Added sugar labelling!

That exclamation point is not an accident. I’m looking forward to this. From the FDA:

Today, the FDA has finalized the new Nutrition Facts label on packaged foods with changes that will make it easier for consumers to make informed choices about what they’re eating.

Some groups aren’t too happy with the change:

The Sugar Association is disappointed by the Food and Drug Administration’s (FDA) ruling to require an “added sugars” declaration and daily reference value (DRV) on the Nutrition Facts Label (NFL). The extraordinary contradictions and irregularities, as well as the lack of scientific justification in this rulemaking process are unprecedented for the FDA.

But the FDA says:

And you can have confidence in the science on which it is based, including evidence used to support the Dietary Guidelines for Americans, nutrition intake recommendations from the Institute of Medicine, and nutrition intake information from the National Health and Nutrition Examination Survey (NHANES).

Whose interpretation of science is correct? Well, the Sugar Association is likely a little biased.

Cow milk allergy and calcium in children

Kathryn Doyle at the Globe and Mail – Kids allergic to cow’s milk may have low bone density: study:

Kids with cow’s milk allergy had lower bone mineral density than others, and 6 per cent had low bone mass, while none of the kids in the comparison group had low bone mass, according to the results in Pediatrics.

“The important message is that these children should be followed preventively to be sure that they take sufficient calcium and vitamin D to have strong bones and avoid bone problems,” Des Roches said. “Otherwise, these kids are in very good health.”

Less than half of kids with cow’s milk allergy were taking calcium and vitamin D supplements.

As a parent of a child with many allergies, it’s been difficult to find a good replacement for the milk/dairy that is recommended in all food guides. We eat plenty of vegetables, but perhaps we also need to find a supplement.

The EWG’s dirty dozen

I’m not sure what to make of the dirty dozen list of fruits and vegetables tested to have the highest level of pesticides, as reported by the Environmental Working Group. Certainly there needs to be constant monitoring of the industry and the products to ensure their safety. But I’m a bit skeptical of their presentation.

From the EWG FAQ:

Shouldn’t I try to buy everything organic?

EWG recommends buying organic whenever possible. Not only is it smart to reduce your exposure to pesticides, but buying organic sends a message that you support environmentally-friendly farming practices that minimize soil erosion, safeguard workers and protect water quality and wildlife.

However, we know that organics are not accessible or affordable for everyone, so we created the EWG’s Shopper’s Guide to Pesticides in Produce™ to help consumers make the healthiest choices given their circumstances.

EWG always recommends eating fruits and vegetables, even conventionally grown, over processed foods and other less healthy alternatives.

Don’t organic food producers use pesticides as well? Do they use less pesticides than conventional food producers?

More:

Do we know enough about the effects of pesticide on people?

No. Americans are likely polluted with far more pesticides than current studies report. Agribusiness and pesticide companies are not required to determine whether their chemicals are present in people, not even for compounds that widely contaminate the food supply. The U.S. Centers for Disease Control and Prevention’s national biomonitoring program has likely only scratched the surface in its efforts to determine the human body burden of pesticides.

“likely”. Yes, it’s worth being skeptical about the use of pesticides. But the EWG report does not give any information about the tested levels found in produce, nor how it compares to the limits for human consumption.

The US EPA provides some information on the human health risk assessment they perform on pesticides.

 

Fat vs sugar

Ian Leslie at the guardian – The sugar conspiracy:

The UN’s Food and Agriculture Organisation, in a 2008 analysis of all studies of the low-fat diet, found “no probable or convincing evidence” that a high level of dietary fat causes heart disease or cancer. Another landmark review, published in 2010, in the American Society for Nutrition, and authored by, among others, Ronald Krauss, a highly respected researcher and physician at the University of California, stated “there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD [coronary heart disease and cardiovascular disease]”.

Many nutritionists refused to accept these conclusions. The journal that published Krauss’s review, wary of outrage among its readers, prefaced it with a rebuttal by a former right-hand man of Ancel Keys, which implied that since Krauss’s findings contradicted every national and international dietary recommendation, they must be flawed. The circular logic is symptomatic of a field with an unusually high propensity for ignoring evidence that does not fit its conventional wisdom.

Exercise times on food labels?

Shirley Cramer, chief executive of the Royal Society for Public Health – Food should be labelled with the exercise needed to expend its calories:

The Royal Society for Public Health has called for the introduction of “activity equivalent” calorie labelling, with symbols showing how many minutes of several different physical activities are equivalent in the calories expended to those in the product. The aim is to prompt people to be more mindful of the energy they consume and how these calories relate to activities in their everyday lives, to encourage them to be more physically active.

As reported by the CBC, not everyone is a fan of this approach:

Not everybody is sold on the idea. Dr. Yoni Freedhoff is the medical director of the Bariatric Medical Institute in Ottawa.

“People believe that exercise is the ticket to the weight loss express,” he said.

But, in fact, exercise doesn’t burn that many calories.

I believe Dr. Freedhoff is correct. Labelling foods with exercise equivalents is not the right message, and mixes up the idea of weight loss with exercise, when they are not well linked at all.

From what I’ve been reading, exercise is key for reducing your risk of dying early due to cadriovascular disease. With better fitness you also reduce your risk of physical injuries. However, the amount of exercise you do is not well correlated to your weight. Meaning that you cannot realistically exercise enough to reduce your weight if you are consuming the same amount of calories.

Generally:
– More exercise => better fitness and live longer
– Fewer calories => lose weight

See Dr. Freedhoff’s talk on the issue:

Canadian Senate Report on Obesity – on sugars

From page 6 of the report:

Sandra Marsden of the Canadian Sugar Institute testified that sugar consumption has declined in recent years, however, as that organization represent the sucrose industry (the sugar extracted from beet and sugar cane), this decline seems to be only associated with sucrose and not all sugars combined.

(Zing!)

The Canadian Sugar Institute says the estimated added sugars* consumption in Canada is approximately 51 – 53 g per day.

A number of witnesses also told the committee that sugary beverages are the primary source of added sugar in our diet and are the primary driver of obesity. They noted that these beverages have little or no nutrient value while being calorie-rich. Further they indicated that these are ‘invisible’ calories as they do not contribute to satiety and are simply added calories over and above food intake. Some witnesses offered testimony that sugar is addictive and that it promotes overconsumption.

Addictive? Interesting.

From page 12 of the report:

At the same time, Manuel Arango, of the Heart and Stroke Foundation of Canada, indicated that as much as 62% of the Canadian diet can be categorized as highly-processed, a percentage that has been rising in recent decades at the expense of whole foods. As a consequence of the increased intake of highly processed foods, sugar consumption has increased dramatically from 4 bounds annually per person 200 years ago to 151 pounds annually per person today.

151 pounds per person is huge. That’s nearly 1 cup of sugar per day. I’m not sure where they get that figure.

The Heart and Stroke Foundation of Canada’s position statement on sugar cites that total sugar intake is 110 g per day, or about 1/2 cup per day.

As mentioned previously, Health Canada’s proposed limit is 100 g per day of total sugars.

Footnotes:
*"Added sugars" is defined as follows:

Sugars and syrups (Statistics Canada Category - Sugar and sugar syrups (from sugar cane or sugar beets), maple sugars, honey. Does not include corn sweeteners.
Corn sweeteners: high fructose corn syrup ("glucose-fructose"), glucose syrup, and dextrose.
Fruit juce/concentrated fruit juice or other ingredients that act as a functional substitute for added sugars.

 

Canadian Senate report on obesity – first thoughts

The Canadian Senate report – Obesity in Canada – A While-of-Society Approach for a Healthier Canada was released last week:

There is an obesity crisis in this country. Canadians are paying for it with their wallets — and with their lives.

Harsh and sobering. The infographic is good.

Among the more controversial recommendations:

  • Consider a tax on sugar- and artificially-sweetened drinks
  • Ban the advertising of food and beverages to children
  • Immediately update the food guide without industry influence

Sugar Tax?

The Canadian Taxpayer Federation and the Canadian Beverage Association both denounce the recommended sugar tax, claiming that it doesn’t work. Three comments:

  1. The discussion and promotion of such a tax is very helpful and brings some awareness to the issue of high sugar consumption, whether the tax is implemented or not.
  2. We need to look at the sugar content of all processed foods and see if such a tax should be expanded to cover foods with added sugars/sweeteners, natural or artificial. Even foods such as fruit juices, which give us the liquid without any of the fibre of the fruit, need to be reviewed for inclusion.
  3. As with salt, we need guidelines on the recommended maximum daily intake of added sugars, and the report suggests this in the text.

The CBC hosted a short forum discussion on the sugar tax last week.

Restricting food advertising to children

As for advertising, currently the Quebec Consumer Protections Act protects children (under the age of 13) from any commercial advertising:

248. Subject to what is provided in the regulations, no person may make use of commercial advertising directed at persons under thirteen years of age.

1978, c. 9, s. 248.

249. To determine whether or not an advertisement is directed at persons under thirteen years of age, account must be taken of the context of its presentation, and in particular of

(a) the nature and intended purpose of the goods advertised;
(b) the manner of presenting such advertisement;

(c) the time and place it is shown.

The fact that such advertisement may be contained in printed matter intended for persons thirteen years of age and over or intended both for persons under thirteen years of age and for persons thirteen years of age and over, or that it may be broadcast during air time intended for persons thirteen years of age and over or intended both for persons under thirteen years of age and for persons thirteen years of age and over does not create a presumption that it is not directed at persons under thirteen years of age.
1978, c. 9, s. 249.
The Senate report calls for a study on the effects of this restriction in Quebec, and for implementation of a similar restriction for all of Canada.

Updating the food guide

The call for updating the food without industry influence is fantastic. I’m not sure how realistic this could be, since many non-industry researchers in academia are funded by industry, so does this mean they can’t be involved? The removal of politics from the food guide is one of the questions I’ve always had, in light of the huge ‘push’ for milk/dairy products as our main recommended calcium intake method.

On contradictory food studies

Paul Taylor at the Globe and Mail – Why do researchers churn out so many contradictory food studies?:

Food studies frustrate me. One week a study says one thing. The next week another study says the opposite. Why do researchers churn out so many contradictory studies – and why does the news media keep covering them?

Taylor covers the various research methods well, but doesn’t discuss the media’s culpability in promoting findings that aren’t really there.

Dr. Donald Redelmeier gives good advice:

For that reason, Redelmeier says the best thing to do is focus on having a lot of variety in your diet – “everything in moderation” – and don’t get distracted by contradictory studies and the latest food fads.

 

Nutrition with food allergies and sensitivities – Calcium

See previous… Nutrition with food allergies and sensitivities

(Update: please also see my further thoughts on this issue here.)

Calcium intake in our diet is a major concern of ours since most of the dietary guidelines push a form of dairy as the primary source of calcium. However, the dietary guidelines do not provide a sufficient variety of foods for those of us with food allergies. Witness Appendix 11 of the recently updated USDA dietary guidelines, published late last year, on the Food Sources of Calcium. I’ve highlighted in pink the foods that we cannot consume.

Appendix 11. Food Sources of Calcium - 2015-2020 Dietary Guidelines - health.gov cropped highlighted
(Click on the picture to enlarge)

That leaves us with the following 5 items from the list, with my comments following each item:

  • Fortified ready-to-eat cereals – many of which we cannot eat due to our wheat, peanut and treenut, and dairy allergies
  • Orange juice, calcium fortified – we would have to purchase this, as whole oranges are not at the top of this list
  • Sardines, canned in oil, drained – okay; though some are packed in soy oil, and so we tend to stay away from these products
  • Mustard spinach (tendergreen), raw – I don’t see this in our grocery stores
  • Rice drink – this is suitable; however, many rice drink producers also manufacture almond and/or soy drinks on the same production line, and so we tend to stay away from these products

There are some good resources out there that list calcium-rich foods to incorporate into your diet:

National Institute of Health – Calcium in Diet
National Osteoporosis Foundation – A Guide to Calcium-Rich Food
Dietitians of Canada –Food Sources of Calcium

Also, the USDA provides a great food-nutrient database from which you can search based on nutrient, categories of food, and even through some popular processed foods (Click on Nutrients List in the header).

Here’s a search based on Fruits, legumes and vegetables. (A lot of it is soy-based, which we can’t have, but we can’t remove soy from the search results.)

Conflict of interest?

Marion Nestle on Industry-funded studies:

It’s been 11 months since I started collecting studies funded by food companies with results favorable to the company’s marketing interests.  I’ve now found 135 such studies versus just 12 with results unfavorable.

When the year is up, I will do an overall interpretation of what this collection does and does not signify, but for the moment I will just state the obvious: it is easier to find industry-funded studies with favorable rather than unfavorable results.

Favourable studies are easier to publish than non-favourable – evident in many other areas of science.

Stay tuned.