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Research on this virus (officially SARS CoV-2, commonly COVID-19) is pouring out and filling every medical journal I typically read.  Here are a few recent articles on food-related aspects (some of these are not yet in print).

Obesity and its Implications for COVID-19 Mortality: The authors argue that the increased prevalence of obesity in Italy older adults as compared to its prevalence in China may account for the higher mortality observed in Italy.

Obesity is associated with decreased expiratory reserve volume, functional capacity and respiratory system compliance. In patients with increased abdominal obesity, pulmonary function is further compromised in supine patients by decreased aphragmatic excursion, making ventilation more difficult. Furthermore, increased inflammatory cytokines associated with obesity may contribute to the increased morbidity associated with obesity in COVID-19 infections.

Sudden and Complete Olfactory Loss Function as a Possible Symptom of COVID-19: This is a case study of a patient infected by SARS-CoV-2 whose presenting symptom was the sudden and complete loss of the ability to smell.

Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection:  “Our study suggests that loss of taste and smell is a strong predictor of having been infected by the COVID-19 virus. Also, the combination of symptoms that could be used to identify and isolate individuals includes anosmia, fever, persistent cough, diarrhoea, fatigue, abdominal pain and loss of appetite.”

COVID‐19 Related School Closings and Risk of Weight Gain Among Children:  “In short, we anticipate that the COVID‐19 pandemic will likely double out‐of‐school time this year for many children in the U.S. and will exacerbate the risk factors for weight gain associated with summer recess.”

Should COVID-19 Concern Nephrologists?  Why and to What Extent? The Emerging Impasse of Angiotensin Blockade:  This is the easiest-to-understand review of the science of this extensively studied virus I have been able to find.  It covers the basics along with detailed explanations of what this virus does, how it works, and where vaccines might operate.    To penetrate human cells, this virus seems to hijack a particular enzyme in the complicated renin-angiotensin system that regulates body fluid balance and blood pressure.

Despite these differences, several studies have reported that SARS-CoV-2 exploits the same membrane-bound angiotensin-converting enzyme 2 (ACE2) as SARS-CoV to gain access to its target cells, although it has greater binding affinity. ACE2 is a carboxypeptidase that preferentially removes carboxy-terminal hydrophobic or basic amino acids. ACE2 cleaves a single residue from angiotensin I (Ang I), generating Ang 1–9, and a single residue from angiotensin II (Ang II) to generate Ang 1–7, whose vasodilator, anti-proliferative, and anti-fibrotic functional effects oppose those of the Ang II generated by angiotensin converting enzyme (ACE).

It’s pretty exciting when a major international science journal starts a satellite journal devoted to food issues.  Welcome to Nature Food.

The press release from the Annals of Internal Medicine arrived last week under embargo, sent to me by several reporters: “New guidelines: No need to reduce red or processed meat consumption for good health.”

The press announcement was accompanied by 5 review papers, a sixth with this recommendation, and an editorial.  These are posted on the website of their publisher, the American College of Physicians, implying this organization’s endorsement of this guideline.

Collectively, these papers challenge dietary advice to eat less processed meat and red meat on the grounds of inadequate science.

These papers argue:

• Eliminating processed and red meat from the diet may reduce disease risks but the effects are small and evidence for them is of low quality and low certainty.
• Omnivores are unwilling to eat less meat.
• If you continue to think eating meat is bad for you in the face of this evidence, you are a victim of the “the less you know, the more you hold to your beliefs” syndrome.
• You can ignore dietary guidelines (regardless of source) and continuing eating meat as you always have.

This is a good example of what I call nutritional nihilism, an approach that insists that because observational studies are based on self-reported information and necessarily flawed, their conclusions are unscientific and should be discounted.  Therefore, because we can’t do more rigorous studies, we should not advise the public about diets best for health or the environment.

I have several concerns about all this:

• Yes, the effects are small but that is true of nutrition studies in general.  The small effects show benefits from eating less meat.  The authors could easily have interpreted their work as suggesting that eating less meat might be useful.  This is an example of interpretation bias.
• The authors took a strictly science-based approach to a problem strongly affected by social, economic, and political factors and values.
• The studies look at previous studies that compared people who eat meat to those who eat less. The authors excluded studies of vegetarians compared to meat-eaters.
• They look at meat outside its context of calories.
• The authors did not look at the totality of the evidence; they excluded laboratory and animal studies that can be more closely controlled.
• They excluded studies of environmental impact, which has a significant bearing on human dietary practices (meat production adds more greenhouse gases than vegetable production).
• The conclusions fall into the category of “everything you thought you knew about nutrition is wrong.”  This rarely happens.  Science usually works incrementally, not in one enormous reversal like this.

Do the authors really believe that all those other committees and commissions urging less meat were wrong and continue to be wrong?   Their strictly science-based approach seems unrealistic.

The papers come across to me as a concerted attack on dietary guidelines (national and international), on nutrition science in general, and on nutritional epidemiology in particular.

The meat industry and its supporters will love them.

Attacks on the quality of nutrition research have been coming from many sources lately: the food industry, of course, but also statisticians (John Ioannidis at Stanford is making a career of this), and some scientists (usually with ties to food companies).  The criticisms themselves are not new.

What is new is the vehemence and level of effort to discredit observational studies, particularly those based on self-reports of dietary intake.  Yes, nutritional epidemiology has flaws, but the methods have been useful in many instances, as argued convincingly by two of its leading practitioners.

In looking at nutrition research, I think it is essential to evaluate the totality of information available: laboratory, animal, human epidemiology and clinical studies—and to do this in the context of what people actually eat and the number of calories they consume, as well as adding in a hefty dose of common sense.

Common sense is what’s missing in these studies.  Do the authors really believe that:

• Meat eaters are healthier than vegetarians?
• Eating more meat is better for health?
• Meat eaters are less obese and have less heart disease and cancer than those who eat less?

If not, the conclusions make no sense.

Most of the authors report no financial ties to the food industry.  I would love to know the back story about why they chose to do these studies and to interpret them in this way.

Reactions (I will be adding to this list as they come in)

• The Harvard School of Public Health Nutrition Department issued a statement
• The True Health Initiative (THI) issued a press release outlining its concerns (the link is here)
• THI council members sent a letter to the journal editor stating objections (the link)
• THI collected quotes from members of its council and others (including mine)
• THI also produced graphics.  Here is one example.

• David Katz weighs in
• New York Times: 5 things you should know
• New York Times coverage: “Eat less meat, scientists said.  Now some believe that was bad advice.”
• From Dean Ornish
• Consumer Reports (I’m quoted)
• From the World Cancer Research Fund
• Vox’s crystal clear explanation
• NPR’s The Salt’s excellent analysis
• Aaron Carroll’s follow-up to his editorial

The Trump administration released more details on its proposed budget, in language straight out of George Orwell’s 1984.

Framed as “savings and reform,” the proposal is to move the USDA’s Economic Research Service out of Washington DC.   Although this proposal says the purpose is to bring the ERS closer to rural America, its real purpose is to put the ERS out of business.

Why do I say this?  Because this proposal comes with a $26 million budget cut.   I also hear rumors that ERS research staff are being offered retirement options.

ERS is the jewel in USDA’s crown, nothing less than a national treasure, not only worth preserving but worth extolling for its truly important contributions to society.

I’ve long said that ERS was the best kept secret in government.  Its researchers worked tirelessly to provide real data on America’s food production and what it means for health.

Here, for example, is its latest report on how the U.S. food dollar is spent.

The best thing I can say about this budget is that it is unlikely to pass.  Members of Congress have been trying to put a stop to this move.  Let’s hope they succeed.

This may be a small piece of what’s happening, but in my field it is essential.

Please tell your congressional representatives to restore ERS’s budget and keep it in Washington, DC.

How?

• Representatives
• Senators

Addition

The Office of Management and Budget’s analysis

The USDA reports that investment in agricultural research is declining (since 2009) in high-income countries, particularly in the U.S.

The U.S. share of total agricultural investment in research was 35% in 1960; it fell to 25% in 2013.

What with global problems of hunger, chronic disease, and climate change, shouldn’t we be doing more agricultural research, not less?

The documents

• Agricultural Research Investment and Policy Reform in High-Income Countries
• Summary report
• Amber Waves article, Agricultural Research in High-Income Countries Faces New Challenges as Public Funding Stalls.
• Webinar, Tuesday, June 5, at 1 p.m. EDT.  Registration webinar page.

Healthy Food America is a relatively new organization.  Based in Seattle, it

Acts on science to drive change in policy and industry practice so that all people can live in places where nutritious food is easy to obtain and exposure to unhealthy products is limited..  We are coordinating with other advocates to energize a national movement to roll back added sugars in food and beverages to healthful levels.​

It runs a blog, publishes a newsletter, and produces useful information.  I was particularly interested in its information on diet drinks.

It’s Policy Brief discusses whether or not artificially sweetened beverages should be included in soda tax initiatives.

Sugary drink taxes were conceived of as a strategy to prevent chronic health conditions by reducing consumption of sugar. Recently, however, some jurisdictions have included artificially sweetened, or “diet”, beverages. There is strong scientific evidence associating sugary drinks with higher rates of chronic diseases such as type 2 diabetes, heart disease, high blood pressure, liver disease and dental disease. The evidence of harm from diet drinks is less certain.  Therefore, we recommend not including diet drinks in beverage taxes.

Its Research Brief summarizes the evidence linking artificially sweetened beverages to disease risk.

This research brief summarizes:

1) reviews or meta-analyses of prospective cohort studies that analyzed the association between ASB consumption and disease risk,

2) randomized trials that studied the metabolic and health effects of ASB consumption, and

3) randomized trials that studied the effect of ASB consumption on weight loss.

Reviews and meta-analyses were restricted to those published in the last 5 years, to ensure that this brief reflected the latest science. All studies were obtained through PubMed searches.

It helps to have all this.

The Association of Public Land-Grant Universities has just released a report titled “Challenge of Change” about how the USDA can do a better job of funding research to solve important problems in food and agriculture.

The challenge:

 

Traditionally, the effort to achieve food security has been largely focused on the need to increase yields in order to produce more food. There is now broad recognition that production alone will not solve the grand challenge. All aspects of our food systems must be considered: nutrition, food safety, food loss, economic costs, individual behaviors, incentive structures, and societal factors affect not only production, but also access and utilization. There is also now an understanding that production increases must be achieved in the context of water availability, energy limitations, and environmental impact.

The report concludes that universities will need to change, so as to:

• Elevate Food and Nutrition Security to a Top Priority
• Align University Resources and Structures for Transdisciplinary Approaches
• Enhance and Build University-Community Partnerships
• Educate a New Generation of Students to be Transdisciplinary Problem Solvers

To achieve food security, food and agriculture will need to change to:

• Broaden the Focus Beyond Yields
• Change the Food System’s Incentive Structure
• Develop the Capacity of Universities in Low-Income Countries
• Leverage Technology, Big Data, and Information Science Information

This is an important report because it comes from land-grant universities .  These are currently responsible for supporting industrial agricultural systems and virtually ignoring—or firmly opposing—sustainable agricultural production methods.

A challenge for change indeed.  I hope land-grant universities listen hard.

I’ve just started getting a new Science and Research newsletter from William Reed: Informing Business Growth.

Some of the listings focus on dietary patterns or emerging microbiome research:

But most of them focus on single nutrients, ingredients, or foods—suggesting that they are about marketing those ingredients, not necessary health (people don’t eat single foods exclusively; we eat meals and mixtures).

These are a lot of fun.  They raise the possibility of magic bullets (if only).

But watch out for the weasel words “may,” “could,” “might”.  These mean “may or may not,” “could or could not,” “might or might not.”

• Long-term multivitamin use linked to fewer heart problems: Harvard study: A daily multivitamin may protect men from cardiovascular events such as heart attack and stroke in the long-term, says a new study… Read
• Eating black raspberries may decrease heart disease risk: Study: An extract found in black raspberries can significantly lower arterial stiffness, a key measure of cardiovascular disease, according to data from a Korean study… Read
• New forum showcases the benefits of pulses: A networking forum to help manufacturers understand the nutritional value of pulses has been created by McGill University in Montreal, Canada… Read
• Fish oil, cocoa & plant sterols: The winning combination against heart disease?: Combining fish oil, cocoa extract and plant sterols food supplements could offer an effective defence against heart disease, a new study suggests.  .. Read
• Plant-derived bacteria shows anti-obesity effects: RCT: Heat-killed Pediococcus pentosaceus LP28 derived from the longan fruit may help trim waist lines and reduce body fat, say results from a double-blind, randomized, placebo-controlled study… Read
• Olive-sourced hydroxytyrosol effective in biscuits: Study: Olive oil phenol hydroxytyrosol has been shown to be highly bioavailable and to lower oxidised LDL (low density lipoprotein) levels when incorporated into biscuits, suggesting functional food applications could be on the horizon for this EFSA-backed polyphenol. .. Read
• Study shows Calanus oil may benefit blood pressure and heart health: Supplements containing Calanus oil may support cardiovascular health via anti-inflammatory effects in blood vessel walls, says a new study… Read
• Review supports immune health potential of larch arabinogalactan: Supplements of Larch arabinogalactan may support immune health and help reduce the incidence of common cold infections, says a new review… Read
• Insights into banana carotenoids could hold key to fighting blindness: Insights into how bananas make and store carotenoids could help in the future development of banana varieties to combat vitamin A deficiency and blindness, say researchers… Read
• Niagen to be researched for neuroprotective effect among football players: Thorne Research and ChromaDex Corp. are partnering with the Mayo Clinic and the University of Minnesota on a study to assess the effect of nicotinamide riboside (NR) on the brains of football players… Read
• Dark chocolate rivals beetroot juice in boosting athletic performance, study shows: Dark chocolate provides similar benefits to beetroot juice consumed already by elite athletes to improve exercise endurance, a study revealing similar levels of flavanol content has suggested… Read

Wouldn’t you rather eat chocolate than beets?  That’s what such studies are about.  And I wonder how many of them are funded by the makers of the products.  Want to take a look?