Florida Department of Citrus seeks to 'educate' scientists about the value of orange juice

Apparently, the Florida citrus industry has a thin skin. When we reported earlier this month that many scientists have come to the conclusion that 100% fruit juice isn’t much healthier than soda, growers took notice.

To recap, here are some of the eerie similarities between fruit juice and soda:

A glass of juice concentrates all the sugar from several pieces of fruit. Ounce per ounce, it contains more calories than soda, though it tends to be consumed in smaller servings. A cup of orange juice has 112 calories, apple juice has 114, and grape juice packs 152, according to the U.S. Department of Agriculture. The same amount of Coke has 97 calories, and Pepsi has 100. And just like soft drinks, juice is rich in fructose -- the simple sugar that does the most to make food sweet.

Of course, fruit juice has many vitamins and minerals, but these are generally not lacking in the modern American diet. Besides, the healthier way to get them is to eat the fruit itself instead of drinking juice.

These facts have left many experts wondering why campaigns to impose taxes on soda and other sugar-sweetened beverages in the name of fighting obesity have neglected to target juice as well. As Dr. Charles Billington, an appetite researcher at the University of Minnesota, put it, juice “is pretty much the same as sugar water.”

That’s not how orange growers in Florida see things. To make their views known, the Florida Department of Citrus enlisted dietitian Gail Rampersaud to inform the experts quoted in our story about the virtues of orange juice. Several copies were delivered Tuesday.

Written on letterhead from the University of Florida College of Agricultural and Life Science’s Food Science and Human Nutrition department, where Rampersaud is a nutrition research and education assistant, the letter points out that:

•  One hundred percent orange juice is a natural source of essential vitamins, minerals and phytonutrients needed for a lifetime of good health. In fact, one 8-ounce glass counts as a fruit serving and can contribute to almost 25 percent of your USDA-recommended daily fruit and vegetable servings, based on a 2,000-calorie diet.

•  An 8-ounce serving of orange juice is an excellent source of vitamin C and provides at least 100% of the Daily Value for this important antioxidant. A recent analysis of NHANES data reports that 60 percent of adult men and 53 percent of adult women had dietary vitamin C intakes less than the Estimated Average Requirement (EAR) established by the Institute of Medicine and over 22 percent of adults had plasma vitamin C concentrations that put them at moderate risk of developing vitamin C deficiency. In addition to being rich in vitamin C, an 8-ounce serving of 100 percent orange juice is a good source of thiamin, potassium and folate and delivers other important nutrients such as vitamin B6 and magnesium.

•  Citrus juices are nutrient-dense and provide a high ratio of nutrients relative to their calorie content. A study that I conducted and published in the Journal of Food Science reported that 100 percent orange juice was more nutrient-dense than many commonly consumed 100 percent fruit juices, such as apple, grape, pineapple and prune.

•  Citrus fruit and juices, including 100 percent orange juice, are free of added sugars and contain only the natural sugars found in whole fruit. A comprehensive review of studies regarding 100% fruit juice intake and increased weight in children and adolescents reported that the preponderance of evidence does not support such an association. In fact, this review suggested that consuming 100% fruit juice in moderate amounts “may be an important strategy to help children meet the current recommendations for fruit.”

•  A recent analysis of NHANES 1999-2002 data reported that 50% of children age 2-5, 74% of children age 6-11, and 81% of adolescents age 12-18 are not meeting MyPyramid fruit intake recommendations based on a single day’s dietary intake. An evaluation of the same NHANES data reported that 100% fruit juice intake was associated with higher daily intakes of whole fruit in children age 2-11 years. The American Academy of Pediatrics’ guidelines include moderate intakes of 100 percent fruit juice (i.e., 4-6 ounces per day for children age 1-6 years and 8-12 ounces per day for older children). One hundred percent fruit juice can help children get the nutrients they need and help meet fruit intake recommendations.

•  While it is true that the 2005 Dietary Guidelines for Americans recommends that the majority of fruit choices should be whole fruit, the Dietary Guidelines Advisory Committee did recognize the nutritional value of including 100% fruit juice in the diet for providing nutrients such as vitamin C, folate, and potassium. The Committee concluded that the “recommended intake of fruits and juices achieve an optimal balance” with regard to meeting nutrient intake recommendations.

The letter failed to impress at least one researcher, who forwarded it on to us. (We posted it with Rampersaud’s permission.)

Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco, was quoted in the story saying, “The upside of juice consumption is so infinitesimal compared to the downside that we shouldn't even be having this discussion." Here is his response to Rampersaud (also posted with his permission):

Thank you for your letter. As it is stated in the Kaplan article, I am not against fruit. As far as I am concerned, the most important nutrient contained in fruit (not just citrus, but any fruit) is fiber. "The juice is Nature's way of getting you to eat your fiber." Thus, I am not against fruit; indeed I am for it. So the Florida Department of Citrus can rest easy in terms of the citrus crop.

Unfortunately, juice has no fiber. Just calories, of which half are fructose. I am attaching an article I wrote on the Fructose Epidemic demonstrating the difficulties in hepatic metabolism from fructose, and another article I co-wrote with the American Heart Association remanding the American public to reduce its consumption of fructose. As you can see, I am not the only one who thinks this is a problem.

The problem is not with fruit, but with juice. Juice is merely a method of decreasing depreciation and increasing profits for the food industry. For if you take the most important nutrient and throw it in the garbage, what person does that benefit?

So, if you are a representative of the citrus growers, you should be in my camp, and should applaud my research and my stance. Fruit affords all the micronutrients you highlight, affords you fiber, and reduces your consumption of fructose (1 orange has one fourth the calories of a cup of orange juice). If, on the other hand, you are merely a shill for the food processing industry, then I will be happy to battle you and your entire industry in an open forum. I welcome the challenge.

-- Karen Kaplan

Photo: Why drink juice when you can eat fruit? Credit: Francine Orr/Los Angeles Times

To fight inflammation with food

Inflammation -- a ramped-up immune system -- seems to be linked to chronic diseases such as cancer and heart disease, and even the very fact of aging. Some foods, it turns out, promote inflammation. Others damp it down.

Shara Yurkiewicz, our 2009 summer intern, wrote a fairly extensive Health section article on the issue of anti-inflammatory foods -- you can read it right here. She noted that there's an awful lot of over-the-top prose about anti-inflammation diets --"amazing results in just 30 days!" etc. etc. -- but also that there is some science to it all -- animal studies, cell culture studies, even some in people -- and that the science in this area is developing.

In broad brush strokes, fish oil, curcumin, antioxidant-rich fruits and vegetables -- they're anti-inflammatory. Saturated fats, trans fats, corn and soybean oil, refined carbohydrates, sugars -- they're pro-inflammatory.

Now some scientists are trying to paint with a narrower brush. They've come up with -- and tested -- an inflammation index for foods.

First, the scientists did a literature search and put together a list of foods with anti-inflammatory or pro-inflammatory properties. They came up with 42.

Top of the list on the bad, pro-inflammation end: carbs. Top at the anti-inflammatory end (should you be interested, but we caution you not to run out and immediately start consuming massive amounts in a quest to live forever): magnesium.

That was step one. In step two, the researchers decided to test whether the people's diets gelled with the levels of inflammation you could measure in their blood. So they tested it 494 people. The participants were asked periodically over the course of a year what they ate, and it was all cataloged very precisely. Samples of their blood were assessed for levels of a protein called CRP, which is a marker of inflammation as well as a risk factor for heart disease.

The scientists found that the measure worked, and that diet and inflammation indexes matched up in a broad sense -- i.e. those eating a lot of anti-inflammatory foods had lower CRP levels, and vice versa. (It wasn't a smooth, continuous relationship, however.) This supports the idea that diet really does influence your inflammation, even after controlling for other lifestyle factors. 

The researchers say that their index could be a great tool for research but that it could also help people who are trying to reduce levels of inflammation in their bodies to lower their risk for chronic diseases. Though you'd think most of us could get a long way by just remembering: Carbs and fat and stuff, EAT LESS. Produce, nuts and fish and stuff: EAT MORE.

The study was done by researchers at the University of South Carolina and the University of Massachusetts, and published in the Journal of Nutrition. You can read it here.

-- Rosie Mestel

Photo credit: Kirk McKoy

Folic acid and cancer: New data might add to suspicion or, better, to discussion

We're not trying to pick on folic acid, honest. As food additives go, the synthetic version of vitamin B9, aka folate, is one of the more noble ones, widely credited -- heralded even -- for reducing the rate of neural tube birth defects. But we are trying to point out, again, that if a little is good, a lot is not necessarily better. 

Several months ago we offered up this story in the Health section: 

Folic acid might be losing its sheen

It said: "New studies suggest that getting too much folic acid might fuel certain cancers in some people. And with the vitamin showing up in ready-to-eat cereals, bread, snack bars, multivitamins and more, some health experts fear that it's easy to far exceed the recommended daily intake of 400 micrograms. There is now an urgent need, experts say, to figure out how much folate is enough but not too much for different segments of the population."

That urgent need isn't going away. Now we have a study, published today in the Journal of the American Medical Assn., that might cause another eyebrow or two to be raised at this miracle of fortification.

Researchers in Norway analyzed data from 6,837 people with ischemic heart disease treated with folic acid, B6 and B12; folic acid and B12; just B6 or a placebo. Those treated with folic acid and B12 had higher rates of cancer, cancer deaths and deaths in general over the course of several years. Lung cancer contributed significantly to the cancer numbers.
 
Of note, Norway doesn't fortify its foods with folic acid, as does the U.S., meaning baseline blood levels were lower to start with than they would be here. Also of note, the researchers point out: Although the folic acid doses in the study were higher than what the typical American would consume through fortification alone, they were below the limits set by our Institute of Medicine.

Just as a lot of folic acid isn't necessarily a good thing, fortification isn't necessarily a bad thing. The researchers conclude:

"Our results need confirmation in other populations and underline the call for safety monitoring following the widespread consumption of folic acid from dietary supplements and fortified foods."

Here's that abstract  and more on folic acid from Medline Plus.

-- Tami Dennis

Photo: Would you like a folic-acid boost with that? You might as well.

Credit: Los Angeles Times

Study points to increasing food allergies among children

Almost 4% of American children have food allergies, according to a sweeping analysis of the problem published today in the journal Pediatrics.

The study is the first to make a broad estimate of the prevalence of food allergies among U.S. children and supports previous, smaller studies suggesting that food allergy rates are rising rapidly for reasons that are unclear.

Researchers from the Centers for Disease Control and Prevention found that self-reported food allergies increased 18% from 1997 to 2007.

The estimates were drawn from surveys of the children's parents and from medical records. Using data from medical records taken in 2005-06, researchers found 9% of all children tested positive for immunoglobulin E antibodies to peanuts. IgE tests are not considered reliable indicators of an allergy, but they do suggest an increased risk or past history of an allergy. The antibody tests were positive for egg allergies in 7% of children, for milk allergies in 12% and for shrimp allergies in 5%.

Finally, the analysis showed that healthcare visits for food allergies in children nearly tripled between the two time periods studied: 1992 through 1997 and 2003 through 2006. In the later period, U.S. children had an average of 317,000 visits to healthcare settings per year for food allergies.

The study also suggests potential racial differences among children with food allergies. While Latino children had the lowest prevalence of food allergies in 2007 compared with other racial groups, they had the greatest increase in reported food allergies over the time period studied.

"We used four different surveys, and to see an increase in food allergies in all of those surveys is very telling," said the lead author of the study, Amy M. Branum of the National Center for Health Statistics. "This is not just limited to one demographic or age group."

-- Shari Roan

Photo credit: Al Schaben / Los Angeles Times

FDA questions caffeine in alcoholic beverages

The Food and Drug Administration on Friday took the first step toward banning alcoholic beverages that contain caffeine, sending letters to nearly 30 manufacturers of such products giving them a month to prove that the products are safe.

The drinks have been a subject of recent controversy. The attorneys general of California and 17 other states have been pressing the FDA to take action against the products because they pose an unusual risk to young people. The caffeine in the drinks tends to mask the impairment produced by alcohol, leading to "increased risk-taking and other serious alcohol-related problems such as traffic accidents, violence, sexual assault and suicide," they wrote in a letter to FDA.

Lawsuits by the states have led the two largest manufacturers to alter the composition of their products or stop selling them. Last year, Anheuser-Busch removed caffeine and some other additives from the flavored malt beverages Tilt and Bud Extra. MillerCoors agreed to stop selling its major product, Sparks.

Under the federal Food, Drug and Cosmetic Act, a substance added intentionally to food (such as caffeine in alcoholic beverages) is deemed "unsafe" and is unlawful unless that particular use has been approved by the FDA or the substance is generally recognized as safe. Caffeine has not been approved for use in alcoholic beverages and the FDA "is not aware of any basis that manufacturers have to conclude that the use of caffeine is generally recognized as safe," Dr. Joshua M. Sharfstein, principal deputy commissioner of food and drugs, said in a news conference.

The caffeinated beverages, which are similar to their non-alcoholic counterparts, account for about 1% of the beer market, with annual sales of about $1 billion, according to Eric Shepard of the trade publication Beer Marketer's Insights.

Among the companies receiving the FDA letter were Joose Beverage of Los Angeles, Mix Master Beverage Co. of Stateline, Nev., and Blank Beverages Co. of San Diego.

More information is available at the FDA website.

-- Thomas H. Maugh II

Now 'Coke is it' on the London Underground

Ah, those London buskers: penniless music students sawing away at Vivaldi or earnest lads thrashing out Dylan classics as commuters throng down packed subway tunnels like so many frenetic gerbils.

Now, thanks to an arrangement between the Coca Cola Co. and the London Underground, a new but familiar offering may fill their ears as the holiday season approaches: a Coke jingle! So we learn from an article in Advertising Age.

"Coca-Cola has signed up buskers to sing its familiar festive jingle 'Holidays Are Coming' to a captive audience of the London Underground's 3.5 million daily Tube riders," the article says. "In a deal with the London Underground, Coca-Cola will sponsor the licensed busking scheme in the run-up to Christmas. Singers and musicians at stations around the network will be given sheet music or CDs so that they can perform the official holiday song."

Buskers won't be forced to sing the song, the article goes on to explain. But "incentives" will be offered. And you never know, maybe commuters would pay the buskers not to play the tune: "Please! Here's a quid! 'The Little Drummer Boy,' anything, I'm bloody begging you...."

The song, should you not recall, is rich with the seasonally appropriate refrain "Holidays are coming, holidays are coming, holidays are coming, holidays are coming" and also contains the phrases " 'Tis the season, it's always the real thing" and "Holidays are coming, always Coca Cola."

Buskers aren't universally happy with the idea, apparently. In an article in the London Evening Standard, 47-year-old jazz guitarist Michael Ball, a veteran busker, is quoted as saying, "Not in a million years will I play some Coke jingle.... What a daft idea."

--Rosie Mestel

Photo credit: George Frey  /Bloomberg News

The McRib is (almost) back! Now, let's read the fine print

Hey, Southern Californians, if you're in the mood for a patty made from pork, water, salt, sugar (dextrose to be exact) and a few preservatives -- a.k.a. a McRib sandwich from your local Golden Arches outlet -- you're in luck. Or soon will be. This just in:

"Featuring a boneless pork rib patty topped with pickles, onions and tangy BBQ sauce served on a fresh bakery roll, the legendary sandwich, which has not been available to customers in Southern California since 2006, will be offered on the menu for a limited time at participating McDonald’s restaurants. ..."

This was too good to resist. We had to check out the nutritional information. The upshot: 500 calories per sandwhich, 26 grams of fat and 980 milligrams of sodium. To be fair, it's a better bet in some ways than the Premium Crispy Chicken Club Sandwich, with 630 calories, 28 grams of fat, and 1,360 milligrams of salt.

That's not to say healthful food can't be had. It can. So, please, choose wisely. The Southwest Salad With Grilled Chicken seems like a fairly smart choice -- unless you're watching your sodium. And you should be. (More on sodium as it relates to blood pressure, food, labels, etc.) And salads are less likely to be ordered with a honking huge side of fries. A large size has 500 calories of its own. (We will not discuss the McFlurry.)

For help in making smart choices when eating fast food, here's some basic advice from helpguide.org.

And for the nitty-gritty on menu options at chain restaurants, fast-food and otherwise (all conveniently compiled in one place), there's CalorieCount.com. It's fascinating stuff. ...

Still, we're left wondering ...

"Legendary sandwich"?

-- Tami Dennis

Photo: Make good choices. They're available.

Credit: Christine Cotter / Los Angeles Times
 

Tsk, Kellogg. Did you think no one would notice?

-- First came the bold statement.

On boxes of Rice Crispies and Cocoa Crispies was the claim: "Now helps support your child's immunity." (The whole thing was in a bright yellow banner, with "immunity" rivaling the size of the product name.)

-- Then came the criticism and, of course, the media attention.

Here's Sunday's USA Today story: Critics blast Kellogg's claim that cereals can boost immunity. Said Kelly Brownell, director of Yale University's Rudd Center for Food Policy and Obesity, in that story: "By their logic, you can spray vitamins on a pile of leaves, and it will boost immunity."

And said the Boston Globe in an editorial today:  "Even if Cocoa Krispies and Rice Krispies were helpful against the flu, the side effects would be unacceptable in a nation where obesity is epidemic among children. Kellogg’s deserves no immunity from public scorn."

Apparently, the San Francisco city attorney got the ball rolling with a letter demanding some explanation. Here's "City takes aim at Kellogg's advertising," from the San Francisco Examiner.

-- Now comes the pullback.

Says today's press release: "Kellogg Company today announced its decision to discontinue the immunity statements on Kellogg's Rice Krispies cereals. ... While science shows that these antioxidants help support the immune system, given the public attention on H1N1, the Company decided to make this change. The communication will be on pack for the next few months as packaging flows through store shelves. We will, however, continue to provide the increased amounts of vitamins A, B, C and E (25% Daily Value) that the cereal offers."

Perhaps smaller companies can get away with such things.

-- Tami Dennis

Photo: All that's missing is the immune-boosting breakfast cereal. Credit: Los Angeles Times

Want to know just how sugary your kid's cereal is? What about your own?

Reese's Peanut Butter Cups rock. No question. And a whole lot of campers rightly appreciate a good s'more now and then. But then, these are desserts or snacks or treats or whatever you want to call them, not meals. Not for most people.

General Mills' Reese's Puffs and Kellogg's Smorz on the other hand pass themselves off -- quite blatantly -- as meals for children. So do many of their kin. And that irritates the researchers at Yale University's Rudd Center for Food Policy and Obesity.

It irritates them a lot.

They analyzed the marketing and nutritional content of breakfast cereals and found that even small kids are a big target for heavy marketing of colorful sweet snacks sold as breakfast.

They write in the home page of their new report, Cereal FACTS (Food Advertising to Children and Teens Score):

"Cereal companies speak to children early, often, and when parents are not looking. The least healthy cereals are the ones most aggressively marketed to children, frequently in misleading and deceptive ways. Food marketing to children negatively influences the dietary choices and health of society's most vulnerable citizens. Given the childhood obesity epidemic at hand, we need meaningful solutions and real change. We're here to give you the FACTS. It's time for action."   

The lowest-scoring cereal, nutrition-wise: Kellogg's Corn Pops - Chocolate Peanut Butter. To be fair, it tied with Quaker's Cap'n Crunch w/ Crunchberries.

The top-scoring cereal, from a nutritional standpoint: Kashi's Puffs -- 7 Whole Grains Puffs.

And the cereal most heavily marketed to children: General Mills' Cinnamon Toast Crunch.

For those consumers so weary of the bad news about children's cereals that they're beyond dismay, outrage, surprise or even mild indignation, just go straight to the search function. It lets you satisfy idle curiosity about your favorite confectionery-in-a-bowl ...

It's accessible from the home page.

Here's the full report.

And here's the press release with the report's highlights. Use it to test whether you truly no longer have the ability to be surprised on the topic. It notes:

"Cereals marketed directly to children have 85% more sugar, 65% less fiber, and 60% more sodium than cereals marketed to adults for adult consumption."

"The average preschooler sees 642 cereal ads per year on television alone, almost all for cereals with the worst nutrition rankings."

Still nothing? What about this: That reference to "Sugar content, 41%," under Reese's Puffs, really does indicate the proportion of the cereal that comes from sugar.

Not doing it for you? Try this one: Kellogg's Special K Chocolatey Delight has a sugar content of 29%. It's marketed to apparently well-trained, sugar-craving adults. 

-- Tami Dennis

Photo: A spoonful of cereal helps the sugar go down.

Credit: Los Angeles Times

Obesity doctors urged to back off soda tax

The annual gathering of the Obesity Society is underway this week in Washington, D.C., and that means the debate over taxes on sodas and other junk food is back on center stage.

A number of health organizations support a soda or junk food tax  -- raising the price on high-calorie, nonnutritious products -- to discourage people from buying them, as was reported here in Booster Shots last month. On Monday, however, the Obesity Society meeting was barely underway when the group Center for Consumer Freedom issued a statement urging health experts to view the obesity epidemic as an issue of personal responsibility that does not require government action.

In case you have forgotten, 33.3% of men and 35.3% of women are obese, according to the U.S. Centers for Disease Control and Prevention.

The statement from J. Justin Wilson, of the Center for Consumer Freedom, said: "The public health community seems dead-set on ever more regulation of our lives. The push for taxes on sugar-sweetened beverages is just the latest example of the disdainful belief that when it comes to matters of personal choices, the regulators know best. Government taxation should not be a tool for social engineering. Nor should it be used to penalize individuals for their personal food choices."

Social engineering?

Leaders of the Obesity Society, meanwhile, believe that having 72 million Americans overweight or obese with an associated $140 billion a year in extra medical costs requires some action beyond personal choice. The society's position statement on the epidemic does not mention a soda tax, but it addresses the issue of personal responsibility, saying obesity is not a character flaw but a complex disease involving genes, behavior and environment.

"While personal willpower and healthy lifestyle choices are part of the solution, a lack of willpower is not the cause, and personal responsibility alone is not enough to solve the problem," they say.

We'll have more news from the Obesity Society in Booster Shots this week.

-- Shari Roan

Photo credit: David McNew / Getty Images

Photo: Obesity prevalence among adults by state. Credit: Centers for Disease Control and Prevention