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Yesterday, the House Appropriations Committee passed the 2017 Agriculture-FDA spending bill.

As Politico explains (behind a paywall, unfortunately)

The bill would boost funding for rural development to $2.9 billion and allocate an additional $33 million over fiscal 2016 levels for the FDA to carry out the requirements of the Food Safety Modernization Act.

This isn’t nearly enough to permit FDA to carry out its functions.

The committee also passed amendments to:

• Block the USDA from carrying out rules to protect chicken farmers with contracts with processing companies (they own the birds).
• Exempt e-cigarettes from FDA regulations that restrict e-cigarettes advertising.

Can someone please explain to me why agricultural appropriations committees have jurisdiction over FDA and FDA spending is linked to agriculture spending?  OK, this is an historical anomaly; the FDA used to be part of USDA, but that was nearly a century ago.

Today’s FDA is part of the public health service, along with the CDC.

Shouldn’t health committees decide how much funding should go to FDA’s mandate to protect public health?

Just asking.

I’ve just received a new report from USDA’s Economic Research Service, U.S. Food Commodity Consumption Broken Down by Demographics.  This looks at trends in per capita food availability—the amounts of specific foods available in the food supply, obtained from data on production and imports, from 1994 to 2008, corrected for waste, per person in the United States.

Food availability data, especially when corrected for waste, suggest trends in per capita consumption patterns (otherwise why would USDA bother to collect them?), but they are not consumption data.  They are about supply, not use.

With that said, the trends seem odd to me.  They demonstrate a decline in the availability of:

• Fruit (mainly oranges)
• Vegetables
• Dairy (mainly milk)
• Beef
• Pork
• Potatoes
• Sugars

The supply of yogurt and cheese, however, has increased (but their per capita availability is relatively low).

The supply of apple juice also has increased:

Food availability data corrected for waste are supposed to come close to what people actually eat.  But if people are eating less of practically all foods, how come so many of us are still gaining weight?  Surely it’s not because of apple juice.

These data are an important source of information on U.S. dietary patterns.

But what do they mean?  The authors do not say, so it’s left to us to figure that out.

As I keep saying, finding out what people eat is the single most intellectually challenging problem in the field of nutrition.

I’m indebted to Maria Godoy of NPR’s The Salt for pointing out where in the new 2015 Dietary Guidelines you can find advice about cutting down on sugary drinks.  As she puts it, this is easy to miss.

Here’s my wonky analysis.

In my post about the 2015 Dietary Guidelines, I noted that they are unambiguous about the need to reduce added sugars to 10% or less of calories.  But what they say about cutting down on sugary drinks—the leading source of sugars in US diets—is buried deep in the text.  Fortunately, Deborah Noble of slowfoodfast.com has performed a great public service by producing the 2015 Dietary Guidelines in a searchable pdf format.Here’s where to find advice about cutting down on sugary drinks:

The Executive Summary: See under “Cross-Cutting Topics of Public Health Importance:”

Similarly, added sugars should be reduced in the diet and not replaced with low-calorie sweeteners, but rather with healthy options, such as water in place of sugar-sweetened beverages.

Figure 2-10 explains:

The major source of added sugars in typical U.S. diets is beverages, which include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters.

Reading the Figure tells you that beverages comprise a whopping 47% of added sugars (closer to half if you add in sweetened milks, teas, and coffees).  The text following the Figure says:

Shift to reduce added sugars consumption to less than 10 percent of calories per day: Individuals have many potential options for reducing the intake of added sugars. Strategies include choosing beverages with no added sugars, such as water, in place of sugar-sweetened beverages, reducing portions of sugar-sweetened beverages, drinking these beverages less often, and selecting beverages low in added sugars.

Strategies?  How about just saying: “Cut down on sugary drinks” or “Drink water instead of sugary drinks.”

Figure ES-1 in the Executive Summary illustrates the 2015-2020 Dietary Guidelines for Americans at a Glance.  All it says is:

Limit calories from added sugars…Consume an eating pattern low in added sugars…Cut back on food and beverages higher in these components to amounts that fit within healthy eating patterns.

Figure 3.2 shows Implementation of the Guidelines through MyPlate: “Drink and eat less…added sugars,” but nothing about sugary drinks.

This circumspection is weird.  Clear, straightforward advice to cut down on sugary beverages has plenty of historical precedent.

Both Figures ES-1 and 3.2 are most certainly derived from a USDA graphic on the MyPlate website (dated January 2016).  This says flat out:

Drink water instead of sugary drinks.

This statement, in turn, derives from:

• The precepts issued with the 2010 Dietary Guidelines in January 2011
• The statements issued with the MyPlate graphic in June 2011

• The USDA’s May 2012 tip for making better beverage choices.

The 2015 DGAC (Dietary Guidelines Advisory Committee) repeatedly urged limits on consumption of sugar-sweetened beverages.  Statements like this one, for example, appear throughout the document:

To decrease dietary intake from added sugars, the U.S. population should reduce consumption of sugar-sweetened beverages.

Why did the USDA and HHS writing committee choose to waffle about his point?

This cannot be an accident.  It must be deliberate.  And it can have only one explanation: politics.

The bill just passed by the House contains this language:

SEC. 734. None of the funds made available by this or any other Act may be used to release or implement the final version of the eighth edition of the Dietary Guidelines for Americans, revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341), unless the Secretary of Agriculture and the Secretary of Health and Human Services ensure that each revision to any nutritional or dietary information or guideline contained in the 2010 edition of the Dietary Guidelines for Americans and each new nutritional or dietary information or guideline to be included in the eighth edition of the Dietary Guidelines for Americans.

(1) is based on significant scientific agreement; and

(2) is limited in scope to nutritional and dietary information.

SEC. 735.

(a) Not later than 30 days after the date of the enactment of this Act, the Secretary of Agriculture shall engage the National Academy of Medicine to conduct a comprehensive study of the entire process used to establish the Advisory Committee for the Dietary Guidelines for Americans and the subsequent development of the Dietary Guidelines for Americans, most recently revised pursuant to section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341). The panel of the National Academy of Medicine selected to conduct the study shall include a balanced representation of individuals with broad experiences and viewpoints regarding nutritional and dietary information.

(b) The study required by subsection (a) shall include the following:

(1) An analysis of each of the following:

(A) How the Dietary Guidelines for Americans can better prevent chronic disease, ensure nutritional sufficiency for all Americans, and accommodate a range of individual factors, including age, gender, and metabolic health.

(B) How the advisory committee selection process can be improved to provide more transparency, eliminate bias, and include committee members with a range of viewpoints.

(C) How the Nutrition Evidence Library is compiled and utilized, including whether Nutrition Evidence Library reviews and other systematic reviews and data analysis are conducted according to rigorous and objective scientific standards.

(D) How systematic reviews are conducted on longstanding Dietary Guidelines for Americans recommendations, including whether scientific studies are included from scientists with a range of viewpoints.

(2) Recommendations to improve the process used to establish the Dietary Guidelines for Americans and to ensure the Dietary Guidelines for Americans reflect balanced sound science.

(c) There is hereby appropriated $1,000,000 to conduct the study required by subsection (a).

Comment:  I continue to be astonished that the House of Representatives would take such an intense interest in the science of nutrition when it is so uninterested in the science of climate change.  And I am puzzled as to why the House thinks that nutrition scientists appointed by the Academy of Medicine (formerly Institute of Medicine) would have views any different from those of the current Dietary Guidelines Advisory Committee.

Will the USDA and HHS release the 2015 Dietary Guidelines before the Senate passes its version of the Appropriations bill?

I’m in Geneva this week and am hoping they wait until I get back.

School is starting and the school food debates will no doubt be starting up again.

The USDA has a new report on what’s happening with adoption of the new nutrition standards.

• A national study of elementary school principals and foodservice managers finds the majority (63%) to agree or strongly agree (7%) that students seem to like the new lunches.
• The participation rate for paid school lunches declined from FY 2008 through FY 2014, with steeper declines during FY 2012-2014.  This could be do to the changes in standards but is more likely the result of higher prices charged for meals.
• Smaller, more rural, and wealthier districts had the most difficulty adopting the new meal standards. Higher meal prices affected smaller and more rural districts.

The 2015 School Food Poll conducted by the Kellogg Foundation just reported:

• 90% of respondents support the national school nutrition standards.
• 86% say the school nutrition standards should stay the same or be strengthened.
• 91% say kids need access to safe drinking water in schools.
• 88% support increased government funding to expand farm to school programs.
• 84% believe sustainable agriculture should be part of the Dietary Guidelines for Americans.

The Kellogg Foundation provides

• An Infographic to go with the Poll
• A Toolkit for using the Poll

My interpretation: The nutrition standards are working well enough but it’s time to advocate even more strongly for universal school meals.  It’s absurd and unconscionable that poor kids are getting priced out of school meals.

Addition: The School Nutrition Association, the group doing everything it can to undermine the new nutrition standards, has just issued a report finding that the standards have caused severe financial harm to 70% of schools.  The reason?

There is strong consensus as to the leading reason for the decline in lunch ADP: decreased student acceptance of meals [.underlined in report].

The report does, however, provide a table of reasons for increased costs:

• Increased per meal food costs — 70.1%
• Decreased lunch participation — 56.8%
• Decreased a la carte revenue — 53.0%
• Increased labor/benefits costs — 48.5%
• Declining student enrollment — 20.6%

Given these results, you might think the SNA would be lobbying night and day for higher reimbursement rates, but no such luck.  The SNA is lobbying for weaker standards.  Pity.

Addition, August 25:  A study from the University of Vermont finds school kids to be consuming slightly fewer servings of fruits and vegetables since the nutrition standards were implemented and to be producing 56% more plate waste.  This is not good news.

Addition, August 28:  But a CDC study finds that in 2014, schools were making significant progress:

• Almost all schools offered whole grain foods each day for breakfast (97.2%) and lunch (94.4%)
• Most schools offered two or more vegetables (79.4%) and two or more fruits (78.0%) each day for lunch.
• Approximately one third (30.5%) of schools offered self-serve salad bars.
• Among the 55.0% of schools that prepared food at the school, about half were trying hard to reduce salt.
• Overall, 97.5% of schools used at least one of the nine school nutrition services practices examined, with 23.9% using one to three of the practices, 48.3% using four to six of the practices, and 25.3% using seven or more of the practices.

My interpretation: Schools are moving to adopt the new nutrition standards.  Some are succeeding better than others.  The outcome of studies therefore depends on whether you see the glass as half full, or empty.

The USDA is asking for input on its plan to test educational messages in the forthcoming 2015 Dietary Guidelines and related products.

It wants the tests to involve about 57,000 respondents in

qualitative and possibly quantitative consumer research techniques, which may include focus groups (with general consumers or with specific target groups such as low-income consumers, children, older Americans, educators, students, etc.), interviews (i.e., intercept, individual, diads, triads, usability testing, etc.), and web-based surveys.

The purpose of the testing is to identify consumers’ understanding of the guidelines’ education messages and to obtain reactions to “prototypes of nutrition education products, including Internet based tools.” As USDA puts it, this information “will be formative and will be used to improve the clarity, understandability, and acceptability of resources, messages and products.”

USDA says this information

will be used to further develop the Dietary Guidelines and related communications. These may include: (1) Messages and products that help general consumers make healthier food and physical activity choices; (2) Additions and enhancements to ChooseMyPlate.gov; and (3) Resources for special population groups that might be identified.

This is interesting.  I don’t remember USDA asking for consumer input on nutrition education materials since the 1992 pyramid.

Let’s encourage USDA to do this.

Send comments to Dietary Guidelines Communications, Center for Nutrition Policy and Promotion, U.S. Department of Agriculture, 3101 Park Center Drive, Room 1034, Alexandria, VA 22302. Comments may also be submitted via fax to the attention of Dietary Guidelines Communications at 703–305–3300 or through the Federal eRulemaking Portal at http://www.regulations.gov. Follow the online instructions for submitting comments electronically.

Yesterday’s Hagstrom Report quotes USDA Secretary Tom Vilsack’s comments to the Commodity Classic on the Scientific Report of the 2015 Dietary Guidelines Advisory Committee:

The “folks who put those reports together … have freedom. They are like my 3-year-old granddaughter. She does not have to color inside the lines.”

His 5-year-old grandson, he said, “is learning about coloring within the lines.”

“I am going to color inside the lines,” Vilsack said.

Sounds like the USDA has no intention of doing what the DGAC recommends.

This is why it’s so important to file comments @ www.DietaryGuidelines.gov by April 8.  You can also register there for the public meeting in Bethesda, Maryland, on March 24.

Addition, March 10: Secretary Vilsack’s speech and press conference remarks are here.

Joel Leftwich has left his job as senior director for PepsiCo’s public policy and government affairs team (since March 2013) to become staff director for the Senate Agriculture Committee now led by Pat Roberts (R-Kansas).

In some ways, it’s a perfectly logical appointment.  Before joining PepsiCo, Leftwich worked for Roberts as a legislative aide from 2005 to 2010 and as deputy staff director for the Ag Committee from 2011 to 2013.

But his connection to PepsiCo raises concerns.  The Ag committee will be dealing with several issues involving sodas and snack foods opposed by some members of Congress:

• Reauthorization of WIC, the Women, Infants and Children nutrition program (its requirements for healthy foods are always under pressure).
• Preservation of the school nutrition standards authorized by the Healthy, Hunger-Free Kids Act (under attack by the food industry and its friends in Congress).
• SNAP nutrition standards (there is a movement to make sodas ineligible for SNAP-EBT purchases).
• Issuance of the 2015 dietary guidelines, always under pressure not to say anything direct about not drinking sodas.
• Issuance of the new food labels.  The soda industry opposes putting in “added sugars.”   While this is FDA’s purview, not USDA’s, the Ag Appropriations Committee governs FDA’s appropriations.

And on the state level, it’s worth taking a look at what the Texas Commissioner of Agriculture is up to, courtesy of Bettina Siegel’s The Lunch Tray: “cupcake amnesty.”

Clearly, agricultural policies affect public health in highly prominent ways.

That’s why we need to do a much better job of connecting food policy to health policy.

And that’s why having a leading PepsiCo lobbyist in charge of agricultural committee staff raises serious concerns about conflict of interest.