nutrition

nestle-baby-foods-loaded-with-unhealthy-sugars—but-only-in-poorer-countries

Nestlé baby foods loaded with unhealthy sugars—but only in poorer countries

babies, baby food, Formula, Infants, nestle, nutrition, obesity, overweight, Science, Sugar / /

Bad track record —

Health experts say children under age 2 should have zero added sugars in their diets.

–

Night view of company logos in Nestlé Avanca Dairy Products Plant on January 21, 2019, in Avanca, Portugal. This plant produces Cerelac, Nestum, Mokambo, Pensal, Chocapic and Estrelitas, among others.

Enlarge / Night view of company logos in Nestlé Avanca Dairy Products Plant on January 21, 2019, in Avanca, Portugal. This plant produces Cerelac, Nestum, Mokambo, Pensal, Chocapic and Estrelitas, among others.

In high-income countries, Nestlé brand baby foods have no added sugars them, in line with recommendations from major health organizations around the world and consumer pressure. But in low- and middle-income countries, Nestlé adds sugar to those same baby products, sometimes at high levels, which could lead children to prefer sugary diets and unhealthy eating habits, according to an investigation released recently by nonprofit groups.

The investigation, conducted by Public Eye and the International Baby Food Action Network (IBFAN), says the addition of added sugars to baby foods in poorer countries, against expert recommendations, creates an “unjustifiable double standard.” The groups quote Rodrigo Vianna, an epidemiologist and professor at the Department of Nutrition of the Federal University of Paraíba in Brazil, who calls added sugars in baby foods “unnecessary and highly addictive.”

“Children get used to the sweet taste and start looking for more sugary foods, starting a negative cycle that increases the risk of nutrition-based disorders in adult life,” Vianna told the organizations for their investigation. “These include obesity and other chronic non-communicable diseases, such as diabetes or high blood-pressure.”

The two groups compared the nutritional content of Nestlé’s Cerelac and Nido products, the company’s best-selling baby food brands in low- and middle-income countries that generate sales of over $2.5 billion. In a Cerelac wheat cereal product, for instance, the product contained up to 6 grams of added sugar in countries including Thailand, Ethiopia, South Africa, Pakistan, India, and Bangladesh. In the United Kingdom and Germany, the same product contained zero added sugars.

The product with the highest sugar content was a Cerelac baby cereal product sold in the Philippines with 7.3 grams of sugar. While children under age 2 are recommended to have zero grams of added sugars in their diet, for reference, children aged 2 to 18 are recommended to have less than 25 grams (about six teaspoons) per day by the American Academy of Pediatrics.

In the Philippines, where the sugar content was the highest, and in other countries—including Nigeria, Senegal, Vietnam and Pakistan—the added sugar content was not listed on Nestlé’s labeling, the investigation found.

Double standard

“There is a double standard here that can’t be justified,” Nigel Rollins, a WHO scientist, told the nonprofit groups. Rollins pointed out that the company does not add sugars to its baby products in Switzerland, where the company is headquartered. Thus, continuing to add it in low-resource settings is “problematic both from a public health and ethical perspective,” he said.

In a report last month, the WHO found that as of 2022, 37 million children under the age of 5 worldwide had overweight. Additionally, over 390 million children ages 5 to 19 had overweight and 160 million had obesity. The prevalence of overweight in children 5 to 19 rose from 8 percent in 1990 to 20 percent in 2022, the United Nations agency noted. Obesity rates in this age group, meanwhile, rose from 2 percent to 8 percent in the same timespan.

Nestlé responded to the investigation with a statement suggesting that the differences in sugar content “depend on several factors, including regulations and availability of local ingredients, which can result in offerings with lower or no-added sugars.” But it argued that these differences do not “compromise the nutritional value of our products for infants and young children.”

Nestlé is a multinational food and drink behemoth with a controversial history of selling baby products in poorer countries. In the 1970s and ’80s, the company came under heavy international fire for aggressively marketing its baby formula to impoverished mothers. Health advocates accused Nestlé of misleading mothers into thinking formula is better than breast milk for their babies, even though leading health organizations recommend exclusive breastfeeding for the first six months of life when possible.

Critics accused Nestlé of providing free formula to hospital maternity wards, causing new, low-income mothers to turn to it shortly after birth in the critical window in which breast milk production would otherwise ramp up in response to nursing a newborn. Without nursing in that time, mothers can struggle to lactate and become dependent on formula. Out of the hospital, the powdered formula is no longer free and must be mixed in proper amounts and in sanitary conditions to ensure it is safe and meeting the nutritional needs of the infant, which can be a struggle for poor families.

Nestlé now states that it follows international standards for marketing breast-milk substitutes, despite ongoing boycotts in some countries.

Nestlé baby foods loaded with unhealthy sugars—but only in poorer countries Read More »

it’s-cutting-calories—not-intermittent-fasting—that-drops-weight,-study-suggests

It’s cutting calories—not intermittent fasting—that drops weight, study suggests

calories, dieting, intermittent fasting, nutrition, Science, time-restricted eating, weight loss / /

Sensational yet obvious —

The study is small and imperfect but offers more data on how time-restricted diets work.

–

It’s cutting calories—not intermittent fasting—that drops weight, study suggests

Intermittent fasting, aka time-restricted eating, can help people lose weight—but the reason why may not be complicated hypotheses about changes from fasting metabolism or diurnal circadian rhythms. It may just be because restricting eating time means people eat fewer calories overall.

In a randomized-controlled trial, people who followed a time-restricted diet lost about the same amount of weight as people who ate the same diet without the time restriction, according to a study published Friday in Annals of Internal Medicine.

The finding offers a possible answer to a long-standing question for time-restricted eating (TRE) research, which has been consumed by small feeding studies of 15 people or fewer, with mixed results and imperfect designs.

The new study—led by Nisa Marisa Maruthur, an internal medicine expert at Johns Hopkins—has its own limitations and, like any one study, isn’t the last word on the matter. But “it takes us one step closer to identifying the underlying mechanisms of TRE,” nutrition experts Krista Varady and Vanessa Oddo of the University of Illinois wrote in an editorial accompanying the study. “Using a controlled feeding design, Maruthur and colleagues show that TRE is effective for weight loss, simply because it helps people eat less.”

The study involved 41 people, 21 who followed a time-restricted diet for 12 weeks and 20 who ate a usual eating pattern (UEP). Most of the participants were Black women (93 percent) with obesity and either pre-diabetes or diet-controlled diabetes, limiting the generalizability of the findings. But the study carefully controlled what and when the participants ate; each participant got controlled meals (breakfast, lunch, dinner, and snack) with identical macro- and micro-nutrients. Each participant was assigned a calorie level for their meals based on an established, standardized equation that estimates baseline caloric need. They were told to maintain their current exercise level, which was monitored with a wrist-worn accelerometer.

No magic necessary

In the time-restricted group, people only ate in a 10-hour window between 8 am and 6 pm, with 80 percent of their total daily calories consumed before 1 pm. In the usual eating group, people ate between 8 am and midnight, with 55 percent of their calories eaten after 5 pm for dinner and a night-time snack. In each eating group, participants were given specific windows of a couple of hours in which they should eat each pre-made meal. The participants ate three meals each week at a research site, where dieticians addressed adherence issues, and their eating was carefully monitored with the use of food diaries and urine tests. Approximately 96 percent of people in both groups followed the schedules to within 30 minutes. Diet adherence—eating all their assigned food and not eating outside food—was also high, with 93 percent in the time-restricted group and 95 percent in the usual eating group.

At the end of the 12 weeks, both groups lost about the same amount of weight, an average of around 2.4 kg (5.3 pounds), with no statistically significant difference between the two groups. The researchers also found no differences between the two groups in their glucose homeostasis, waist circumference, blood pressure, or lipid levels.

“Our results indicate that when food intake is matched across groups and calories are held constant, TRE, as operationalized in our study, does not enhance weight loss,” Maruthur and her colleagues concluded. The authors are upfront about the limitations of the study, though, noting that the results could have been different in different groups of people and potentially in shorter time-restricted windows, such as eight hours instead of 10. They called for more research to explore those questions.

Outside experts applauded the study while also adding that it’s not surprising. “The headline finding that TRE does not magically lead to more weight loss sounds sensational but is also obvious,” Adam Collins, a nutrition expert at the University of Surrey, said.

Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow, called the study “well done.” It “tells us what we expected—that there is nothing magical about time-restricted eating on weight change other than effects to reduce caloric intake,” he said. “If time-restricted eating helps some people eat less calories than they would otherwise, great.”

The experts Varady and Oddo, meanwhile, see it as a boon for anyone trying to lose weight. “Many patients stop following standard-care diets (such as daily calorie restriction) because they become frustrated with having to monitor food intake vigilantly each day,” they wrote in their commentary. “Thus, TRE can bypass this requirement simply by allowing participants to ‘watch the clock’ instead of monitoring calories while still producing weight loss.” It’s a “simplified” and “accessible” dietary strategy that anyone can follow, including lower-resource populations, the researchers wrote.

It’s cutting calories—not intermittent fasting—that drops weight, study suggests Read More »

great-british-bake-off’s-festive-christmas-desserts-aren’t-so-naughty-after-all

Great British Bake Off’s festive Christmas desserts aren’t so naughty after all

baking, chemistry, cooking shows, Food science, Great British Bake Off, health, nutrition, Science / /

A Christmas miracle? —

Study: Several ingredients actually reduce rather than increase risk of death or disease.

–

four smiling people at a festive picnic table munching on a tasty snack

Enlarge / Great British Bake Off judges Paul Hollywood and Prue Leith (top) and presenters Alison Hammond and Noel Fielding.

Mark Bourdillon/Love Productions/Channel 4

The Great British Bake Off (TGBBO)—aka The Great British Baking Show in the US and Canada—features amateur bakers competing each week in a series of baking challenges, culminating in a single winner. The recipes include all manner of deliciously decadent concoctions, including the occasional Christmas dessert. But many of the show’s Christmas recipes might not be as bad for your health as one might think, according to a new paper published in the annual Christmas issue of the British Medical Journal, traditionally devoted to more light-hearted scientific papers.

TGBBO made its broadcast debut in 2010 on the BBC, and its popularity grew quickly and spread across the Atlantic. The show was inspired by the traditional baking competitions at English village fetes (see any British cozy murder mystery for reference). Now entering its 15th season, the current judges are Paul Hollywood and Prue Leith, with Noel Fielding and Alison Hammond serving as hosts/presenters, providing (occasionally off-color) commentary. Each week features a theme and three challenges: a signature bake, a technical challenge, and a show-stopper bake.

The four co-authors of the new BMJ study—Joshua Wallach of Emory University and Yale University’s Anant Gautam, Reshma Ramachandran, and Joseph Ross—are avid fans of TGBBO, which they declare to be “the greatest television baking competition of all time.” They are also fans of desserts in general, noting that in medieval England, the Catholic Church once issued a decree requiring Christmas pudding four weeks before Christmas. Those puddings were more stew-like, containing things like prunes, raisins, carrots, nuts, spices, grains, eggs, beef, and mutton. Hence, those puddings were arguably more “healthy” than the modern take on desserts, which contain a lot more butter and sugar in particular.

But Wallach et al. wondered whether even today’s desserts might be healthier than popularly assumed and undertook an extensive review of the existing scientific literature for their own “umbrella review.” It’s actually pretty challenging to establish direct causal links in the field of nutrition, whether we’re talking about observational studies or systemic reviews and meta-analyses. For instance, many of the former focus on individual ingredients and do not take into account the effects of overall diet and lifestyle. They also may rely on self-reporting by study participants. “Are we really going to accurately report how much Christmas desserts we frantically ate in the middle of the night, after everyone else went to bed?” the authors wrote. Systemic reviews are prone to their own weaknesses and biases.

“But bah humbug, it is Christmas and we are done being study design Scrooges,” the authors wrote, tongues tucked firmly in cheeks. “We have taken this opportunity to ignore the flaws of observational nutrition research and conduct a study that allows us to feel morally superior when we happen to enjoy eating the Christmas dessert ingredients in question (eg, chocolate). Overall, we hoped to provide evidence that we need to have Christmas dessert and eat it too, or at least evidence that will inform our collective gluttony or guilt this Christmas.”

The team scoured the TGBBO website and picked 48 dessert recipes for Christmas cakes, cookies, pastries, and puddings, such as Val’s Black Forest Yule Log, or Ruby’s Boozy Chai, Cherry and Chocolate Panettones. There were 178 unique ingredients contained in those recipes, and the authors classified those into 17 overarching ingredient groups: baking soda, powder and similar ingredients; chocolate; cheese and yogurt; coffee; eggs; butter; food coloring, flavors and extracts; fruit; milk; nuts; peanuts or peanut butter; refined flour; salt; spices; sugar; and vegetable fat.

Wallach et al. identified 46 review articles pertaining to health and nutrition regarding those classes of ingredients for their analysis. That yielded 363 associations between the ingredients and risk of death or disease, although only 149 were statistically significant. Of those 149 associations, 110 (74 percent) reduced health risks while 39 (26 percent) increased risks. The most common ingredients associated with reduced risk are fruits, coffee, and nuts, while alcohol and sugar were the most common ingredients associated with increased risk.

Take Prue Leith’s signature chocolate Yule log, for example, which is “subtly laced with Irish cream liqueur.” Most of the harmful ingredient associations were for the alcohol content, which various studies have shown to increase risk of liver cancer, gastric cancer, colon cancer, gout, and atrial fibrillation. While alcohol can evaporate during cooking or baking, in this case it’s the cream filling that contains the alcohol, which is not reduced by baking. (Leith has often expressed her preference for “boozy bakes” on the show.)

By contrast, Rav’s Frozen Fantasy Cake contains several healthy ingredients, most notably almonds and passion fruit, and thus carried a significant decreased risk for disease or death. Ditto for Paul Hollywood’s Stollen, which contains almonds, milk, and various dried fruits. “Overall, without the eggs, butter, and sugar, this dessert is essentially a fruit salad with nuts,” the authors wrote. That is, of course, a significant caveat, because the eggs, butter, and sugar kinda make the dessert. But Wallach et al. note that most of the dietary studies condemning sugar focused on the nutritional effects of sugar-sweetened beverages, and none of TGBBO Christmas dessert recipes used such beverages, “no doubt because they would have resulted in bakes with a soggy bottom.”

The BMJ study has its limitations, relying as it does on evidence from prior observational studies. Wallach et al. also did not take into account how much of each ingredient was used in any given recipe. Regardless of whether the recipe called for a single berry or an entire cup of berries, that ingredient was weighted the same in terms of its protective effects countering the presumed adverse effects of butter. Would a weighted analysis have been more accurate? Sure, but it would also have been much less fun.

So, is this a genuine Christmas miracle or an amusing academic exercise in creative rationalization? Maybe we shouldn’t overthink it. “It is Christmas so just enjoy your desserts in moderation,” the authors concluded.

BMJ, 2023. DOI: 10.1136/bmj‑2023‑077166  (About DOIs).

Great British Bake Off’s festive Christmas desserts aren’t so naughty after all Read More »