Friday, July 21, 2017

Prominent nutrition researcher who helped develop and researched failed NuVal nutrition scoring system: "I would have done things very differently"

Leonard H. Epstein PhD, SUNY Buffalo (source)
Via a November 19, 2014 press release, Eatingwell Magazine Partners With Nuval®:
The NuVal Nutritional Scoring System is a unique food labeling system which ranks all foods between 1 and 100; the higher the score, the better the nutrition. NuVal scores can be found in nearly 2,000 supermarkets, as well as in schools, hospitals and other health facilities. The NuVal System is endorsed by the American College of Preventive Medicine (ACPM), and a recent Harvard School of Public Health study showed that those who ate food with more favorable NuVal Scores had a lower risk of chronic disease and had a better chance of living a longer, healthier life. NuVal LLC is a joint venture formed in 2008 by Topco Associates, LLC, and Griffin Hospital. To learn more about NuVal, visit www.nuval.com | Facebook: https://www.facebook.com/NuVal | Twitter: @NuVal.
Per a story I broke last week, the director of NuVal LLC in Quincy, MA, wrote me that the company has terminated its supermarket scoring system, so presumably the "nearly 2,000 supermarkets" that once used it are making other plans.

Click the links in the above press release and you'll get the picture.

Per Tops to scrap NuVal nutrition ratings criticized as 'fatally flawed,'
Tops Markets is getting rid of a controversial nutrition ratings system it has used to help customers make food purchasing decisions...Two other grocery chains have dropped NuVal recently, including California-based Raley's and Massachusetts-based Big Y, which told the Yale Daily News the system was "out of date."
...Leonard H. Epstein, a distinguished professor and chief of behavioral medicine at the University at Buffalo medical school, served on NuVal's scientific advisory board. He said he didn't always agree with the creators'  decisions, the system's creators didn't always take the board's advice and that, if he had been one of the system's makers, he "would have done things very differently...If you don’t believe in the criteria that NuVal uses, then the algorithm would not work to guide you to healthier eating," he said.
Presumably Dr. Epstein speaks from authority because from 2012-2014 NuVal-related research provided him with NIH grants totaling $1,670,444:

 

Via a public records request, here's Ms. Christmann's complete Q&A with Dr. Epstein; page down for a copy of the original correspondence. 

Hi Samantha:

I am not one of the creators of NuVal, but rather was a member of their scientific advisory board. As with any of the scientific advisory boards, sometimes the leadership takes your advice and sometimes the leadership does not take your advice. David Katz from Yale created the system, not me or any other members of the advisory board. I'm sure each of us agrees with some aspects of NuVal and not with others.

1) How do you respond to people who say the NuVal system is outdated and "fatally flawed"?

NuVal is one among many nutrient profiling systems. The idea of a nutrient profiling system became popular because most consumers have a very difficult time making sense of information on the nutrition label when purchasing food, so different groups attempted to simplify decision making by using numbers (either continuous or categorical) or color-based systems. There is still quite a lot of activity in this area.

Each nutrient profiling system uses different criteria for rating foods. NuVal does not publish the full algorithm but does indicate what characteristics of foods increase the rating, and what characteristics of foods decrease the ratings. The secret, that no one outside of NuVal knows, is the specific weights given to characteristics of foods. If you don't believe in the criteria that NuVal uses, then the algorithm would not work to guide you to healthier eating. The criteria they use is based on the general USDA recommendations, but if you were eating a paleo diet NuVal would not be useful, for example. Guidelines for healthy eating and what types of foods to avoid evolve as new research is published. I have not been involved on the scientific board of NuVal for many years, but it is my impression that the algorithm has been changing to keep track of the science, but that's something you would have to check with NuVal.

2) How is it that brownies and ice cream can be scored higher than canned fruits and vegetables?

There are two ways to use any nutrient profiling system, whether it is NuVal or another system. First, these systems can help you choose among foods within a class of foods. For example, if you were going to buy cereal, NuVal might be helpful in identifying a low-fat, low-sugar cereal that is nutrient dense. Similarly, if you were going to buy yogurt, or ice cream, NuVal could help you identify the healthiest option based on the criteria they use to rate foods within that class of foods. In terms of your question, can NuVal help identify the healthiest ice cream, or the healthiest fruit or vegetables. Once again, if you believe the criteria they are using is correct, then the NuVal rating would be helpful.

In addition, NuVal could help consumers make decisions about whether they wanted to increase purchasing of a class of foods versus another class. For example, if you wanted animal protein as the centerpiece of a meal, NuVal could help decide whether fish, fowl or red meat were better choices. Even within one category, like fish, NuVal could help you decide what type of fish is the healthiest.

Since NuVal scores many foods, there may be some brownies or ice cream that score higher than some canned fruits or vegetables, but that does not mean that as a category brownies or ice cream are healthier than canned fruits or vegetables. The backlash in 2012 against NuVal was for brownie mix, but not brownies. There are also variations of low-fat, low-sugar ice milks that are better choices than standard ice cream, and could have higher scores than canned vegetables in syrup that has a lot of sugar, or canned vegetables that have a lot of salt. There are also many canned fruits not in syrup or canned vegetables with low amounts of sodium that would have higher scores.

When comparing brownie mix with NuVal score of 22 and mandarin oranges in syrup with score of 7, neither of these are very healthy choices for dessert or a snack, and trying to make distinctions between them will not lead to a healthier diet. A much better choice than mandarin oranges in syrup would be an actual mandarin orange, or an orange. You would see large differences in NuVal or any nutrient profile score for that, more relevant, comparison.

3) Do you still stand behind the system you helped create?

Once again, I was on the scientific advisory board, and provided advice to Katz and his group, some of which they took and some of which they did not take. I did not agree with all of their decisions. If it had been my creation, I would have done things (very) differently.

A more relevant question is whether I think nutrient profiling systems are useful. I do, but only when I agree with the assumptions of the algorithm. Nutrition science is continually evolving, and nutrient profiling systems need to evolve with the science. A good example is the shift in emphasis from fat in the diet to added sugar in the diet.

I don't think any nutrient profiling system is perfect, and you will find anomalies of the type you noted above in any system (how can this food rate higher than that food - not in my book). They were designed to help consumer make healthier choices, and that should be the final arbiter of whether they are useful. Do consumers who use a specific nutrient profiling system purchase healthier foods that consumers who just use the nutrition label? These systems can help, but they can also be improved.


Friday, July 14, 2017

Widely-promoted NuVal nutrition scoring system discontinues its supermarket shelf tag system [UPDATED]

7/21/17 UPDATE: Prominent nutrition researcher who helped develop and researched failed NuVal nutrition scoring system: "I would have done things very differently"

#####

Yesterday I blogged an item attempting to crowdsource information about which supermarkets continued to use NuVal, a widely-promoted nutrition scoring system that was developed by some of the most prominent names in nutrition science:


What sparked my interest was that the website of NuVal LLC, the Quincy, MA, company that markets the system, had gone bare bones, and the company's Facebook and Twitter accounts were MIA.

This afternoon I got this e-mail from NuVal LLC director, Anne Bernier -- emphasis added.
Peter,

As you well know, the health and wellness space has evolved significantly since the Nuval Shelf Tag program was introduced, and the choices for consumers to obtain health and nutrition information online has grown exponentially.

In light of these insights and feedback from our customers, we have discontinued the Nuval Shelf Tag Program. NuVal will continue to support the popular NuVal Attributes system and will continue to work to find new and innovative ways to help consumers make informed choices about the foods they purchase and consume.

The image from the cached page you submitted is out of date and is consequently no longer posted on our website. In response to your inquiry regarding current participants, please know that we no longer publish this information.
Regards, Anne Bernier
Here's the cached page:





Thursday, July 13, 2017

Crowdsourcing re: NuVal nutrition rating system -- if you shop at these supermarkets, I can use your help [UPDATED]

UPDATE, July 14, 2017: Widely-promoted NuVal nutrition scoring system discontinues its supermarket shelf tag system
#####

Not including the three lilac-shaded logos, do you shop at any of these supermarkets?


If so, would you help me report a story? I'm trying to find out if they still use a nutrition rating system called NuVal.

Based on my experience, when it comes to getting information from supermarket corporations, they're like Fort Knox. Perhaps not surprisingly, I'm having trouble getting answers from the media relations reps of these companies.

It occurred to me they might be more likely to respond to customers, hence this outreach. If you're game, just write and ask if they're still using NuVal and forward the results to me at peter.heimlich@gmail.com

For more background, read on, but if you want to cut to the chase, here are the e-mail addresses and website contact forms.

Alexander's Highland Market: http://alexandersmkt.com/contact
Cash Wise: https://www.cashwise.com/contact-us
Coborn's: https://www.coborns.com/contact-us
Festival Foods: mealtimementors@festfoods.com
Food City:https://www.foodcity.com/contactus/
Hy-Vee: ProductInquiry@hy-vee.com
Lund &Byerlys: Contact@LundsandByerlys.com
Nojaim Bros: http://nojaimbrosmarcellus.com/contact  
Price Cutter: https://www.pricecutteronline.com/contact-us/question-or-comment
Reasor's: https://reasorscontactus.survey.marketforce.com/
Scolari's and Sak'n Save: http://www.scolaristores.com/contactus

Why is this of interest?

Via a July 29, 2016 Huffington Post column by celebrity doctor David L. Katz:
Perhaps the single, proudest achievement to date of my 25-or-so-year career in public health was leading the development of the Overall Nutritional Quality Index algorithm, or the ONQI®. That effort, which was completed in 2006, involved an illustrious team of colleagues from throughout North America, who worked closely with my staff and me for two years.
He wasn't kidding about an illustrious team:



Back to Dr. Katz's column:
When we were done, we had a sophisticated formula that incorporated more than 30 nutrient properties of a food (including glycemic load), weighted each one for its health effects, and generated a number on a continuous scale, the higher that number, the higher the overall nutritional quality of the food. My original intent had been to give the system to the FDA. When that didn’t work out, because the system went beyond what the agency was willing to do at the time (and perhaps even now), a private company called NuVal, LLC was formed to license the program into supermarkets. The NuVal® system uses the ONQI to rate all foods on a scale from 1 (least nutritious) to 100 (most nutritious). The ONQI has been providing nutrition guidance to shoppers in nearly 2,000 supermarkets throughout the U.S...
Here's the deal.

Click on the links in his column and you'll discover that they lead to dead pages on the website of NuVal LLC (based in Quincy, MA).

Further, at this writing NuVal LLC's Facebook and Twitter accounts are MIA and the company's last blog post was on December 21, 2016.

There have been other problems at the company. According to a Buffalo News article last year about three supermarket chains that dropped NuVal -- Topps, Big Y, and Raley's -- the system has been criticized as "fatally flawed."

source

This week I sent e-mails to NuVal LLC director (and self-described lemonade maker) Anne Bernier and left her a voice message. (When I phoned the company, my call was routed to her voice mail by a recording. If there's a human being now working at the company, I haven't spoken to them.) I haven't gotten any response.

The graphic of the logos at the top of this item above is a screenshot from a recent (now missing) page listing NuVal LLC's client supermarkets. I've sent inquiries to the media relations department of a number of them and only one has affirmed (the lilac-highlighted Price Chopper group) that they're still using the NuVal system.

In an attempt to get the other companies to respond, I thought I'd try this crowdsource approach. (It could also be a fun journalism experience.)

Any/all help is appreciated. Questions? Just ask.

Wednesday, July 12, 2017

Anti-choking device inventor claimed the president of Turkey relies on his invention -- but the product's Turkish distributor says that's "completely lies and fictions...we condemn this ugly news"



Via my June 12 item:
Is an anti-choking plunger device called the Dechoker part of the medical protocol for the President of the United States, "both on land and aboard Air Force One"?

That's what a distributor of the product claims.
Via my June 21 item, I received this e-mail from Alan Carver, inventor of the Dechoker and CEO of Dechoker LLC in Concord, NC -- that's him in the above video:
From: Alan Carver <acarver@dechoker.com>
Date: Tue, 20 Jun 2017 20:37:40 -0400
Subject: Re: blogger inquiry
To: Peter M. Heimlich <peter.heimlich@gmail.com>

Peter,

We just spoke to the Director of Operations in Europe - our units are in the President's house and airplane for the President of Turkey, not the United States. We have asked Dechoker Spain to rectify the statements on their website.

Thank you for the notification.

Best,

Sent from my iPhone
source

Here's an e-mail I received last night from an executive at Ottoped, the Turkish distributor of the Dechoker, and related follow-ups, all unedited. (Sean Pittman is Dechoker LLC's Director of Strategic Development.):



It's unclear why Carver went on the warpath against me because I attempted to fact check his claim.

It's also unclear what he meant by "I am sure you will edit this comment like you did 2 weeks ago," but click here for our complete prior correspondence that culminated in him inviting me to participate in a medical seminar.

I politely declined.

Thursday, June 22, 2017

Via NBC Bay Area, another chest thrusts choking rescue wrongly attributed to "the Heimlich" -- will they publish a correction? [UPDATED]


In a June 18, 2017 Sunday Times media watchdog column, John Burns at the paper's at the paper's Dublin bureau reported about my successful journalistic odyssey to obtain published corrections to numerous factual errors in obituaries about my dad, for example:
(The) headline (in the Irish Sunday Independent's obit) was wrong. “Henry Heimlich — surgeon who invented chest thrust,” it said.
(The) Heimlich manoeuvre is an abdominal thrust, performed below the rib cage. Big deal? “As it happens, there’s an ongoing debate in the medical community about whether chest thrusts are more effective and safer than the Heimlich,” Peter (Heimlich) says. “Also, my father went to considerable effort to discredit the use of chest thrusts when someone’s choking."
Speaking of chest thrusts, based on a dashcam video of a choking rescue in Rochester, NY that went viral, a couple days ago I posted an item that raised this question.

How many choking rescues in which the rescuer used chest thrusts have been wrongly attributed to "the Heimlich"?

Coincidentally, via an NBC Bay Area story that aired the same day, 12-year-old Rylie Palfalvi of Pleasanton, CA, described how she successfully performed chest thrusts on her bushy-haired younger brother Max who was choking on popcorn.

But newsman Garvin Thomas incorrectly reported that Max's intrepid sis "did the Heimlich."



I certainly don't expect most people, including general assignment reporters [see update below], to be aware of the distinction, but as I told the Sunday Times, why not get it right?

Plus why not give Ms. Palfalvia credit for perhaps being on the cutting edge of lifesaving first aid?

With that in mind, I'll send a request for a published correction to NBC Bay Area and will report the results here. [Page down for the results.]

For more information on the topic of chest thrusts vs. "the Heimlich," click here.

Finally, re: my dad's obit in the Irish Sunday Independent -- aka The Sindo -- here's the headline before my corrections request...


...and here's the current version:


UPDATE (6/24/17):

A few days ago I e-mailed my item and supporting information to Garvin Thomas at NBC Bay Area which resulted in a friendly, productive correspondence and the addition of this paragraph at the beginning of his story:


source

Also, he set me straight about this: 
And since we're having fun with accuracy, I'm not a general assignment reporter. I produce a feature segment (Bay Area Proud) that highlights stories of kindness, generosity, and success. And, yes, it's as great a job as it sounds.
Thank you, Garvin -- and regret the error!

Wednesday, June 21, 2017

Clarification from Dechoker inventor -- his anti-choking device is NOT being used for U.S. president, but for Turkish president Erdoğan [UPDATED]

UPDATED JULY 12, 2017: Anti-choking device inventor claimed the president of Turkey relies on his invention -- but the product's Turkish distributor says that's "completely lies and fictions...we condemn this ugly news"

If Turkey's brutal president Recep Tayyip Erdoğan chokes on this chicken leg, he'll be treated with the Dechoker, according to the device's inventor

Last week I reported If the U.S. President has a choking emergency, will he be treated with this anti-choking plunger? about this page I found on the website of Dechoker Spain, based in Madrid.


According to Google Translate, here's the headline in English: The Secret Service of the United States protects The President with Dechoker both on land and aboard Air Force One. The identical text is on the photo of President Barack Obama next to Air Force One. On the top right corner is the badge logo of the U.S. Secret Service.

When it comes to accurate reporting, journalists would do well to heed this advice from President Ronald Reagan: Trust, but verify.

And who better to verify than Alan Carver, inventor of the device and CEO of Dechoker LLC in Concord, NC, near Charlotte?

In response to my inquiry, here's what I received from him yesterday. 
From: Alan Carver <acarver@dechoker.com>
Date: Tue, 20 Jun 2017 20:37:40 -0400
Subject: Re: blogger inquiry
To: Peter M. Heimlich <peter.heimlich@gmail.com>

Peter,

We just spoke to the Director of Operations in Europe - our units are in the President's house and airplane for the President of Turkey, not the United States. We have asked Dechoker Spain to rectify the statements on their website.

Thank you for the notification.

Best,

Sent from my iPhone
If any members of the security force of Turkey's brutal president Recep Tayyip Erdoğan are reading this, if you're not busy instigating bloody brawls with peaceful protesters, here's a training video featuring Mr. Carver.


Tuesday, June 20, 2017

Choking first aid: Are New Zealand, Australia, and a guy in Rochester, NY, ahead of the curve?

As Sidebar readers know, medical authorities in New Zealand and Australia don't recommend the Heimlich maneuver (aka abdominal thrusts) for responding to a choking emergency.

Per Aviva Ziegler's 2009 documentary, in the Land Down Under my dad's namesake treatment is considered unproven and potentially harmful.

That opinion was echoed in the American Heart Association's 2005 guidelines which state, "Life-threatening complications have been associated with the use of abdominal thrusts."

Instead Kiwi and Oz first aid experts recommend back blows and chest thrusts.

The latter treatment was first proposed in a 1976 study by my friend Dr. Chuck Guildner of Everett, Washington. Click here for more about that and related information.

Yesterday, Radio Live New Zealand aired Do you know what to do when a child is choking? which included this clip of first aid instructor Billy Doyle explaining the back blows followed by chest thrusts protocol. To my knowledge it's the first time the chest thrusts treatment has been described in a video.



As it happens, "the Heimlich" has been credited with saving choking victims when, in fact, the rescuer performed -- yep -- back blows and chest thrusts.

For example, in January a dashcam video of a dramatic choking rescue in Rochester, NY, was picked up by numerous news outlets.

Via the original YouTube video, here's the description:

source

Here's the video: