Marion Nestle Continues To Fight For The Integrity Of Nutritional Science

Nutritionist and food safety activist extraordinaire Marion Nestle wrote a sternly worded email in response to a letter of nomination from the American Society of Nutrition (ASN) to join the Board of Directors of the Smart Choices program.  She declined, explaining her reasons in an open letter that she posted to her blog:

Marion Nestle: Smart Choices, you may recall from my previous posts on this program as well as on other such systems, is a food industry-initiated plan to put a check mark – a stamp of approval – on processed food products that meet certain nutritional criteria.  Apparently, the ASN Board agreed to administer (and, implicitly, endorse) this program without discussing the matter with the membership.  I think involvement of independent nutrition researchers with Smart Choices represents a conflict of interest and the ASN should not be involved in this effort.  Here is what I told Katrina Dunn, the ASN Program Coordinator:

Dear Katrina—

Thank you for inviting me to join the Board of Directors of the Smart Choices program.  I regret that I cannot accept.  Participating in Smart Choices represents a serious conflict of interest for nutrition educators who wish to maintain independence from the influence of the food industry on nutrition advice.

But participation also represents a serious conflict of interest for the American Society of Nutrition (ASN).  I am dismayed that the ASN—an organization devoted to the highest standards of nutrition research–is involved in this project.  I think the ASN should reconsider this involvement and withdraw immediately.

The ostensible purpose of Smart Choices is to guide the public to select more healthful foods.  I am unaware of a research basis indicating that the program is likely to succeed in this goal.

Evidence does, however, support two additional goals of the program.  The first is to provide a basis for marketing highly processed food products.  I think we would all agree that highly processed foods are, in general, demonstrably nutritionally inferior to whole or minimally processed foods.

The second is to stave off federal regulations requiring a traffic-light food rating system such as that in use in the United Kingdom.   Preliminary research indicates that consumers prefer this system to numerical scores and understand the colors to mean that they should choose green-lighted foods and avoid red-lighted foods.

The cut points selected for the Smart Choices program may meet criteria of the Dietary Guidelines, but their health benefits are debatable (the sodium cut point is particularly generous).  Surely, a great deal more research is needed before ASN directly or indirectly endorses specific processed foods simply because they meet arbitrary nutrient cut points.

These concerns all address questions of intellectual conflict of interest.  But I am also concerned about financial conflicts of interest.  If ASN receives payment for its endorsement and administration of this program, the organization—and its members—risk losing intellectual independence.

I appreciate the invitation but I believe the entire program is ill advised and I urge ASN to extricate as quickly as possible.

Sincerely yours,

Marion Nestle
Paulette Goddard Professor of Nutrition, Food Studies, and Public Health
New York University

The letter she receives in response does little to address the various concerns Marion Nestle has, especially points regarding the nutritional content of “Smart Choices” products:

Marion Nestle: Last week, I posted correspondence regarding the American Society of Nutrition’s (ASN) partnership with the industry-sponsored Smart Choices program.  This program places a check mark on food products that meet its nutrient standards.  I am concerned about ASN’s involvement in this project as it puts the society in conflict of interest.  Several other food rating systems are under development, among them the traffic-light system used in Great Britain.  How can the ASN objectively evaluate the relative merits of these systems if it is paid for administering – and, therefore, endorsing – Smart Choices?  I much prefer the traffic light system, have concerns about the entire approach, and think some of the standards overly generous, particularly the upper limits of 25% of calories from added sugars and 480 mg sodium per serving.  Several people who commented on my post asked to see the ASN’s response.  Here it is:

From: John E. Courtney, Ph.D., Executive Officer, American Society of Nutrition
Sent: Tuesday, May 12, 2009 10:24 AM
Subject: Sunday, May 10, 2009 10:36 AM email to Katrina Dunn
Importance: High

Dear Dr. Nestle,

Thank you for your comments on ASN and the Smart Choices program. We value feedback from our members and I’d like to take this opportunity to address some of your concerns and amend a few of the points you made. First, The Smart Choices Program is not an industry-initiated plan. The Smart Choices idea was facilitated by the Keystone Center, which works with a broad array of stakeholders to develop solutions to complex health and social problems. The Smart Choices front-of-pack symbol was developed through a series of plenary meetings over two years and intensive work groups with academics, food manufacturers, public health organizations, and with observers from federal agencies.  This unique process with a broad array of stakeholders along with the fact that the program is completely transparent sets it apart from other programs that have been developed.

In the fall of 2008, Keystone Center issued a RFP for organizations interested in administering the program. The ASN Executive Board was briefed on the program, discussed and evaluated it, and approved moving forward. ASN partnered with NSF to administer the program and was selected. ASN’s role will primarily be one of oversight and facilitation of the program governance, and the Society will be responsible for maintaining the scientific integrity in the Smart Choices program. This program was discussed at the ASN Volunteer Member Leadership Summit in January and most recently at the ASN Scientific Sessions and Annual Meeting at Experimental Biology in New Orleans, LA in April, 2009.

Perhaps most exciting for the Society and consistent with its mission is that ASN will be coordinating a rigorous evaluation of the program as well as consumer research to determine the effectiveness of the program. Perhaps most importantly, ASN neither “owns” the program nor are we making any profit from the program. The funds generated from company participants will be reinvested into the program.  ASN is the pre-eminent society for nutrition researchers and practitioners and encourages scientific debate and transparency and is looking forward to evaluating the effectiveness of this program in helping consumers.

Thank you again for your comments and for your commitment to advancing nutrition research and practice.

Unfortunately, no word yet on what Dr. Nestle’s response is to their response.  I’m sure she will be looking out for the scientifically rigorous evaluation of the program Dr. Courtney says ASN will conduct.

Out of curiosity, I went the Smart Choices website to see if I could get a more detailed list of their “broad array of stakeholders”.  No such luck.  What I found was this pithy and vague statement:

The Smart Choices Program™ was developed by a diverse group of scientists, academicians, health and research organizations, food and beverage manufacturers and retailers with the common goal of developing a single, trusted symbol that could help consumers make smarter food and beverage choices within product categories.

Just in case you thought they made up that word as well….
academician:
noun
1 an academic; an intellectual.
2 a member of an academy, esp. of the Royal Academy of Arts, the Académie Française, or the Russian Academy of Sciences.

Idea: If this is a group of such righteous “academicians” and what not, why are none of their names and affiliations listed?  Something is definitely fishy here.  And just what is this Keystone Center, which is mentioned in the letter but on the website?  This non-profit is a “seeks to solve our society’s most challenging environmental, energy, and public health problems. We bring together today’s public, private and civic sector leaders to confront these issues and we arm the next generation with the 21st Century intellectual and social skills required to effectively approach the questions they will face.”

Non-profits should be independent and unbiased, yet need to get their money from somewhere.  However, I feel the need to point out that in their annual report one-third of their top benefactors are major food companies.  These are Cargill, General Mills, Kraft Foods, Monsanto Company, & PepsiCo.  The Coca-Cola Company only made to the ‘patron’ level, and many more well known corporations are scattered throughout the sponsor page.  Let’s just call this food for thought;  I am sure they are doing good work and good science.

Another idea: Maybe food activists and industry could compromise by using the term ‘Smarter Choices’.  Does anyone actually pay attention to that little green check mark anyway?  After I saw it on a package of Diet Pepsi (soda = smart choice?), I knew I couldn’t take it seriously.  Consequently, I blocked it out.

In any case, there is so much (mis)information on packages that it may be easiest just to ignore it all.

May 18, 2009  Tags: , , , , ,   Posted in: Health, Science & Technology

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