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The Institute of Medicine (IOM) just released its second report on front-of-package (FOP) labeling.  It tells FDA to allow only four items in any front-of-package evaluation scheme:

• Calories
• Saturated and trans fat
• Sodium
• Sugars

To display this, the IOM committee recommends a point system based on levels of saturated and trans fats, sodium, and sugars for evaluating food products.  The points are to be indicated with check marks or stars.  Here is an example of how stars might be used to indicate products that qualify for zero, one, two, or three points.

I’m guessing that anything this clear and understandable will elicit storms of protest.

Recall that food companies have been setting their own nutrition criteria for evaluating their very own products and identifying the “better-for-you” or “more nutritious” products with special front-of-package logos.  By company standards, many of their products qualify for the logos.

To deal with the multiplicity and absurdity of such schemes, the FDA asked the IOM to take a look at the various FOP logos that were out there and recommend how to clean up the mess.  The first IOM report said the FDA should allow FOP labels to state only calories, saturated and trans fat, and sodium, but not sugars (this last was a mistake, I thought).

But—while the FDA was waiting for the IOM to produce its next report, the Grocery Manufacturers Association (GMA) and Food Marketing Institute (FMI) jumped the gun.  Their preemptive logo included “positive” nutrients such as vitamins and fiber along with the “negatives.”  This scheme is already in use on food packages.

The IOM committee was faced with an impossibly difficult task: to come up with a front-of-package scheme that would reduce the overall nutritional quality of processed foods to the sum of a few key factors.

Given strong industry marketing pressures to retain front-of-package labels—and the lack of an option to remove them altogether—the committee did the best it could with an inherently bad idea.

Why a bad idea?  FOP labels are a tool for selling, not buying.  They make highly processed foods look healthier, whether or not they really are.

And whether slightly better-for-you processed foods assessed by this method will help anyone to make better food choices and to be healthier remains open questions.

Nevertheless, the IOM proposal is a huge improvement over what food companies are now doing.  I consider it courageous.

Why courageous?  Because the scheme makes it so easy to distinguish products that qualify for the various point levels.

For example, here are some products that qualify for stars:

• Toasted oat cereal
• Oatmeal, instant
• Milk, 1% fat
• Yogurt, plain nonfat
• Salad dressing, light
• Orange juice, 100%
• Grape juice, 100%
• Kidney beans, canned
• Peanut butter
• Tomato soup, “healthy”
• Tomatoes, canned

Examples of products that do not qualify:

• Animal crackers
• Graham crackers
• Breakfast bar
• Sweetened toasted oat cereal
• Oatmeal, instant with fruit, nuts
• Chocolate milk
• Yogurt, sweetened

I can’t wait to see the GMA and FMI press release on this report.

And the FDA must now take this report under consideration to begin its interminable rulemaking process.

Why, you might ask, does any of this matter?  Aren’t questions about what food companies put on package labels basically trivial?  Don’t FOP label fights divert attention from other, more important food issues?

Maybe, but I see this as a test of the FDA’s authority to regulate and set limits on any kind of food industry behavior.  If the FDA cannot mandate a label that might help consumers choose healthier food options or refuse to permit labels that mislead consumers, it means the public has little recourse against any kind of corporate power.

I think this matters, and I’ll bet food companies do too.

And now, sit back and watch the lobbying begin!

That did not take long:  Here’s the GMA press release—fairly tame all things considered:

The Institute of Medicine’s Committee on Examination of Front-of-Package Nutrition Rating Systems and Symbols report adds a perspective to the national dialogue about front-of-pack nutrition labeling.  In the meantime, food and beverage companies have developed a real-world program that delivers real value to real consumers in real time.

Consumers have told us that they want simple and easy to use information and that they should be trusted to make decisions for themselves and their families. The most effective programs are those that consumers embrace, and consumers have said repeatedly that they want to make their own judgments, rather than have government tell them what they should and should not eat.  That is the guiding principle of Facts Up Front, and why we have concerns about the untested, interpretive approach suggested by the IOM committee.

My translation: Consumers prefer to have the food industry’s “Facts Up Front” tell them what to eat?  I don’t think so.

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According to Food Chemical News (October 7), the European Union has finally agreed on rules for food labels.  These are disappointing.  They allow much of the current confusion to continue. 

Here’s what they are said to do:

• Packaged foods will have to be labeled with amounts of calories, fat, saturated fats, carbohydrate, protein, sugars and salt.  This is the “mandatory nutrition declaration.”
• Amounts are to be expressed per 100 grams or 100 milliliters.  Per-portion will be voluntary as will percentage of reference intakes, meaning that the confusing Guideline Daily Amounts can continue.
• Packages may display traffic lights or other graphics and symbols, as long as they don’t mislead consumers, are supported by evidence of consumer understanding, and don’t create trade barriers in the EU’s internal market [my interpretation: goodbye traffic lights].
• All elements of the nutrition declaration must appear together, but some can be repeated on the “front of pack.” 
• The mandatory nutrition declaration can be supplemented voluntarily with “better for you” nutrients such as mono-unsaturated fats, polyunsaturated fats, polyols, starch, fiber, vitamins, and minerals [alas, this is a sellout].  
• Calories must be expressed per 100 g/ml, but also per portion.

Too bad.  I was hoping for something better, more along the lines of what the Institute of Medicine(IOM)  has proposed and less along the lines of what the Grocery Manufacturers and Food Marketers are doing.

The second  IOM report on front-of-pack (FOP) labeling is due out in a few weeks.  I am eager to see what the IOM committee thinks the FDA should do about FOP labels.  Stay tuned. 

 

 

Are you as puzzled about the latest cantaloupe outbreak as I am?  This time it’s Listeria again (see previous post on this particular pathogen).

According to the CDC, 72 people have been infected with the strains of Listeria associated with the outbreak in 18 states.  Most appalling,  13 people have died.

The CDC says that the people who have become ill range from 35 to 96 years, with a median age of 78 years.  Most are over age 60 or have health conditions that weaken the immune system.  Pregnant women are at especially high risk as are their fetuses.

As always, the recall occurred after most of the cases were reported to the CDC.  The cantaloupe were traced to Jensen Farms, which issued a recall on September 14.

Why cantaloupe?  They are, after all, grown in dirt and their skin is rough, textured, and has plenty of places for bacteria to hide.  People pick up Listeria by handling the fruit and cutting into it.  FDA’s information page lists the recalls and press releases on the Jenson Farms outbreak.

The FDA’s advice: throw it out.

Do not try to wash the harmful bacteria off the cantaloupe as contamination may be both on the inside and outside of the cantaloupe. Cutting, slicing and dicing may also transfer harmful bacteria from the fruit’s surface to the fruit’s flesh.

What do food safety experts say you have to go through to avoid getting sick from eating cantaloupe?

• Wash the melon under running water with a clean vegetable brush.
• Blot with paper towels to remove excess water.
• Put melon on a clean surface, one that hasn’t come into contact with meat or poultry or other foods that could cause cross-contamination.
• Cut off the stem end about 3/4 to 1 inch from the end, using a clean kitchen knife.
• Place melon on a clean cutting board, plate, or other clean surface with the cut end facing down.
• Using a clean knife, cut the melon from the blossom end to the stem end.
• Follow this by washing the knife with clean running water and setting it aside.
• Gently scrape out the seeds with a clean spoon and cut the melon into slices or whatever is desired.
• Don’t use dish soap or detergent; cantaloupes can absorb detergent residues.
• Do not allow the rind to touch any part of the edible fruit.
• Melon that isn’t eaten should be peeled, covered and refrigerated.
• Discard any melon that has been at room temperature for longer than 2 hours, or 1 hour when the temperatures are over 90 degrees F.
• Follow these procedures for all melons, no matter where they were grown.

What?  No HazMat suit?

We are talking about cantaloupes here.

How about a food safety system where everyone makes sure—and tests—that Listeria don’t get on cantaloupe in the first place.

Single food agency anyone?

_____

*Translation: Weapon of Mass Destruction

I’ve just gotten an urgent plea from Margo Wootan at the Center for Science in the Public Interest (CSPI).

Please encourage everyone to write to President Obama, First Lady Michelle Obama, and federal agencies to support the nutrition standards for marketing foods to kids.

As I’ve discussed previously, these were created jointly by the Interagency Working Group (IWG) of four federal agencies—CDC, FDA, FTC, and USDA.

Under intense pressure from the food and entertainment industries and their friends in Congress, the IWG’s proposed guidelines—voluntary, no less—are in danger of being withdrawn.

Doing that might help corporate health but would do nothing for public health.

CSPI organized 75 researchers (including me) to send a letter to the President urging support of the voluntary guidelines and expressing dismay at the campaign of disinformation aimed at getting them withdrawn.

Junk-food advertisers, in the guise of the Sensible Food Policy Coalition, have attacked the voluntary guidelines as an assault on the First Amendment, a point debunked by top Constitutional experts, and claimed that adopting the voluntary guidelines would result in job losses, based on a flimsy industry “study.”

….It would be a real setback for children’s health if the Administration backed down on strong guidelines for food marketing to children, especially given the transparently specious arguments of junk-food advertisers….Denying the science on food marketing and childhood obesity is like denying the science on global warming or evolution.

But the food industry is dug in on this one.  For example, a reader sent me this letter from Tom Forsythe, Vice President, Corporate Communications, General Mills (excerpts follow with my comments in brackets):

Your email notes that we have lobbied against the Interagency Working Group (IWG) proposal.  That is correct.  We have serious concerns about the IWG proposal.

Our most advertised product is cereal – and we stand behind it.   Cereal is one of the healthiest breakfast choices you can make….If it is a General Mills cereal, it will also be a good or excellent source of whole grains.

Childhood obesity is a serious issue – and General Mills wants to be part of the solution.  But if the issue is obesity, cereal should perhaps be advertised more, not less.

…You can be assured than food and beverage companies have studied every letter, comma and period in the proposal.  We know what it says, and what it does not.

For example, we know that 88 of the 100 most commonly consumed foods and beverages could not be marketed under the IWG guidelines.  The list of “banned” items under the guidelines would include essentially all cereals, salads, whole wheat bread, yogurt, canned vegetables, and a host of other items universally recognized as healthy [Note: I’m not at all sure this is true–MN].

Despite the characterizations used to advance them, the IWG guidelines would not be voluntary, in our view.  The IWG guidelines are advanced by two of the agencies most responsible for regulating the food industry, as well as the agency most responsible for regulating advertising.  Ignoring their “voluntary guidance” would not be an option for most companies.

Regulation has already been threatened (even demanded) should companies choose not to comply – and litigation would inevitably follow.

The IWG guidelines also conflict with most existing government programs and definitions relative to food.  For example, many products that meet the U.S. Food and Drug Administration’s current definition of “healthy” could not be advertised under the IWG guidelines [It would be interesting to see examples].

Many products included in the U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program fail the IWG standards, as do most products encouraged and subsidized under the USDA’s Women, Infants and Children Feeding Program (WIC) [If so, this is a sad commentary on what we encourage low-income mothers and children to eat].

Finally, your email suggests companies should focus on providing feedback via public comment.  We agree.  We have reviewed every detail of the IWG proposal – and we remain opposed, as our public comment explains.

My interpretation: if food companies are this upset, the guidelines must be pretty good.

Companies have the right to sell whatever they like.  But they should not have the right to market it as healthy or to kids.

Tell the IWG you support their guidelines.  Tell the White House to protect the guidelines.  Now, please.

 

 

In an astonishing display of what can only be described as chutzpah* Del Monte sued the FDA for insisting on a recall last March of its cantaloupes likely to be contaminated with a toxic form of Salmonella Panama. Now Del Monte is also suing the State of Oregon.

On what grounds?

Notably, “[t]he FDA investigation ultimately found no connection between Del Monte Fresh cantaloupes and any cases of Salmonella Panama, including in Oregon,” the company says. “FDA issued a notice ending the recall on July 29, 2011.”

The CDC thinks otherwise.  Its investigations pointed to imported Del Monte cantaloupes as the source of an outbreak that affected 20 people in several states:

Twelve of 16 ill people reported eating cantaloupe in the week before illness. Eleven of these 12 ill people ate cantaloupes purchased at eight different locations of a national warehouse club. Information gathered with patient permission from membership card records helped determine that ill persons purchased cantaloupes sourced from a single farm. Product traceback information indicated these cantaloupes were harvested from single farm in Guatemala.

FoodSafetyNews reviews the history of this particular recall.  It agrees with Del Monte that tests performed in April on cantaloupe samples from the Guatemala farm came out negative for Salmonella and that the FDA has now ended the recall.  But:

Del Monte had announced the recall in March, after the suspect melons had passed their shelf-life date. It is not clear whether any of the cantaloupes tested were actually the suspect melons. In foodborne illness investigations, samples of the food from the same batch eaten may no longer available by the time the connection to an outbreak is made. Epidemiology, rather than a contaminated sample, is the evidence that points to a likely source.

For these reasons, attorney Bill Marler terms the lawsuit “frivolous.”  He is suing Del Monte on behalf of a sick client.

Public health agencies doing their jobs to protect the public now have to defend against lawsuits like this?  Putative cause is no longer enough to order recalls?

U.S. courts are not famous for understanding epidemiology or other aspects of public health and I’m wondering what effect this suit will have on public protection against foodborne illness.  What standard of proof will the courts require?

Lawsuits are chilling.  Congress has just granted the FDA the authority to order recalls.  Food producers were not happy about that provision.  This is one way to get around Congress and the FDA.

It is worth asking who gains and who loses from lawsuits like this.

*Hence: chutzpah, which if you aren’t familiar with the term, is the Yiddish word for outrageous audacity.

I’ve been rounding up information about the Cargill recall of ground turkey contaminated with Salmonella Heidelberg.  William Neuman at the New York Times related the story on August 3. Same old same old.

Cargill is a huge company with, as Bill Marler counts them, a long history of food safety problems.  Did Cargill not bother to test for pathogens?   As I explain in my book Safe Food: The Politics of Food Safety, no meat company wants to test for pathogens.  If they found pathogens, they would have to recall the products.

And where was the USDA in all of this?  Best not to ask.

The USDA was testing.  The testing found Salmonella.  The USDA did nothing.

According to the Wall Street Journal,

Federal officials said they turned up a dangerous form of salmonella at a Cargill Inc. turkey plant last year, and then four times this year at stores selling the Cargill turkey, but didn’t move for a recall until an outbreak killed one person and sickened 77 others.

How come?

Food-safety specialists said the delay reflected a gap in federal rules that don’t treat salmonella as a poisonous contaminant, even if inspectors find antibiotic-resistant forms such as the Heidelberg strain implicated in the latest outbreak.

But CDC investigations show that turkey-related illnesses have been reported for months.  Despite the reports, the USDA took its own sweet time insisting on a recall.

The rationale for the delay is—get this—the USDA believes it does not have the authority to order recalls for any contaminant except E. coli O157:H7.  It has no authority to recall meat contaminated with Salmonella or other toxic forms of E. coli.

Or at least that’s how USDA interprets the legal situation (for the history of all this, see Bill Marler’s summary.

One reason for the USDA’s foot-dragging must surely be pressure from the meat industry which wants as little testing as possible and preferably none.  The meat industry would rather leave it up to you to cook your food safely.

According to a report by Elizabeth Weise in USA Today,

The reasons these bugs aren’t currently regulated are a mix of politics, money and plain biology — the bacteria are constantly evolving and turning up in new and nastier forms, making writing rules about them a bit of a nightmare. For example, the German E. coli variant that sickened more than 4,075 in Europe and killed 50…wasn’t known before this spring.

The meat industry takes advantage of this situation and argues:

“We don’t have a true baseline determining the prevalence of these organisms in the beef supply,” says Betsy Booren of the American Meat Institute (AMI) Foundation, the research arm of AMI. Without knowing how common they are, it’s impossible to say whether they should be considered adulterants, she says.

What they seem to be saying is that meat always has bacteria on it.  And just because these particular bacteria can kill people doesn’t mean the industry is responsible if anyone gets sick.  But shouldn’t the industry be doing a better job?

In Food Safety News, Michele Simon has a terrific analysis of the safety loopholes that allow this absurd situation to continue:

How did the meat industry get so powerful that it can keep USDA from doing its job? Now, instead of preventing illnesses from occurring by requiring testing with teeth, we have USDA regulations that are so lax they allow almost half the samples tested at ground turkey plants to be contaminated with Salmonella — a pretty easy standard to meet. And one that allowed this outbreak to occur.

I keep asking: how much worse does it have to get before Congress does something about ensuring safe food.  Cargill’s inability to protect the public from unsafe meat is reason alone to create a single food safety system that unites the functions of USDA and FDA.

If Congress isn’t ready to take that step, it could at least give USDA the power to act and the FDA the funding it needs to do its job.

The Berkeley group that organized a contest to redesign the food label has picked its top choices from among 24 entries.   Take a look at them on that site and vote for your favorite by midday Sunday.

Tara Parker-Pope has a nice summary on her New York Times blog along with interviews with the judges.  Lily Mihalik, cocreator of the project explains:

We asked food thinkers and design minds to come together and give advice on how they might rethink the food label and bring some insight into how design impacts choice…There are a lot of things right with the current label, but at the same time people are confused. The question is whether a new nutrition facts label could help people make more educated decisions.

Good question.  My take is that most of the entries are even more complicated than the current Nutrition Facts label and leave out a lot of useful things you might like it to do:

• State the content of calories per serving
• State the serving size
• State the content of nutrients of interest per serving (opinions can vary as to which are worth listing)
• Compare those levels to standards for daily intake
• Explain how those levels apply to a typical day’s diet
• Indicate how the food fits into diets that vary in calorie intake
• List ingredients
• List allergens
• Be accurate, noticable, understandable, and usable

Overall, the label is supposed to help consumers make more healthful food choices.  It also has to fit on food packages.

As several of the entries suggested, it would also be helpful if the label could indicate the degree of processing.  Actually, you can figure that out now by looking at the ingredient list.  Count the ingredients, see if you can pronounce them, and make sure they are recognizable as food.

If anything, this project demonstrates how difficult it is to develop a design that addresses all of these issues.   The January 6, 1993 Federal Register notice that announced the Nutrition Facts label takes up nearly 900 pages.

That notice reviewed the research that led to the current label.  The review makes it clear that nobody understood any of the available design options.   The FDA, under great pressure to meet a deadline set by Congress, chose the design that was least poorly understood.

Hence the FDA’s web pages devoted to explaining how to read and interpret the Nutrition Facts label, and its even lengthier web guide to the food industry on how to create the labels.

The FDA is currently doing the preparatory work for an eventual revision of the label, so these designs come at an opportune time.  Take a look and see what you think of them. 

The designers were brave to take this on. 

And so is the FDA.

Today is the last day to comment on the federal Interagency Working Group’s (IWG) proposed nutrition standards for marketing food products to kids.  The IWG is a joint project of four federal agencies with at least some responsibility for public health: FTC, FDA, USDA, and CDC.

As I discussed back in April, I thought the IWG standards were generous and gave food companies plenty of room to market junk foods with impunity.  Maybe, but that’s not how food companies see it.  They think it will cause so much havoc with their marketing that they are fighting back, big time.

Large food companies joined together to create the “Sensible Food Policy Coalition.”  This entity paid for an economic assessment.  On July 8, the Coalition released Global Insight’s report of this assessment—a call to arms arguing that the “administration’s misguided ad restrictions would cost 74,000 American jobs.”

The report’s point is that restricting advertising would have unintended economic consequences, particularly losses in sales and revenues, and therefore jobs.  The report estimates an astonishing loss of $28.3 billion from manufacturing and retail sales, just in the first year, translating to “at least 74,000 lost jobs.”

This makes me think that the standards may have some merit.  Campbell Soup, for example, has just announced that because its low-salt soups aren’t selling, they are putting the salt back in.  Oh.

In any case, industry pushback seems to be having an effect.  As I discussed in my post a week or so ago, David Vladeck of the FTC used his blog to discuss industry mythology about the proposed standards.  I thought his statement backpedaled on even a hint of federal regulation of food marketing to kids.

MYTH #2: The Working Group’s proposal is regulation by the back door

….This is a report to Congress, not a rulemaking proceeding, so there’s no proposed government regulation. In fact, the FTC Act explicitly forbids the Commission from issuing a rule restricting food advertising to children. So the FTC couldn’t issue a rule on this subject if it wanted to, which it doesn’t. Simply put, a report like this can’t be a rule — whether it’s delivered to Congress by the front door, the back door, or the kitchen door.

The IWG is collecting comments on its proposals through close of business today.  If you need a rationale for filing a comment, read Larry Cohen’s piece in the Huffington Post.

Comments don’t have to be long or complicated.  Just say what you think.

Go to this site to file them.

Or go to the PreventObesity site for additional suggestions.

Do this today!