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The World Health Organization (WHO) has a new, tough report out: “Set of recommendations on the marketing of foods and non-alcoholic beverages to children.”

It’s policy aim: to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.

Here are some of its recommendations (edited):

• Given that the effectiveness of marketing is a function of exposure and power, the overall policy objective should be to reduce both the exposure of children to, and power of, marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• To achieve the policy aim and objective, Member States should consider different approaches, i.e. stepwise or comprehensive, to  reduce marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt, to children.
• Settings where children gather should be free from all forms of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• Governments should be the key stakeholders in the development of policy and provide leadership, through a multistakeholder platform, for implementation, monitoring and evaluation. In setting the national policy framework, governments may choose to allocate defined roles to other stakeholders, while protecting the public interest and avoiding conflict of interest.
• Considering resources, benefits and burdens of all stakeholders involved, Member States should consider the most effective approach to reduce marketing to children of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• Member States should cooperate to put in place the means necessary to reduce the impact of crossborder marketing (in-flowing and out-flowing) of foods high in saturated fats, trans-fatty acids, free sugars, or salt to children.

The Rudd Center at Yale has just released Fast Food F.A.C.T.S., a thoroughly comprehensive report on the marketing of fast food to children and adolescents.

The report lavishly illustrates and extensively documents the ways in which fast food companies market to kids, the strategies they use, and the effects of these efforts on kids’ diets.

Readers: add it to your library!  FDA and FTC: get busy!

Addition: Advertising Age reports on the fast food industry’s response to the Rudd Center report.  All the industry can come up with, says Advertising Age, is a “canned response.”  Looks like the Rudd Center got it right.

In a online press release yesterday, the Grocery Manufacturing Association (GMA) and Food Marketing Institute (FMI) announced a new labeling initiative for their member companies:

America’s leading food and beverage manufacturers and retailers joined forces today in the fight against obesity and announced their commitment to develop a new front-of-package nutrition labeling system. The unprecedented consumer initiative will make it easier for busy consumers to make informed choices when they shop….America’s food and beverage manufacturers and retailers have agreed to support the change to their product labels with a $50 million consumer education campaign.

Forget the consumer-friendly rhetoric.

There is only one explanation for this move: heading off the FDA’s Front-of-Package (FOP) labeling initiatives.

Only two weeks ago, the Institute of Medicine released its first FDA-sponsored FOP labeling report.  The IOM committee recommended that FOP symbols only mention calories, sodium, trans fat, and saturated fat.  This led William Neuman of the New York Times to summarize its approach as: “Tell us how your products are bad for us.”

GMA and FMI would much rather label their products with all the things that are good about them, like added vitamins, omega-3s, and fiber.  If they must do negatives, they prefer “no trans fat” or “no cholesterol.”

What they especially do not want the FDA to impose is “traffic-light” symbols.  These U.K. symbols, you may recall from previous posts, discourage consumers from buying anything labeled in red, and were so strongly opposed by the food industry that they caused the undoing of the British Food Standards Agency.

GMA and FMI, no doubt, are hoping the same thing will happen to our FDA.

In today’s New York Times, Mr. Neuman quotes a GMA representative:

Mary Sophos, an executive vice president for the group, said the label would not characterize a food’s overall nutritional qualities as good or bad — like the traffic signal label in Great Britain that displays a red circle for less healthy nutrient levels and a green circle for healthier levels.

“We’re not going to get into interpreting elements of the food,” Ms. Sophos said.

This move is all the evidence the FDA needs for mandatory FOP labels.   GMA and FMI have just demonstrated that the food industry will not willingly label its processed foods in ways that help the public make healthier food choices.

Let’s hope the GMA/FMI scheme goes the way of the ill-fated, not-so-Smart Choices program.

FDA: you should be outraged by this move.  Say so!

The Institute of Medicine (IOM) released its first Front-of-Package (FOP) labeling report this morning. Phase I is a tough, detailed examination of about 20 of the existing FOP schemes along with some recommendations about what such schemes ought to do.

FOP labels are those little spots, check marks, and tokens that are all over food packages these days and that are supposed to indicate that the product is especially healthy for you.  They may seem utterly trivial, but they are of desperate importance to food companies.  FOP labels sell food products.  Food marketers love them and need them.  The FDA worries that having so many of them confuses the public, and that the schemes are based on criteria that serve industry purposes more than to promote public health.

As the IOM press release explains:

A multitude of nutrition rating, or guidance, systems have been developed by food manufacturers, government agencies, nutrition groups, and others in recent years with the intent of helping consumers quickly compare products’ nutritional attributes and make healthier choices. Ratings are typically communicated to shoppers through symbols placed prominently on food packaging, usually on the front, or on retail shelf tags. Unlike the Nutrition Facts panel, these rating systems and symbols are unregulated, and different systems focus on different nutrients. The variation may confuse consumers, and questions have been raised about the systems’ underlying nutritional criteria.

The committee did a terrific analysis of current FOP schemes.  My favorite parts are its

• Clear, concise histories of nutrition and FOP labeling (students: take note!)
• Detailed evaluation of the strengths (few) and weaknesses (many) of the existing schemes
• Demonstration of the inconsistent results of applying the schemes to specific foods

The report gives examples of the inconsistent results of three scoring schemes: Guiding Stars, NRFI [Nutrient-Rich Foods Index], and Nu-Val

• Instant oatmeal received 3 Guiding Stars, and scores of 87 by NRFI and 39 by NuVal.
• Non-instant oatmeal received 2 Guiding Stars, and scores of 22 by NRFI and 57 by NuVal
• Toasted oat cereal received 2 Guiding Stars, and scores of 84 by NRFI and 37 by NuVal
• Fat free milk, 1% fat milk, and fat free plain yogurt received 3 Guiding Stars, but fat free milk was scored 56 by NRFI and 91 by NuVal; 1% fat milk was scored 30 by NRFI and 81 by NuVal, and fat free plain yogurt was scored 43 by NRFI and 96 by NuVal.

The committee’ key recommendation: FOP labels should deal with just four nutrients: calories, saturated fat, trans fat, and sodium.

These nutrients, says the committee, “are routinely overconsumed and associated most strongly with diet-related health problems affecting many Americans, including obesity, heart disease, high blood pressure, Type 2 diabetes, and certain types of cancer.”

Comment: Trans fat seems unnecessary here.  It is already out of most packaged foods.   Or maybe the committee thinks that leaving it off will give food companies permission to put hydrogenated oils back in?

The committee chose not to add sugars to this list:

The committee concurred that both added and naturally occurring sugars contribute to the caloric content of foods and beverages and overconsumption of high-calorie products can lead to obesity.  Highlighting calories per serving in nutrition rating systems would address this concern.

Comment: I think consumers want to know about added sugars in food products.  I certainly do.

Phase II comes next

It will examine designs and look at consumer understanding of the labels, and will discuss “the pros and cons of having a single, standardized front-label food guidance system that is regulated by the Food and Drug Administration.”

Presumably, Phase II will deal with questions that are not addressed in the Phase I report:

• Will this scheme supersede all of the other labeling systems currently on food packages?
• Will it be voluntary or mandatory?  For all food products, or just selected ones?
• If the scheme is voluntary, why would food companies choose to use it since it mostly highlights the negatives—the nutrients to be avoided?
• How will it affect the nutrient-content claims currently on food packages?  (Examples: “Contains 8 vitamins!”  “100% vitamin C!” “High fiber!”)
• How will it affect shelf-labeling schemes such as the Nu-Val system used at Price Chopper supermarkets and the ANDI system used by Whole Foods?

FOP labels are about marketing, not health

This scheme, like the many others developed by food companies singly or together, is designed to help the public decide whether one highly processed, packaged food product is nutritionally better than another.

As I have discussed many times on this site, this approach raises a philosophical question: Is a slightly “better for you” food product necessarily a good choice?

I hope the committee will ponder this and some of my other questions as it enters Phase II.

Addendum: I gather from what I’ve heard about the press conference this morning that some of my questions were answered.  The FOP proposal will not affect nutrient content claims on the front of packages.  Companies will still be able to proclaim the nutritional benefits of their products in words and banners.  They just won’t be able to use them in whatever symbol gets chosen.  So what difference will this report make?  Not much, alas, except to get rid of the silly symbols in use right now.

Update, October 14:  William Neuman’s account of this event in the New York Times starts with this: “Tell us how your products are bad for us.”

My first-Sunday-of-the-month San Francisco Chronicle Q and A column, Food Matters, is out.  This month it’s about figuring out what “whole wheat” labels mean on food packages.

Q: I pay $4 for multigrain or whole wheat breads because I’ve heard white bread isn’t as healthy. But when I compare nutrition labels, $2 white breads look much the same. Are they?

A: My Talmudic answer: yes and no. You are asking about commercial sliced breads. Bread may be the staff of life, but you would never know it from reading the ingredient lists of most commercial products.

Commercial breads are indeed much the same, with only a few differences that matter.

To decide whether these have anything in them worth eating beyond their calories, you must inspect labels to make sure the first ingredient is whole grain, the total number of ingredients is small and devoid of unpronounceable chemicals, the fiber content is at least 2 grams per 1-ounce serving and the label says 100 percent whole wheat. Anything less is reconstituted white bread with occasional pieces of the original grain added back.

And then there is taste. Artisanal breads begin with just four ingredients – flour, water, salt and yeast – and turn them into loaves so crusty, chewy and fragrant that you cannot stop eating them. If they have some whole grain in them, even better.

But handmade breads take forever to make and quickly go stale. Commercial bakeries deal with these problems by rushing the bread-making process and compensate for the loss of flavor by adding stabilizers, dough softeners and preservatives, and covering up the chemical tastes with sweeteners. Breads with 30 or more ingredients are not unusual and violate my rule: Never buy processed foods with more than five ingredients.

To compare breads, you must read labels. Bread companies do not make this easy. Some list the serving size as one slice, some two, and their weights can vary by twofold. When you convert everything to ounces, the nutrient content of supermarket breads looks much alike.

An ounce provides 70 to 80 calories, a trivial difference. The grain is what counts.

Wheat grains have three components – the nutrient-rich bran and germ (“chaff”), and the endosperm, which is mostly starch and protein. One hundred percent whole wheat flour contains all three in the same proportion as in the original grains.

White flour contains about 80 percent of the original components. It is mostly endosperm.

Nutrients in the chaff are lost, so bakers are required to replace the five nutrients least likely to be available from other foods: niacin, riboflavin, thiamin, folic acid and iron. The others are not replaced.

Neither is fiber. White flour contains only trace amounts of fiber.

Because high-fiber diets promote healthy bowel function and appear to reduce risks of heart disease and bowel cancers, dietary advice is to eat at least three daily servings of whole grains – 3 ounces of 100 percent whole wheat bread, for example.

Food labeling rules do not make it easy to figure out fiber content. Some white breads list 1 gram of fiber, but watch out for serving size. It takes two slices to reach half a gram, which can be rounded up to 1.

Whole wheat bread with 2 grams of fiber per 1-ounce slice may have four times as much fiber as white breads. But watch out for breads listing 3 grams fiber; their slices may weigh nearly 2 ounces.

In response to dietary advice, commercial bakeries have introduced whole grain breads acceptable to white bread eaters. These grind the wheat bran super fine, add extra dough conditioners to keep the bread soft, and toss in some bran or cracked wheat to make the bread look like whole wheat. Check for fiber grams and the position of chaff ingredients on the list. The further down the list, the smaller their contribution.

And where is the Food and Drug Administration to help with whole grains? Alas, the FDA has not set rules for grain content. It permits manufacturers to make statements such as “100 percent whole grain” as long as the statement is true and does not imply that the food is an “excellent source.”

The FDA’s nonbinding guidance says anything labeled “100 percent whole grain” must contain all three components of the original wheat seed, in proportion.

This regulatory gap permitted creation of the industry-sponsored Whole Grain Council. The council issues a certifying stamp in two forms: 100 percent and Basic. One hundred percent means all grains are whole. But the more prevalent Basic stamp allows refined grains and disproportionate additions of bran or germ.

This article appeared on page K – 3 of the San Francisco Chronicle.

Note: E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.  Read previous columns at sfgate.com/food.

I have now seen the talking points used by FDA senior scientific advisor Jessica Leighton in her speech to the Food Policy Conference last week.  These are indeed quite different from those I reported a few days ago.  Here is my understanding of what she actually said.

Dr. Leighton reported that the FDA was working on a number of food labeling initiatives:

• Updating elements of the Nutrition Facts Panel such as calories, serving sizes, and Daily Values.
• Identifying a front-of-pack nutrition label based on sound nutrition science and easily noticed, understood and used by consumers.
• Implementing the new federal menu labeling law with regulations to be released by March 2011.

She emphasized that the focus of FDA’s public health efforts is to address chronic disease and obesity problems by making the best information available in the best way to help consumers make healthy food choices.

FDA seeks input.  To that end, it is releasing solicitations and draft guidance documents.

FDA especially seeks research that can help the agency determine the best way its initiatives can improve consumer food behavior.

These goals make sense to me, and I’m glad to have them clarified.

Footnote: Food Chemical News has just filed a correction to its original story:

Food Chemical News, in our Sept. 27 weekly issue, incorrectly identifies a flow-chart containing a list of dates for proposing food labeling-related proposals and final rules as coming from Jessica Leighton, a FDA senior science advisor. The document was actually provided by the Center for Science in the Public Interest and drafted with the assistance and/or blessing of as many as 12 consumer and health-oriented trade groups as a recommended approach for the FDA to follow, clarifies Bruce Silverglade, CSPI’s director of legal affairs.

The one-page document was handed out during a session at the 33^rd National Food Policy Conference, an event jointly sponsored by the Consumer Federation of American and Grocery Manufacturers Association, in Washington, D.C.  Leighton, Silverglade and three others were presenters in the session. The one page sheet, entitled “Timetable for Food Labeling Reform and Need for Concurrent FDA/USDA Action,” does not identify a source.

Silverglade, who takes credit for having the document given to attendees at the meeting, says it originally was provided as part of a three-page letter sent to Martha Coven, special assistant to the President for the Domestic Policy Council, and Zeke Emanuel, senior advisor in the Office of Management and Budget (see FCN Aug. 9, Page 1). The American Cancer Society, American Medical Association, Consumers Union and American Heart Association were among the many groups to sign the letter.

The editorial staff of Food Chemical News apologizes for the error.

Jessica Leighton, the FDA senior science advisory whose speech was quoted in Food Chemical News (I wrote about this yesterday) writes to tell me that she has been badly misquoted about the FDA’s plans for food labels.

The reporter, she says, appears to have mixed up a variety of talks or questions from the audience to the panel.

I said nothing about caffeine or “natural.”  I don’t remember mentioning the percent of key ingredients in parentheses after the ingredient name either.    I also said we are looking into added sugars but did not say we are doing anything about them.

I am taking her word for it and have taken down the post.  Apologies to all.

A reader writes that the discussion over genetically modified foods makes no sense because: “virtually every food we consume today  has been genetically  modified.”

The accuracy of this statement depends, of course, on how you define “genetically modified.”  If you include traditional genetic crosses done through plant and animal breeding, the statement is correct.

If, however, you restrict the definition of GM foods to those involving actual manipulations of DNA (rather than eggs and sperm), and the insertion of DNA from one organism into the DNA of another, then the number of GM foods approved for production in the United States is quite limited.

The FDA provides a list of such foods in its inventory of completed consultations on bioengineered foods.

The list includes GM corn, soybeans, cotton, cotton, alfalfa, canola, and sugarbeets, most of which are fed to animals or used as ingredients in processed foods.

But what about supermarket fruits and vegetables?  To answer this question requires a clear separation between approval of production and actual production.

To date, the FDA has approved production of GM varieties of plums, cantaloupe, papaya, squash, radicchio, tomatoes, and potatoes.  Note: sweet corn–the kind you eat off the cob–is not on the list.

Even if approved, the GM varieties may not be in your supermarket.  GM varieties, it turns out, are difficult to produce under field conditions.

When I was doing the research for What to Eat in 2005 or so I tried hard to find out which supermarket foods might be GM.  This was not easy.  Basically, nobody knew.  Unless you test for GM, you can’t tell, and nobody was testing.

So I did some testing.  The foods most highly suspected of being GM were papayas from Hawaii engineered to resist ringspot virus.  I sent samples of seeds from several varieties of supermarket papayas to GeneticID, a company that does such testing (at, alas, great expense).   As I recount in the book, the only papaya that tested positive was the one from Hawaii.  The one labeled organic did not and neither did any of the others.

I believe that the public has a right to know whether supermarket foods are GM varieties.  Without labeling, you can’t tell.  That is why we need GM labeling.

As I explained a year ago, the U.K. requires labeling of GM ingredients and companies making products with GM ingredients do so.  We could do this too, and we should.

Addition: The Associated Press writes about the significance of these discussions (I’m quoted).

The FDA has just concluded two days of hearings on the safety and labeling of genetically modified (GM) salmon. I’ve been collecting comments about this and will add a few of my own.

USA Today: Let’s begin with Elizabeth Weise’s clear, insightful summary of what this is about. She summarizes the situation with GM salmon in a nifty Q and A format:

Q: What happens next?

A: Nothing soon. Before issuing a decision on the application, FDA will publish an Environmental Assessment of the salmon, followed by a required 30-day comment period. The agency would then determine whether it would file a Finding of No Significant Impact or an Environmental Impact Statemen….then use those findings to make a decision on whether or not to allow the sale of the salmon. The agency has said it has no set timeline for reaching a decision. Were the agency to decide to approve the sale of the salmon, it would take two years before the first crop was ready, company officials say.

Food Chemical News (September 20):  reports that AquaBounty’s CEO has no intention of restricting GM salmon farms to Panama. At the FDA hearing, he “forecast a spread of transgenic salmon operations from a proposed site in Panama to other countries, including the United States.”

Oops. The FDA had to remind him that his company’s application is for Panama only, and any other sites would require supplemental applications from the firm.”  The FDA said it was “not interested in AquaBounty’s future business plans.”

FoodNavigator.com reporter Caroline Scott-Thomas predicts that the hearings will lead to no recommendation.

The FDA’s Veterinary Medicine Advisory Committee (VMAC) did not vote or make a recommendation at the end of the hearings, saying that it does not yet have sufficient data…After two days of hearings, a Food and Drug Administration (FDA) advisory panel has called for more research to decide whether genetically engineered salmon is safe for consumption.

The New York Times says that the advisory group favored approval of the GM salmon, but that this could take ages.

Food Chemical News (September 21) says that most speakers at the hearing on GM labeling did not want it to be mandatory. It quotes Greg Jaffe, the director of biotechnology at Center for Science in the Public Interest (CSPI), as opposing mandatory labeling. Apparently, Jaffe:

urged AquaBounty to require its customers to provide “real” voluntary labeling on food products, such as “AquaBounty salmon,” “fast-growing salmon” or “environmentally friendly salmon”….He agreed that “no ingredients from a genetically engineered source” would be acceptable language provided there’s a comparable GE product in the marketplace.

Why would a representative of a consumer organization oppose mandatory labeling?  For that, go to

Jill Richardson’s lengthy analysis of FDA’s actions, written for Grist.  She lays out some of the more complicated issues, and takes a tough look at the biases of the committee members.

Washington Post: Lindsey Layton writes about the debates over labeling (I’m quoted).

A Washington Post poll found 78% of respondents to be worried about the health and safety risks of GM salmon.

Meanwhile, in the UK, the new government has stopped a scheduled public dialogue about GM foods.  That’s one way to handle it. All those pesky consumers don’t want it? Too bad for them.

My interpretation: of course the public does not trust genetically modified foods. The foods are not labeled. If the biotech industry and the FDA want the public to trust them, they need to label the GM salmon and all the other GM foods in the marketplace.

The public wants the right to choose.  The public should have the right to choose.

The issue of GM foods cannot just be about safety.

My mantra on this one: Even if genetically modified foods are safe, they are not necessarily acceptable.

I was a member of the FDA’s Food Advisory Committee in 1993 when, under pressure from Monsanto, the agency rejected labeling of GM foods.  I wish the FDA had listened to me and the other consumer representatives on the committee, all of us convinced that labeling is essential for promoting trust, and giving the public a choice. And, we said, it’s the right thing to do.

The FDA now has a chance to redeem it’s bad decision.  I hope they take this opportunity and decide to require labeling.

Footnote: I wrote about all this in my book, Safe Food: The Politics of Food Safety, just published in a new edition in July.  In preparing the second edition seven years later, I was surprised by how little about food biotechnology had changed.  The issues have not changed.  The field is stuck.   Labeling is one way to break the stalemate.  Let the public have a choice.  I’ll bet doing that will solve a lot of problems.