Do McDonald's burgers and fries belong in hospitals?

Talk about your mixed messages. Go to grab a bite in some hospitals and you will see cafeterias offering salad bars and other healthful fare right next to McDonald's outlets offering burgers and fries.

Nearly two dozen hospitals that host McDonald's restaurants just got a letter from an advocacy group asking them to evict their fast-food tenants and to "stop fostering a food environment that promotes harm, not health." The group, Corporate Accountability International, is leading a larger campaign to get McDonald's to stop marketing to kids. That effort has been endorsed by nearly 2,000 health professionals, some of which work at the very hospitals still housing the fast food giant, says campaign director Sara Deon.

"We hear from physicians saying kids come in for their diabetic check-ups and they hear the parents saying 'If you are well-behaved, we'll take you for a treat at the McDonald's down the hall,' " Deon says. And McDonald's doesn't just get business in these deals: It gets a healthy image boost, Deon says.

But breaking these ties is easier said than done, NPR reports. In many cases, long-standing contracts -- created before hospitals adopted what some call a "culture of wellness" -- keep unwelcome food vendors in place. Doctors at prestigious Cleveland Clinic tried to oust McDonald's back in 2005; it is still there - even though one of the doctors who led the effort is now the hospital's CEO.

McDonald's says it still has 27 outlets in hospitals (nine fewer than reported in 2005) and that it offers plenty of balanced choices. "Today, we offer more variety than ever in our menu and we trust that our customers will make the appropriate choices for them, their families and lifestyles," a spokesperson tells NPR.

In all fairness, McDonald's isn't the only seller of fatty, salty or sugary fare in hospitals: Pizza Hut, Subway, Chick-fil-A, Starbucks and other chains have in-hospital outlets. And a review by the vegan advocacy group Physicians Committee for Responsible Medicine found several hospitals that gave space to multiple fast food outlets and also had staff cooks serving such dishes as fried chicken and country-fried steaks in their own cafeterias.

Deon admits her group is picking on McDonald's because it is big: "They profit most and they lead the way."

Consumers often ignore food allergy labels: study

The different allergy labels in common use may be confusing consumers instead of helping them decide whether to buy a food product, a new Canadian study shows.

"We should narrow (various allergy labels) to only one which will be clear," said Dr. Moshe Ben-Shoshan, a professor of allergy and immunology at McGill University Health Center in Montreal, who worked on the study.

An estimated 2.5 million Canadians and 15 million Americans suffer from food allergies, which can cause reactions ranging in severity from itchiness and vomiting to breathing problems, loss of consciousness and even death.

Allergy labels are governed in the U.S. by the Food Allergen Labeling and Consumer Protection Act of 2004, and in Canada by the Food Allergen Labelling Regulations, a new version of which will go into effect in August.

Although all these labels warn that a product could harm a person with allergies, they present that message in various ways. Researchers found that some labels are less effective than others in helping consumers to avoid potentially dangerous foods.

Ben-Shoshan's team recruited more than 2,400 subjects from the general public and from allergy registries and advocacy groups for the new study, conducted between May 2007 and March 2009. The work was funded by Health Canada, a federal agency, and AllerGen, a network of allergy experts, and published in a letter to the editor in the Journal of Allergy and Clinical Immunology.

The participants included "directly affected" households in which at least one family member had a food allergy, as well as "indirectly affected" households which supply food to others with allergies such as students and preschoolers.

They answered questions about their likelihood of buying a food product depending upon various types of allergy alerts, including "may contain" foods to which people are allergic, "manufactured in a facility" that processes such foods, and "not suitable" for people with food allergies.

Researchers found people were more likely to ignore warning labels if their households were directly rather than indirectly affected by food allergies. Those who belonged to advocacy groups were most vigilant about their food purchases.

About 44 percent of directly affected consumers from the general public said they would buy a product which warned it "may contain (peanut/tree nut/sesame)." Only about 10 percent of those recruited from allergy associations, and 16 percent of consumers indirectly affected by food allergies, said they would buy a product with this label.

Across all groups, the "not suitable" label had the greatest effect in preventing purchase of a product. Participants in households were less vigilant if only adults had a food allergy than if a child had an allergy.

TAKING MORE PERSONAL RISKS?

The finding that consumers were less diligent about heeding labels when buying for their own households surprised researchers, said Ben-Shoshan.

"They may feel more responsibility when preparing food for other people," he explained. Food purchases for an allergic person in one's own household are also made much more frequently, which might make it harder to exercise caution, he added.

Adults may indeed take more chances with their own health than they would if the food allergy involves a child or someone outside their household, agreed Dr. Rauno Joks, chief of allergy and immunology at SUNY Downstate Medical Center in Brooklyn.

"They think they can get away with a certain amount (of restricted foods) before having a reaction," said Joks. "I really caution them not to take chances with their health."

The greater motivation to heed allergy labels among advocacy group members highlights the need for more awareness, he told Reuters Health.

"The more educated people are, the more likely they are to be proactive in avoiding food allergens," said Joks, who was not involved in the study.

The findings in Canada should apply to the United States, given their similarities in labeling standards and public awareness, he added.

The disorder appears to be on the increase in several countries, especially among children. According to a 2008 study by the Centers for Disease Control and Prevention, the rate of food allergy rose 18 percent among children between 1997 and 2007.

7 FOOD INGREDIENTS MOST PRONE FOR FOOD FRAUD

Olive oil, milk, honey, saffron, orange juice, coffee and apple juice are the seven most likely food ingredients to be targets for intentional or economically motivated adulteration of food, or food fraud, according to analysis of the first U.S. public database created to compile information on risk factors for food fraud published in the Journal of Food Science.

The database was created by the U.S. Pharmacopeial Convention (USP) and provides baseline information to assist interested parties in assessing the risks of specific products. It includes a total of 1,305 records for food fraud based on a total of 667 scholarly, media and other publicly available reports.

Food fraud is a collective term that encompasses the deliberate substitution, addition, tampering or misrepresentation of food, food ingredients or food packaging, or false or misleading statements made about a product for economic gain. A more specific type of fraud is the fraudulent addition of nonauthentic substances or removal or replacement of authentic substances without the purchaser’s knowledge for economic gain of the seller.

According to the authors of the paper, food fraud may be more risky than traditional threats to the food supply because the adulterants used in these activities often are unconventional and designed to avoid detection through routine analyses.

“The vast majority of food fraud is primarily technical and economical," said John Spink, associate director with the anti-counterfeiting and product protection program at Michigan State University. “However, there are some cases where there can be serious health consequences as illustrated when melamine was added to infant formula and pet food in order to falsify the level of protein content in these products."

The database provides information that can be useful in evaluating current and emerging risks for food fraud. In addition to providing a baseline understanding of the vulnerability of individual ingredients, the database offers information about potential adulterants that could reappear in the supply chain for particular ingredients. For example, records in the database regarding melamine as an adulterant for high-protein-content ingredients date back to 1979.

“Perhaps if this information had been readily available to risk assessors before the 2007 and 2008 incidents of melamine adulteration and wheat gluten and milk powders, it could have helped risk assessors anticipate these adulteration possibilities," the authors wrote. This information also could have stimulated research aimed at developing new methods to measure protein content, which could signal adulteration with melamine and other unexpected constituents—an effort that has only recently gained substantial interest.

“Food ingredients and additives present a unique risk because they are used in so many food products and often do not have visual or functional properties that enable easy discrimination from other similar ingredients or adulterants throughout the supply chain," the authors wrote. Glycerin, for example, is a sweet, clear, colorless liquid that is difficult to differentiate by sight or smell from other sweet, clear, colorless liquid syrups—including toxic diethylene glycol, which in the past has been substituted for glycerin with deadly consequences. Diethylene glycol has been fraudulently added to wines, and also used as an adulterant of glycerin used in pharmaceuticals.

In addition to identifying specific food ingredients and food categories vulnerable to adulteration, the researchers also analyzed the types of analytical detection methods used to discover the fraud, as well as the type of fraud using three categories: replacement, addition or removal. They found 95% of records involved replacement—an authentic material replaced partially or completely by another, less expensive substitute. Examples include partial substitution of olive oil with hazelnut oil, substitution of toxic Japanese star anise for Chinese star anise, and the partial replacement of low-quality spices with lead tetraoxide or lead chromate to imitate the color of higher-quality spices.

Merchandisers who emphasize convenience in value-added offerings will have an advantage

Retailers face an increasingly competitive market for fresh foods and those merchandisers who emphasize convenience in value-added offerings will have an advantage in the marketplace.

That was one key concept explored in an April 3 web seminar by Chicago-based Nielsen and Nielsen Perishables.

The event, hosted by Jeff Gregori, vice president of consumer and shopper practice, Nielsen retail and Sherry Frey, vice president of account services, Nielsen Perishables Group, also exlored how retailers can use center-store brand power in joint promotions with the produce, meat, bakery and deli.

“There are huge growth opportunities for the fresh market from where we have been and where we see it going,” Gregori said.

Total fresh food retail sales in the U.S. are estimated by Nielsen at $216 billion, Gregori said. The perishables departments (deli, produce, meat, bakery and seafood) have been gaining contribution to total store sales, Nielsen statistics show. The share for the fresh segment is up 2% since 2006 to nearly 30% of the store,

The speakers suggested retailers can create “meal solution centers” that cross-merchandise fresh and center store categories.

Gregori said U.S. consumers are focused on food, and food at home. He said food and cooking websites are attracting between 67 million and 91 million unique visitors per month. The Food Network attracted a viewership of 1.2 million people in the fourth quarter of 2011, and cookbook sales are outperforming the general book market by a wide margin.

“Shoppers are much more engaged and interested in food preparation,” he said.

In fact, Nielsen research reports that 50% of households fall into either the “foodie” category (extremely interested in cooking) or the “young family cook” (interested in cooking but values convenience). Nielsen research reveals “foodies” spend nearly twice as much on fresh vegetables as the average household.

Reflecting the interest in fresh food, consumers now have access to fresh foods in all channels and all forms, such as premium salads in quick-serve operations, or sushi in a Walgreens.

“There really are no rules, it is just about who your shopper is and what their needs are and delivering on that need,” Gregori said.

The strongest sales growth in fresh produce categories has been seen in organic produce, which posted double-digit dollar growth and positive volume growth on the fourth quarter of 2010. Nielsen reports that the value-added vegetable category saw a 7% increase in dollars and volume.

Other retail outlets

Gregori said that grocery stores control 71% of fresh produce sales, compared with 13% for mass merchandisers, 9% in club stores and 7% in all other channels.

Looking ahead, Gregori said Nielsen project a decline for grocery stores’s market share of all fresh food, from 64.2% in 2011 to 62.2% in 2015. Club stores are expected to increase their market share for fresh food from 9.7% in 2011 to 11.2% in 2015. Mass merchandisers will also grow their share of total fresh sales, from 13.5% in 2011 to 14.4% in 2015.

“While there is a lot of upside for club and mass in the future, it is going to be tough in some of these markets where they have a real tough competitor among leading grocers,” he said.