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I listened in on the conference call at which the Grocery Manufacturers of America and the Food Marketing Institute announced their new Nutrition Keys design for front-of-package labels.

My favorite comment: We are all “singing kumbaya” here.  Nutrition Keys, they said, was the result of a” monumental, historic effort” in which food companies “stepped up to the plate in a big way,” “with 100% support.”

Why did they go to all this trouble?  Because “A healthy consumer makes for a happy consumer.”

Kumbaya, indeed.

The real reason, as I explained yesterday, is to preempt the FDA’s front-of-package food labeling initiatives which might make food companies reveal more about the “negatives” in processed foods.

Here’s what GMA and FMI say the new label will look like:

Four of these things are required: Calories, Saturated fat, Sodium, and Total (not added) sugars.  Packages can also display up to two “nutrients to encourage” picked from this collection:  protein; fiber; vitamins A, C, and D; and potassium, iron, and calcium.

Let’s give these food trade associations credit for listing sugars instead of the Institute of Medicine’s recommendation for trans fat.  Trans fats are already gone from most processed foods.  Everyone cares about sugars.  But these are total sugars, not added sugars, which is what really matters.

And protein?  Since when does protein need to be encouraged in American diets?  We already eat twice the protein we need.  The rationale?  Vegetarians.   I repeat.  Since when don’t vegetarians get enough protein?  Never mind, protein makes the products look better.

Nutrition Keys merely repeats what’s on the Nutrition Facts labels, only worse.  It makes the percent Daily Values practically invisible.  Which is better?  High or low milligrams or grams.  You have to know this, and Nutrition Keys doesn’t help with that problem.

Nutrition Keys, says the industry, is about “more clarity in labeling.”  Really?  Here’s what it will look like on a food package.

I’ve been collecting reactions.

Although GMA and FMI insist they they are doing this in response to the First Lady’s Let’s Move campaign, the White House issued this statement:

The White House, including the First Lady, recognizes these companies for the leadership they have shown in advancing this initiative. We regard their commitment to dedicate space, for the first time, to an industry-wide front-of-pack label as a significant first step and look forward to future improvement. The FDA plans to monitor this initiative closely and will work with experts in the field to evaluate whether the new label is meeting the needs of American consumers and pursue improvements as needed. We will continue to work on seeking solutions for the problem of childhood obesity in America.

Congresswoman Rosa DeLauro was more forthcoming:

The industry’s unveiling today of its front-of-package labeling system is troubling and confirms that this effort should not circumvent or influence FDA’s effort to develop strong guidelines for FOP labels.

Given that negative and positive nutrients will not be differentiated on the package, there is significant risk that these labels will be ignored.  An adequate labeling system must clearly alert consumers about potentially unhealthy foods, and should not mislead them into believing that some foods are healthy when they clearly are not.

Reporters asked tough questions on the conference call about preemption of FDA efforts to do front-of-package labeling in a rational way (see my post from yesterday).  Perhaps space limitations made full accounts impossible:

• USA Today story (I’m quoted)
• Washington Post
• New York Times

The Grocery Manufacturers Association (GMA) and the Food Marketing Institute (FMI) are announcing their “Nutrition Keys” plan for front-of-pack (FOP) nutrition labels.  Their member companies have agreed to display calories and percent of saturated fat, trans fat, and sodium, per serving, on the front of product packages.

So far, so good.

But they also will be displaying up to eight “positives,” nutrients that are supposed to be good for you.  They say they will be using some kind of design similar to what some companies are using now, only with “positives” added.

Note: this illustration comes from Mars (the company, not the planet).  It is not what GMA and FMI will necessarily use.

Let me repeat what I wrote last October when GMA and FMI first said they intended to do this:

Forget the consumer-friendly rhetoric.

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

In October, the Institute of Medicine (IOM) released the first of its FDA-sponsored reports on FOP labels.  Based on research on consumer understanding of food labels and other considerations, the IOM committee strongly recommended that FOP symbols only list calories, sodium, trans fat, and saturated fat.

This led William Neuman of the New York Times to summarize the IOM 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 have to do negatives, they prefer “no trans fat” or “no cholesterol.”

What they especially do not want is for the FDA to impose “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 the FDA.

At the moment, the FDA is waiting for the IOM’s second report.  This one, due in a few months, will advise the FDA about what to do about FOP labels—again based on research.  Couldn’t GMA and FMI wait?

From what I’ve been hearing, GMA and FMI could not care less about the IOM or FDA.  This is what they had to do to get member companies to agree.  They say the new labels will go on about 70% of branded products by next year.  They also say they will spend $50 million on public education.

How this will play out in practice remains to be seen.  You can bet that plenty of highly processed foods will qualify for “positives,” just like they did with the industry-initiated Smart Choices logo, may it rest in peace.

As I said in October: 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 flunks the laugh test and arouses the interest of city and state attorneys general—just as the Smart Choices program did.

The official announcement is coming this afternoon.  Stay tuned.

Addition: Scott Obenshaw, Director of Communications for GMA files the following clarification:

1.)     In addition to the information regarding calories, saturated fat, sodium and total sugars content, the Nutrition Keys icon on some products will display information about two “nutrients to encourage.”  The two nutrients to encourage that may appear on some products as part of the Nutrition Keys icon must come from the following list: potassium, fiber, vitamin A, vitamin C, vitamin D, calcium, iron and also protein.  These “nutrients to encourage” can only be placed on a package if the product has more than 10% of the daily value per serving of the nutrient and meets the FDA requirements for a “good source” nutrient content claim.

2.)     Transfat is not part of the label – only calories, saturated fat, sodium and total sugars content.

Let’s give GMA and FMI lots of credit for replacing the IOM’s recommendation for trans fat with sugars.  Trans fats are heading out of the food supply and consumers want to know about sugars.  So that’s an improvement.  And two positives might not overwhelm the so-called negatives.  But I’m eager to see what the design really looks like and will report as soon as it is released.

The Oakland-based Prevention Institute has just released its new research report: Claiming Health: Front-of-Package Labeling of Children’s Food.  The report summarizes the Institute’s investigation of whether kids’ foods with “better-for-you” front-of-package labels meet dietary recommendations and nutrition standards.

Bottom line: they don’t.

Researchers bought 58 kids’ food products made by companies who have promised to meet certain nutritional criteria.  All had front-of-package labels that indicate healthier options.

The researchers measured the contents of these foods against a fairly standard—and quite generous—set of nutrient criteria.

The criteria allow products to have up to 25% of the calories from added sugars, up to 480 mg of sodium, and as little as 1.25 grams of fiber per serving.

Even so, the data show that:

• 84% of the study products could not meet one or more of the nutrient criteria
• 57% of the study products were high in sugar
• 53% of the study products were low in fiber
• 93% of cereals were high in sugar and 60% were low in fiber
• 36% of prepared foods and meals were high in sodium, 24% were high in saturated fat, and 28% were low in fiber
• 90% of snack foods were high in sugar, and 90% were low in fiber

Nutrient criteria make it easy to game the system, and front-of-package labels do exactly that.

The Institute of Medicine (IOM) will soon release its second report on front-of-package labels, this one recommending what the FDA should do about them.  Let’s hope the IOM committee pays close attention to this report.

Claiming Health makes it clear that without rigorous nutrient standards, plenty of not-so-good-for-you foods will be labeled as better for children.

As I keep saying, alas, front-of-package labels, like health claims, are about marketing, not health.

The USDA announced today that it is starting the interminable rulemaking process for new nutrition standards for school breakfasts and lunches.

The new standards are designed to add more fruits, vegetables, whole grains, fat-free and low-fat milk to school meals.

These are food-based standards.  The lengthy Federal Register notice specifies the number and size of servings of fruits, vegetables, meat, dairy, and grains (table 3, page 2516).  This is a huge step forward and USDA deserves lots of support for doing this.

I am somewhat less enthusiastic about some of the other provisions, but perhaps they are the price to pay for progress:

Nutrient-based standards? The standards also are designed to limit levels of saturated fat, sodium, calories, and trans fats.  They specify a range of calories as well as maximum values for saturated fat and sodium (trans fats have to be zero).

Alas, the devil is in the details.

Nutrient-based standards force some questionable choices on menu planners.  This is evident from the menus comparing the old and new standards.  The old menus included “kids food”—food-like objects such as pizza sticks and breaded beef patties.

Happily, the new menus drop those and call for real foods.  Some of them—jicama, kiwi, and grape tomatoes, for example—are likely to seem exotic to kids accustomed to chicken fingers.  So far, so good.

But the foods are accompanied by strangely tasting miracles of food technology such as reduced-fat mayonnaise, low-fat salad dressings, and soft margarines.  Why?  To meet nutrient standards.

What about sugars? The standards don’t mention sugars except to say that if the others are followed, there isn’t much room allowed for sugary foods.  Canned fruits are to be low in sugar.  Use of highly fortified sugary foods is discouraged.

Chocolate and other flavored milk? The new standards allow skim “flavored” milk (translation: sugar-sweetened).  Otherwise, says USDA, kids might not drink milk and will not get enough calcium.  Sigh.  Milk, as I keep saying, is not an essential nutrient.  Chocolate or strawberry milk is a dessert.  Chalk this one up to dairy lobbying.

The USDA based the new standards on the report released in October 2009 by the Institute of Medicine (IOM): School Meals: Building Blocks for Healthy Children. It looks to me as though the USDA actually followed the IOM recommendations, a miracle in itself.

If you want to comment on the new standards, you can do so until April 13 at  http://www.regulations.gov. Enjoy!

In a report likely to send shock waves through the dietary supplement industry, the Institute of Medicine (IOM) released new Dietary Reference Intakes for vitamin D and calcium.   The report summary says Americans are getting all the vitamin D and calcium we need, and we do not need more.

The committee emphasizes that, with a few exceptions, all North Americans are receiving enough calcium and vitamin D. Higher levels have not been shown to confer greater benefits, and in fact, they have been linked to other health problems, challenging the concept that “more is better.

In an account of the report in today’s New York Times, Gina Kolata writes that the committee was puzzled about how vitamin D became the hot nutrient of the year.  Sales rose 82% from 2008 to 2009.

Some of this surely had to do with testing.  A method for testing existed, so doctors used it.  The test, however, looked at an intermediate in vitamin D synthesis—not at the vitamin itself.  And the test did not have a standard until recently.

And groups like the Vitamin D Council promote much higher intakes of vitamin D supplements.  According to the Council:

Current research has implicated vitamin D deficiency as a major factor in the pathology of at least 17 varieties of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, periodontal disease, and more.

In my San Francisco Chronicle column on this topic a year or so ago, I pointed out that “vitamin” D is not really a vitamin.  It is a hormone. This means that vitamin D supplements are a form of hormone replacement therapy—not necessarily a good idea.

Are vitamin D supplements needed?  Not if you expose your skin to sunlight for a few minutes a day, even in winter.

In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes “The big issue is ultra-processing.”  Because his Commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.

The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.

Monteiro makes it clear that all foods and drinks are processed to some extent.  Fresh apples are washed and, sometimes, waxed.  Drinking water is filtered.  Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:

• Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
• Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt.  These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
• Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).

The purpose of Type 3 ultra-processing is to create:

durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration (‘long shelf life’), to be transportable for long distances, to be extremely palatable (‘high organoleptic quality’) and often to be habit-forming. Typically they are designed to be consumed anywhere – in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.

Monteiro argues: “the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world.”

As evidence, he notes that ultra-processed products as a group are:

• Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
• [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
• Relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy.
• Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
• Available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
• The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.
• Promoted by lightly regulated or practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being of children.

Overall, he says:

Their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.

His groups the main points of his argument in three theses:

• Diets mainly made up from combinations of processed ingredients and unprocessed and minimally processed foods, are superior to diets including substantial amounts of ultra-processed products.
• Almost all types of ultra-processed product, including those advertised as ‘light’, ‘premium’, supplemented, ‘fortified’, or healthy in other ways, are intrinsically unhealthy.
• Significant improvement and maintenance of public health always requires the use of law. The swamping of food systems by ultra-processed products can be controlled and prevented only by statutory regulation.

Lest there be any confusion about the significance of this proposal for public health nutrition, an accompanying editorial (unsigned but assumed to be by Geoffrey Cannon) poses a serious challenge: “Nutrition science: time to start again.”

This editorial is about the significance of food processing, and in particular of ‘ultra-processed’ food and drink products. It is also about the nature, purpose, scope and value of nutrition science, which as conventionally taught and practiced, is now widely perceived to have run into the buffers or, to change metaphor, to have painted itself into a corner.

The editorial argues that nutritionists’ focus on nutrients, rather than foods, has led to the assumption that if foods contain the same nutrients, they are the same—even though it is never possible to replicate the nutritional content of foods because too much about their chemical composition is still unknown.

This notion is an exquisite combination of stupidity and arrogance, or else of intelligence and cunning. For a start, similar results can only be of those chemical constituents that are at the time known, and actually measured.

These are important ideas, well worth consideration and debate.  I am struck by their relevance to the latest survey of soft drink availability in American elementary schools.  Despite the efforts of the Clinton Foundation and the voluntary actions of Coca-Cola and Pepsi-Cola, the availability of soft drinks to young school children increased from 49.% to 61% just in the year from 2006-07 to 2008-09.  Soft drinks, in Monteiro’s terms, are ultra-processed.  Doing something about them requires statutory regulation.

Consideration of the effects of ultra-processing might help us look at what we feed our kids in a more constructive way.  This is important work.

Addition: I should have mentioned that Monteiro’s approach is consistent with that of the people (including me) who worked with the Strategic Alliance in Oakland, CA to write Setting the Record Straight: Nutritionists and Health Professionals ” Define Healthful Food.

The Alliance is California’s network of food and activity advocates, we’ve developed a definition of healthy food that asserts that truly healthful food comes from a food system where food is produced, processed, transported, and marketed in ways that are environmentally sound, sustainable, and just.

If you agree with Setting the Record Straight, you can endorse it on the Strategic Alliance’s website.

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!