MONDAY, June 27 (HealthDay News) -- Americans' widening waistlines are the main force behind rising U.S. health care costs, a new study shows. Between 1987 and 2002, the proportion of private health spending attributable to obesity increased more than tenfold, researchers report, from $3.6 billion to $36.5 billion. In the year 2002, obesity-related medical care spending accounted for 11.6 percent of all private health care spending compared to just 2 percent in 1987, concludes an article published today in Health Affairs.
Monday, June 27, 2005
So, I checked to see if WebMD had done anything to correct the record on dairy weight loss claims. Indeed, it had. Without mentioning its earlier role in promoting the dairy weight loss hype, WebMD ran a major article in early June focusing on the new study showing an association between dairy consumption and weight gain among the young: "A growing body of research is taking aim at the claim that there is something special about milk and other dairy foods that help people lose weight." In contrast with WebMD's earlier coverage by a different author and editor, the new article treats Michael Zemel's research much more skeptically and mentions his industry funding, though not his unusual patent on the dairy weight loss claim. It quotes Tufts' Alice Lichtenstein explaining the mainstream view among nutrition scientists that calorie balance, rather than any particular nutrient, holds the key to weight gain or loss: "[Lichtenstein] tells WebMD that she has seen nothing to convince her that any single nutrient or nutrient mix holds the key to easy weight loss."
The contrast between WebMD's reversal and the unresponsiveness of the American Dietetic Association is striking. A brief research update written by ADA's own staff in June 2004 mentioned Zemel's research on dairy weight loss but added the sensible caveat: "As always, remember that no one study should form the basis for overhauling your eating plan. More research is needed to fully understand the results of this study." As we noted earlier, a recent web page on the ADA site shows the dairy industry's heavy hand. I wrote ADA to ask about this strangely credulous account of the dairy weight loss claims, which (without mentioning it) precisely mimics the dairy industry's 24/24 milk advertising slogan. Among other things, I asked who wrote the language on the ADA's site. The ADA response by email stated that the web page acknowledged that it was written in collaboration with the MilkPEP, the milk processors' industry organization. You can see for yourself on the page that the page only briefly mentions "milk processors" at the very bottom. It does not acknowledge any role of MilkPEP in authorship. The ADA web page is especially misleading in selectively linking to research that supports the dairy weight loss claim, but ignoring the considerable research that failed to corroborate this claim. This web page is inconsistent with the ADA's official position in support of the mainstream weight loss message, focusing on calorie balance rather than particular nutrients, articulated by Lichtenstein above and in the federal government's dietary guidelines. I think ADA's unwillingness to reconsider this web page undermines the association's claim of editorial independence from its financial supporters in the dairy industry. Is anybody at the association monitoring this?
Sunday, June 26, 2005
Thanks to Radio News America for the AP link. The Center for Media and Democracy has been covering the BSE issue for a long time, and has some comments on the media-savvy timing of Johanns' announcement on Friday: How to Bury a Mad Cow.
WASHINGTON - A third and more sophisticated test on the beef cow suspected of having mad cow disease would have helped resolve conflicting results from two initial screenings, but the U.S. refused to perform it in November. That additional test, ordered up by the Agriculture Department's internal watchdog, ended up detecting mad cow — a finding that was confirmed on Friday by the world's pre-eminent lab, in England.
Only 18 months ago, the department had used the Western blot test to help uncover the first American case of the brain-wasting illness in cows. The department is pledging that, from now on, it will conduct such testing on suspicious animals. U.S. officials in November had declared the cow free of the disease even though one of two tests — an initial screening known as a rapid test — indicated the presence of the disease. A more sophisticated follow-up — immunohistochemistry, or IHC — came back negative.
"They had two diametrically opposed results which begged to be resolved," said Paul W. Brown, a former scientist at the National Institutes of Health who spent his career working on mad cow-related issues. "If you had what they had, you would immediately go to a Western blot and get a third test method and see which one of the previous two was more accurate," Brown said.
Consumer groups and scientists urged the department to perform a Western blot test and seek confirmation from the lab in Weybridge, England. In a letter to Consumers Union last March, the department said there was no need for the British lab to confirm the results and that the Western blot test would not have given a more accurate reading. "We are confident in the expertise of USDA's laboratory technicians in conducting BSE testing," wrote Jere Dick, an associate deputy administrator. Mad cow disease is medically known as bovine spongiform encephalopathy, or BSE.
Troubled by the conflicting test results, the department's inspector general, Phyllis Fong, ordered the Western blot test this month. By the time an aide notified Agriculture Secretary Mike Johanns, the testing was under way. The testing was positive. The department then sent tissue samples to the British lab, which subjected the samples to all the tests again.
Johanns, amid an uproar from the cattle industry, was irked that she did so without his knowledge or consent. "From my standpoint, I believe I was put there to operate the department and was very disappointed," he told reporters Friday morning. By that afternoon, the verdict from Britain was in: The cow had mad cow disease....
The structure of farms, farm households, and the rural communities in which they exist has evolved markedly over the last century. Historical data on a range of farm structure variables—including the value of agricultural production, commodity specialization, farming-dependent counties, and off-farm work—offer a perspective on the long-term forces that have helped shape the structure of agriculture and rural life over the past century. These forces include productivity growth, the increasing importance of national and global markets, and the rising influence of consumers on agricultural production. Within this long-term context of structural change, a review of some key developments in farm policy considers the extent to which farm policy design has or has not kept pace with the continuing transformation of American
Thursday, June 23, 2005
Tomorrow, 30,000 disabled, elderly Massachusetts residents are expected to receive letters in the mail telling them about their eligibility for new hassle-free food stamps.Thomas took my statistics class this past semester at the Friedman School. Here's more on food stamp participation rates in general, and for the elderly in particular (.pdf).
The pilot project, called Bay State Combined Application Project, or CAP, seeks to boost the state's low participation rate in the food stamp program by providing electronic food stamp cards to elderly, disabled recipients of Supplemental Security Income benefits -- without them waiting in long lines or filling out lengthy applications. Another 38,000 disabled seniors will be eligible for the program at the end of summer.
Food stamp participation in Massachusetts is the lowest in the nation, with 39 percent of those eligible getting their share of $30 million in federal food assistance, according to the state Department of Transitional Assistance.
Thanks to the Huffington Post for the link.
Meat and milk from cloned farm animals is about to be declared safe for human consumption by the US Food and Drug Administration, one of the world's most powerful regulatory bodies.
A favourable risk assessment from the FDA is expected to start the commercial exploitation of cloning to improve livestock quality around the world. FDA officials told the BIO 2005 biotech industry conference they had completed a four-year assessment process and concluded that cloned animals and their progeny would be as safe to eat as conventionally bred animals. They also found that cloning was acceptable from the viewpoint of animal welfare.
Wednesday, June 22, 2005
Tufts researchers recently reported that while the leading source of calories in the average American diet used to be from white bread, that may have changed. Now, according to preliminary research conducted by scientists at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Americans are drinking these calories instead. The research was presented in abstract form at the Experimental Biology Conference in April of this year and a more comprehensive paper is being developed.
A sharp report by Naila Moreira at the Science News Online site discusses how Bermudez' study fits in the context of other recent research, including an invited commentary by Robert Murray of the Ohio State University in the Journal of Pediatrics last month:
Odilia Bermudez, PhD, MPH, studied the reported diets of a large nationwide sample of American adults. Among respondents to the 1999-2000 National Health and Nutrition Examination Survey (NHANES), more than two thirds reported drinking enough soda and/or sweet drinks to provide them with a greater proportion of daily calories than any other food. In addition, obesity rates were higher among these sweet drink consumers. Consumers of 100% orange juice and low fat milk, on the other hand, tended to be less overweight, on average.
Bermudez, who is also an assistant professor at Tufts University’s Friedman School of Nutrition Science and Policy, is hopeful that, “by helping to identify the main sources of excess energy in the American diet, this work may contribute to the development of much-needed strategies to combat obesity in the American public.”
“These results are startling,” she continued, “and indicate that we need a much better understanding of how the American diet has changed.
Our paper will look more closely at the issue of sweet drink consumption and its relation to obesity factors among three of the main ethnic groups included in the national surveys: African Americans, Hispanics and non-Hispanic whites.”
Experimental Biology 2005, San Diego. Abstract # 839.5 Bermudez, O., "Consumption of sweet drinks among American adults from the NHANES 1999-2000.”
Moreira links to other sources, including Murray's commentary (.pdf), which appears to be online for free. Another good resource is the Institute of Medicine's project on preventing childhood obesity at the National Academies. Somebody should forward a folder of recent research to Drew Davis of the National Soft Drink Association, who said of the recent Commercial Alert petition about soda and junk food in schools: "They didn't provide any proof that a problem exists -- where's there proof of a problem?"
Dieters may not realize how sugary beverages affect them, because they focus on avoiding calorie-rich solid foods, says Robert Murray of Ohio State University. "Liquid calories like this, I think we tend to just ignore them," he says.
Although Bermudez' findings might startle consumers, Murray says he's "not overly surprised" by the new data. In the May Journal of Pediatrics, he and his colleagues reviewed existing studies on the impact of soft drinks on children's diets and obesity levels. The researchers found that U.S. children and teenagers consume, on average, about two cans of soda or fruit drink a day. And a quarter of all teens drink as many as four cans a day, each one containing about 150 calories.
"That's a lot of calories. That's 600 calories," Murray says. "That's like an additional meal." For a teenage girl, who should be eating around 1,800 calories a day, he adds, "that's a third of her daily energy requirement taken in the form of just one food, soft drinks."
A host of problems accompanies such excessive sweet-beverage consumption, Murray's team found. The more sodas and fruit drinks children drank, the more obese they tended to be. Soft drinks also displaced milk in children's diets, diminishing their intake of nutrients such as calcium, iron, folic acid, and zinc.
Tuesday, June 21, 2005
To reach a healthier weight this summer, consider throwing some portobello mushrooms, veggie burgers and fish on the grill in place of steak, hot dogs and chicken.
A new study of some 55,000 healthy, middle-aged Swedish women finds that those who ate little or no meat weighed significantly less than their more carnivorous counterparts. The findings are some of the first to show a direct link between a plant-based diet and a lower body mass index, or BMI....
Even so, Newby and other nutrition experts note that not all vegetarian foods are healthy. A steady intake of sweetened soft drinks, french fries and candy bars qualifies as vegetarian, but is loaded with saturated fat, unhealthy trans fat and added sugar. Plus, it's high in calories and lacks fiber and many essential nutrients.
Justin may mock, but the reality is that these people are on to something, though perhaps not a viable legal claim. Given that lactose intolerance actually seems to affect most of the world's population (a minority of white folks, but most non-whites and non-whites outnumber whites pretty badly) there actually is something a bit odd about the tone and omnipresence of pro-milk propaganda. Now, personally, I think milk is just about the grossest substance on the planet but I love my cheese despite some very mild intolerance.Of course, many reasonable people including most economists are suspicious of litigation as a road to sound policy. A sensible position would be for the federal government just to stop pushing increased dairy consumption through weight loss claims, stop supporting efforts to belittle the seriousness of lactose intolerance, or at the very least to stop its federally supported advertisements promoting cheese, butter, and other high-fat dairy products whose increased consumption is not endorsed by the government's own Dietary Guidelines.
Monday, June 20, 2005
Here are two quick blurbs on the ... internet today. I allow you to draw your own conclusions.
In a move that could help reduce its "Supersize" image problems while encouraging /capitalizing on the fight against childhood obesity, McDonald’s has signed with Burbank-based DIC Entertainment to promote a more active lifestyle for kids.
Blurb 2: [update 06/21: original link changed.]
McDonald`s is bringing back its 42-ounce soft drinks. The fast food chain pulled the gigantic drinks after the release of the movie "Supersize Me" last year, but restaurants in Chicago are bringing them back. For a short time, the 42-ounce drink will be free for customers who buy a Big Mac and fries.
Sometimes the stories write themselves.
GMA's support for community decisions in place of federal action is ironic, given the association's longstanding support for federal preemption of stronger proposed state rules for food labels.
Drew Davis, vice president of federal affairs for the National Soft Drink Association, said he didn't think Commercial Alert made a case that warranted federal action. "They didn't provide any proof that a problem exists -- where's there proof of a problem?" Davis said.
Stephanie Childs, a spokeswoman for the Grocery Manufacturers of America, added: "It is our belief that community decisions are the best approach. Our companies work with schools to provide whatever products they want in schools."
*The name of the consumer group, Commercial Alert, has been corrected (7/1/2005).
Sunday, June 19, 2005
Thursday, June 16, 2005
"More babies, young kids going hungry in US" That's the headline of an Agence France-Presse story. There's a similar headline on the link in HuffPo--"More U.S. Kids Going Hungry While 2/3 of Population is Overweight." But if you read the story all the way through, it turns out that the kids aren't going hungry. They're malnourished, which is not quite the same thing (and not unrelated to obesity).I don't think Kaus uses the term "malnourished" in any technical sense. It is certainly not true that the U.S. food security statistics are based on questions about eating junk food and so forth. Out of 18 questions, there is one question about affording balanced meals and another about feeding children just a few low-cost foods, but most of the survey items are about going without.
But Kaus is not alone in criticizing the current use of the term "hunger" for the type hardship found in the United States, which is characterized by adequate calories during most times, punctuated by episodes of food crisis. Perhaps under pressure from the Office of Management and Budget, USDA last year contracted with a National Academies of Science committee to reconsider several hunger measurement issues. That committee's report said the term "hunger" should be studied further, a recommendation that generated some interesting debate, which we covered earlier. My comment in Slate's Fray, pointing out this larger political context that Kaus did not mention, already has some discussion in response.
After rummaging around on the Internet I found a press release snippet, "Batman, a masked crusader uses his strength, intellect and an array of high tech contraptions to fight the sinister forces that threaten the city." The ad copy reads: "For the hero in all of us. Milk's 9 essential nutrients give me the strength and energy I need to fight the forces of evil. Not drinking milk? Now that would be a crime." Actually, it could do just the opposite.And off the weblogger goes -- imagining the would-be hero abandoning his job as advertising spokesman and instead, as Batman, tracking down the hidden facts on how milk is really produced.
Tuesday, June 14, 2005
The on-line paper (.pdf) is also nicely written, with a good exposition of how random assignment to a treatment is related to statistical approaches using instrumental variables. I will use the paper in teaching.
- Michele Simon on how Ronald McDonald became a health ambassador.
- Center for Science in the Public Interest on the contrasting fates of new school meals rules in New Jersey and Connecticut.
- Commercial Alert on USDA's negative response to a petition asking the Department to enforce its rules on junk food in schools.
Monday, June 13, 2005
I can. Raise the price. Yes, I know organic food already carries a stigma from high prices, but rationing organic milk according to willingness-to-pay is no worse than other ways of allocating a scarce resource. The higher price sends a signal to farmers to produce more organic milk. If you were an English professor who writes about environmental issues, you might strongly suspect this is one of those doctrinaire economist religious chants (and I'd be sympathetic -- I was made to learn those chants in school). But this one is true. If you don't believe it from an economist, ask an organic dairy farmer. I feel 100 percent sure she or he will corroborate this (and please post a comment if I'm mistaken).
WASHINGTON - The government says there is no new health risk from mad cow disease despite fresh suspicions about an animal that was previously cleared of the lethal infection.
The Agriculture Department said Friday night it will seek further testing of a tissue sample from a "downer" beef cow — one unable to walk — after receiving conflicting results on tests of it for mad cow disease.... Only one case of mad cow disease has been confirmed in the United States, in a dairy cow in Washington state in December 2003. Since then, preliminary tests indicated the existence of the disease in three cows, but further testing had ruled out any infection.
USDA decided this week to perform additional tests, and one of those three — a beef cow — turned up positive. Johanns said the department's inspector general had recommended the additional testing, but the secretary did not say why.... A sample from the animal was being sent to an internationally recognized laboratory in Weybridge, England, that provided independent confirmation of the first U.S. case of mad cow disease. The Agriculture Department will also conduct further tests....
Commonly called mad cow disease, bovine spongiform encephalopathy, or BSE, is a brain-wasting ailment. In humans, it can cause a variant of the degenerative, fatal brain disorder known as Creutzfeldt-Jakob disease. It has killed more than 150 people, mostly in Britain, where there was an outbreak in the 1990s.
The transcript of the Friday press conference with Agriculture Secretary Johanns contains more detail about the recent postive test for the disease, called the Western Blot, and how it differs from the earlier negative tests.
Here is the activist perspective from John Stauber at the Center for Media and Democracy:
The US government’s elaborate cover-up of mad cow dangers in the United States has begun to unravel. Twenty-four hours after our successful protest (with Organic Consumers Association) of the US Department of Agriculture’s mad cow dog-and-pony show in St. Paul, USDA Secretary Johanns was forced to admit that a cow tested last year and declared safe in fact DID have mad cow disease, or at least has tested positive on the definitive Western Blot test recently administered by USDA and considered the 'gold standard' for BSE testing.
I’ve often charged that the USDA is hiding US cases of mad cow by using the wrong testing procedures and by failing to conduct food safety tests on millions of animals and this announcement proves it. USDA finally used the correct test — the Western Blot test — on this suspect animal and it has proven to be a case of mad cow disease.
Notwithstanding Secretary Johanns' stated hopes in the press conference, I suspect this event will have implications for exports to important overseas markets that have been closed to U.S. beef, especially Japan. In this morning's news, there is talk that Taiwan might close its market to U.S. beef (Reuters).
In other weblog coverage, Thoughts from the Middle of Nowhere questions some of the media coverage of this case, suggesting it may overstate the riskiness of U.S. beef.
Friday, June 10, 2005
Senator Richard Durbin (D- IL) introduced the Hunger-Free Communities Act of 2005 today to increase federal funding available to local organizations working to reduce hunger in communities nationwide and establishing an ambitious commitment to end hunger in the United States by 2015. The bill has bipartisan support with Senators Richard Lugar (R- IN), Blanche Lincoln (D-AR), and Gordon Smith (R-OR) as cosponsors.Those last statistics are the federal government's estimate of how many Americans and American children live in household that are "food insecure" (a smaller number of households are estimated to have hunger). For all the possible quibbles one might have with the hunger measure, one of the measure's main purposes is for monitoring progress toward national goals. In recent years, the rate of food insecurity has been increasing, bringing us further away from the goal for 2010.
According to the USDA, hunger and food insecurity in the United States has increased for the fourth straight year. In 2004, more than 36 million Americans -- including 13 million children -- lived with hunger or on the brink of hunger.
Monday, June 06, 2005
Children who drink more than three servings of milk each day are prone to becoming overweight, according to a large new study that undermines a heavily advertised dairy industry claim that milk helps people lose weight.But even with that strong first paragraph, the article is far too understated.
Stein writes, "The National Dairy Council has spent $200 million since 2003 to promote the idea that milk can help people lose weight." But most people will think of the Dairy Council as a private-sector industry group. That money actually comes from the National Dairy Board and the National Fluid Milk Promotion Board, two of the checkoff boards sponsored by the federal government, which enforces collection of a tax on the producers. The Supreme Court recently upheld the Constitutionality of these checkoff boards, which are opposed by substantial minorities of producers, on grounds that the board's message represents the federal government's own speech.
Stein's article ends with a counterpoint offered by University of Tennessee researcher Michael Zemel, who believes that heavy dairy consumption accelerates weight loss in a reduced calorie diet. The article notes that Zemel "receives some funding from the dairy industry." This, again, greatly understates the issue. Zemel has a highly unusual patent on the dairy weight loss claim, which is marketed by another industry organization allied with the checkoff program, the International Dairy Food Association. For a fee, this association permits dairy companies to make dairy weight loss claims, and if the companies attempt to make such a claim without permission, the association threatens to sue them (.pdf).
All of this reminds me to point out some dairy weight loss hype on the website of the American Dietetic Association. This hype is inconsistent with the Dietary Guidelines. The Dietary Guidelines Advisory Committee specifically considered the dairy weight loss claim at the request of the National Dairy Council, and declined to endorse it. Compare the language on the American Dietetic Association's website to the 24/24 campaign on the checkoff sponsored website touting the dairy weight loss claim. The bottom of the Association's web page links to a long list of scientific research articles apparently corroborating the dairy weight loss claim, but this list is so selective as to be dishonest. Try to find the following articles and letters in scientific journals on the list:
- Barr S. Increased Dairy Product or Calcium Intake: Is Body Weight or Composition Affected in Humans?. J Nutr. 2003;133:245S–248S.
- Gunther CW, Legowski PA, Lyle RM, McCabe GP, Eagan MS, Peacock M, Teegarden D. Dairy products do not lead to alterations in body weight or fat mass in young women in a 1-y intervention. Am J Clin Nutr. 2005;81(4):751-6, 2005.
- Lanou AJ. Letters to the Editor: Data Do Not Support Recommending Dairy Products for Weight Loss. Obes Res 13(1):191.
- St. Onge M-P. Dietary fats, teas, dairy, and nuts: potential functional foods for weight control? Am J Clin Nutr. 2005;81:7-15.
Saturday, June 04, 2005
Fraser's article ends with an exhaustive (and exhausting) bibliography rebutting Kahn's claims disputing the stronger varieties of the sugar and diabetes connection.
Gary Ruskin, executive director of Oregon-based Commercial Alert, a website that monitors commercial culture, called the ADA's partnership with CSAB "corrupt" and demanded that the contribution be returned to CSAB immediately. "If Cadbury Schweppes really wanted to reduce the incidence of obesity and diabetes, it would stop advertising its high-sugar products, and remove them from our nation’s schools," said Ruskin. "This is just another attempt by a major junk food corporation to obfuscate its responsibility in the epidemic of obesity and diabetes in the United States."
Another public interest group, the Corporate Crime Reporter (CCR), recently published an interview with Richard Kahn, the ADA's chief medical and scientific officer. CCR asked Kahn, "Why exactly is the ADA taking money from big corporate donors, including junk food pushers?" Kahn revealed that the association's so-called "multi-million dollar" alliance was actually only slightly more than one million dollars.
In exchange for that sum of money, Cadbury-Schweppes can put the ADA's label on all of its diet soda products. According to Kahn, however, CSAB cannot use the association's logo on any product not nutritionally approved by the ADA, nor on any product specifically marketed toward diabetics.Despite the terms of the alliance, in a press release posted on www.beverageworld.com, CSAB Senior Vice President of Marketing Jim Trebilcock implied that products with the ADA logo will be marketed toward diabetics. "I acknowledge that it is a little bit of a tricky dance here, given that we also sell sugared beverages," says Trebilcock, "but it's about communicating the choice. And it's also really about doing the right thing. And the right thing is we do offer products that are great for diabetic patients or people who are overweight and we want to get that message out, but done in a way that contributes to an overall solution."
Wednesday, June 01, 2005
The examined daily bread, as a stepping stone toward the examined life, is an honorable tradition. The new weblog cheap veggie gourmet led me to Kitchen Parade's "veggie venture" and to a four-year-old weblog that we might euphemistically describe as ....corporategroceries.net, who seeks to buy food only from independently owned sources. An earlier post in these pages also mentioned Half Changed World and Henry Thoreau. From Alex Tabarrok at Marginal Revolution, the delightfully literate economics weblog, I heard some time ago about the astonishing Seth Roberts, a Berkeley psychologist whose experiments on himself have included drinking five liters of water daily to test a theory of weight loss.
I am tempted to try my own exercise, suited to the peculiar interests of this forum, which include the political, nutritional, and home economics implications of personal food choices. Does anybody want to propose a goal or challenge for this exercise? Appropriate for a busy family of four, with 2 adults and 2 young children, all big on fruits and vegetables? Say, one month in length?