the concluding sentence in the Abstract: “Humans do not consume isolated nutrients, they consume foods, and they do so as part of culturally complex dietary patterns that, despite their complexity, need to be carefully considered in food policy making.”

But the purpose of this piece is to defend meat as a nutritious source of protein.

Why feel the need to take this on?

That’s what made me wonder who paid for it and whether authors had ties to the meat industry, which of course they do.

Reference: For research on why and how industry sponsorship can influence opinions and study outcomes, see Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Mar 7 2022

Industry-funded study of the week: animal-source foods in health and sustainability

I was sent an email with this message:

Calling your attention to this newly released review article, Animal source foods in healthy, sustainable, and ethical diets – An argument against drastic limitation of livestock in the food system. It was published in the March 2022 edition of Animal and is well worth a read, as it makes a strong case for the role of animal source foods in healthy, environmentally sustainable and ethical diets. See below for “highlights” taken directly from the paper, with the full review attached.

–Animal source foods are seen by some as unhealthy, unsustainable, and unethical.

–Outcomes depend on practical specificities, not on the fact that animals are involved.

–As for any food, the challenge is to promote best practices and limit harm.

     –Well-managed animals contribute to food security, ecological function and livelihoods.

     –Heavy reduction of livestock may lead to a fragile food system and societal damage.

I happen to agree that food animals are essential components of regenerative agriculture systems but there was something about this that triggered my “who paid for this?” question.  Bingo!

Here is the paper’s financial support statement:

FL acknowledges financial support of the Research Council of the Vrije Universiteit Brussel, including the SRP7 and IOF342 projects, and in particular, the Interdisciplinary Research Program “Tradition and naturalness of animal products within a societal context of change” (IRP11). PM acknowledges financial support of the Helsinki Institute of Sustainability (HELSUS) through the project “Understanding pastoralism sustainability through an interdisciplinary lens”. PG and FL acknowledge financial support of the project “Grazing for environmental and human health” funded by the New Zealand Royal Society’s Catalyst Seeding Fund. SvV acknowledges grant support from the North Dakota Beef Association to study the health effects of red meat in relation to diet quality. SvV reports additional grant support from USDA-NIFA-SARE (2020-38640-31521; 2021-67034-35118), the Turner Institute of Ecoagriculture, the DixonFoundation, and the Greenacres Foundation for projects that link agricultural production systems (including livestock and crops) to the nutritional/metabolite composition of foods and human health.

Here are the authors’ conflict of interest declarations:

All authors follow omnivorous diets. FL is a non-remunerated board member of various academic non-profit organisations including the Belgian Association for Meat Science and Technology (president), the Belgian Society for Food Microbiology (secretary), and the Belgian Nutrition Society. On a non-remunerated basis, he also has a seat in the scientific committee of the Institute Danone Belgium, the World’s Farmers Organization, and the Advisory Commission for the “Protection of Geographical Denominations and Guaranteed Traditional Specialties for Agricultural Products and Foods” of the Ministry of the Brussels Capital Region. PM is a non-remunerated member of the Spanish Platform for Extensive Livestock and Pastoralism. SvV reports financial renumeration for academic talks, but does not accept honoraria, consulting fees, or other personal income from food industry groups/companies.

Comment: The authors say much more than is usual about their potential conflicts of interest, either via their personal diets or their professional financial links to the meat industry.  Still, those links exist, as I could predict from the paper’s title.  The role of food animals in health and sustainability is heavily disputed.  Because of its funding and the ties of some of the authors to the meat industry, this study appears less convincing than it might if funded independently and carried out by independed researchers.

Reference: For research on why and how industry sponsorship can influence study outcome, see Unsavory Truth: How Food Companies Skew the Science of What We Eat.

Mar 3 2022

Infant formula marketing: an update

As the WHO/UNICEF report I posted yesterday makes clear, the marketing of infant formula—impossible for new mothers to avoid—interferes with breast feeding and, therefore, is a public health concern.

I posted about the Abbott Labs infant formula recall last week.

Here are some additional items I’ve collected on this topic.

I.  What the marketing looks like.

II.  Study finds no benefit of enriched infant formula on later academic performance: Children who are given nutrient or supplement enriched formula milk as babies do not appear to have higher exam scores as adolescents than those fed with standard formula, suggests a study published by The BMJ, leading researchers to argue renewed regulation is needed to better control infant formula promotional claims…. Read more

III.  IBFAN, the International Baby Foods Action Network, writes that it is:

launching a PETITION calling for an immediate halt to a new study  –  funded by the Gates Foundation and led by researchers from the University of California – that is randomly allocating infant formula to breastfeed in low-birth-weight babies in Uganda and Guinea-Bissau on assumption that this might prevent wasting and stunting.

The study, which has been cleared by ethics committees in the USA, Uganda and Guinea -Bissau – uses purchased ready-to-use infant formula made by Abbott, a US pharmaceutical corporation operating in 160 countries.  Abbott is a major violator of the International Code and is currently at the centre of a media storm in the USA because of contamination in its powdered formula. (NB. The formula used in the trial is liquid Ready-to-Feed).

IV.  IBFAN issued an earlier statement: The baby food industry’s destruction of an irreplaceable natural resource.

The International Code of Marketing of Breastmilk Substitutes was adopted forty years ago by the World Health Assembly, the world’s highest health policy setting body…Today 70% of countries have adopted laws based on the Code, however far too many are limited in scope and full of loopholes as a result of industry interference. As a consequence predatory marketing of baby food products continues throughout the world.  and the global Baby Food Drink Market is forecast to rise more than 30% in 5 years (from $68bn in 2020 to $91.5bn by 2026)….Aside from its crucial role in child survival (more than 800,000 children die each year because they are not breastfed and many more do not reach their full potential, ­­ breastfeeding is the most environmentally friendly way to feed an infant, resulting in zero waste, minimal greenhouse gases, and negligible water footprint. As a renewable natural food resource, mother’s milk makes an important contribution to local food and water security.the baby food industry lost no time in exploiting the fear and confusion during the pandemic: falsely claiming their products build immunity; that their  ‘donations’ are humanitarian; encouraging the needless separation of mothers and babies and pretending that they are essential ‘partners’ who are genuinely working to address the problems.

V.  The Access to Nutrition Initiative (ATNI) assesses nine formula companies’ adherence to WHO recommendations.  Its report is here.

According to its press release,

Despite the World Health Assembly (WHA) adopting ‘The International Code of Marketing of Breast-milk Substitutes’ forty years ago and passing 18 associated resolutions since (collectively referred to as ‘The Code’), the BMS/CF Marketing Index 2021 found that none of the companies it assessed fully abides by The Code’s recommendations and most fall well short.

The summary: 

  • Danone retained first place with a score of 68%, up from its 2018 score of 46%
  • Nestlé, the market leader in sales value, retained its second place with a score of 57% – also a substantial improvement on its score of 45% in 2018
  • KraftHeinz achieved the greatest improvement, ranking third, with a score of 38% compared to in 2018 when it didn’t score at all
  • Reckitt (previously RB) substantially improved its BMS Marketing policies which led to a big jump in its score from 10% in 2018 to 32% in 2021 and climbing one place to fourth in the ranking.

VI.  A study: Conflicts of interest are harming maternal and child health: time for scientific journals to end relationships with manufacturers of breast-milk substitutes.  Pereira-Kotze C, et al.  BMJ Global Health. 2022 Feb;7(2):e008002. doi: 10.1136/bmjgh-2021-008002

The promotion and support of breastfeeding globally is thwarted by the USD $57 billion (and growing) formula industry that engages in overt and covert advertising and promotion as well as extensive political activity to foster policy environments conducive to market growth. This includes health professional financing and engagement through courses, e-learning platforms, sponsorship of conferences and health professional associations and advertising in medical/health journals…journal publishers may consciously, or unconsciously, favour corporations in ways that undermine scientific integrity and editorial independence—even perceived conflicts of interest may tarnish the reputation of scientists, organisations or corporations.  Such conflicts have plagued infant and young child nutrition science for decades.

Comment: As I mentioned yesterday, we now have more than enough evidence to put a stop to this.