Editor's Note: This is the final installment of a 3-part series.
(MCT) FRAMINGHAM, Mass. − It was here in this thriving New England town that America's love affair with beef started to lose its sizzle.
It was here a half-century ago that obesity, high blood pressure and high cholesterol levels were all identified as risk factors for heart disease.
Indeed, it was here that scientists coined the term "risk factor," triggering the deluge of nutrition research that keeps beef from being "what's for dinner" in many households.
But Big Beef is fighting back.
The beef industry has funneled millions into a public relations campaign to cast steaks and burgers as something akin to health food − something you can eat every day, even twice a day.
In its yearlong study of the issue, The Kansas City Star found that Big Beef is:
Attempting to influence the next rewrite of the federal government's Dietary Guidelines in 2015. Big Beef wants them to include new research the industry paid for that promotes a beef diet intended to lower cholesterol and blood pressure. It also has paid for advertising and promotions, for example, getting lean cuts certified by the American Heart Association as "heart-healthy" food.
Spending even more money influencing the nation's dietitians, treating them to junkets and dinners. The industry arranges continuing education programs for nutritionists to spread the gospel immediately after beef-sponsored research is published in scientific journals.
Stifling criticism of food or its production methods through what are called "veggie libel" laws now in effect in 13 states. The laws were promoted by the American Feed Industry Association, whose members include large beef packers and animal pharmaceutical firms.
In an effort to maintain market share, the beef industry has gone on the nutritional offensive. Its own marketing research shows that concerns about nutrition, and fat in particular, remain a major disincentive to consumers from buying beef as voraciously as they did a generation ago.
The average American maxed out on beef in 1976, eating a record 67.9 pounds that year. Since then, beef consumption in the United States has fallen by about a third. Chicken surpassed beef as the nation's most popular meat nearly a decade ago.
"Everybody is competing for the same calories. The only way you can sell your product is by giving it a health aura," said Marion Nestle, a professor of nutrition and food studies at New York University and a regular critic of the food industry.
Despite a seemingly endless onslaught of medical research that implicates beef and other red meat in heart disease, cancer, diabetes and weight gain, the beef industry remains hopeful, citing marketing data that 94 percent of us eat beef at least once a month.
Industry-sponsored research, such as the diet study, is designed to "address important information gaps," said Shalene McNeill, a registered dietitian and executive director of nutrition research at the National Cattlemen's Beef Association.
Yet other nutrition experts remain skeptical of the continuing marketing push to burnish beef's public image.
"There's just so much evidence that beef is related to heart disease," said Michael Jacobson, executive director of the health advocacy organization Center for Science in the Public Interest.
The beef industry can "add a little confusion to the health message of eating less meat," Jacobson noted. "But their propaganda and lobbying and advertising haven't been that effective. They're fighting a rear-guard action."
That tectonic shift in America's diet attitudes arguably began in Framingham in homes like the Tostis'.
Dinner at the Tosti household always was a big production. Joe, Dorothy, and their five children gathered round the table every evening for a huge spread.
And in the 1950s and '60s that meant beef practically every other day _ roast beef, steaks and, true to their Italian heritage, meatballs.
That was then. Today, as has been the case for many health-conscious Americans, seafood, chicken, vegetables and even tofu have replaced most of the beef on the Tostis' table and on the tables of their adult children.
"You kids all got older and realized that wasn't a healthy diet," Dorothy Tosti said as she chatted recently with her two daughters, Barbara Tosti and Paula Cuneo, at the offices of the Framingham Heart Study.
Since 1948, the heart study has used this middle-class town about 21 miles west of Boston as a virtual research laboratory. The Tostis and thousands of other people − continuing to this day into a third generation − have been surveyed about their lifestyles and undergone regular comprehensive medical exams.
Early findings from the Framingham Heart Study, and from other research at that time, helped set off the nation's turbulent relationship with food and fat − and turned prime rib into a prime suspect.
The basic message has always been that having high cholesterol levels raises our risk of heart disease. And eating saturated fats − which are found in animal products such as meat and dairy − raises those levels.
Americans know a lot more about diet and health now than they did when the first studies started coming out of Framingham. And more nuanced nutritional messages are beginning to get through:
Not all fat in your diet is bad for you. Not all the cholesterol in your blood is unhealthy, and the cholesterol in foods such as meat and eggs generally isn't the biggest contributor to the cholesterol in your blood.
Red meats like beef no longer are Nutrition Enemy No. 1 − that role has been assumed by sugary drinks, white bread and french fries. Refined carbohydrates can wreak havoc with heart health.
But that doesn't mean red meat has won a total reprieve.
"Meat has got to be a rare experience, and whenever you can eat a plant protein over an animal protein, you're better off," is the advice William Castelli, former director of the Framingham study, gives his patients.
Big Beef, as might be expected, will give you different advice.
Beef is a different food from what it was in the 1960s, the industry maintains. It's a lot leaner. On average, a well-trimmed sirloin steak has 34 percent less fat, 17 percent less saturated fat, than it did 49 years ago.
Beef is not only a good source of iron, zinc and B vitamins, its high-quality protein helps maintain muscle mass and keeps you feeling full between meals. There's industry-sponsored and other research to back up these claims.
There's even a scientifically tested diet plan − Beef in an Optimal Lean Diet, or BOLD − to lower cholesterol levels in your blood while serving up modest portions of lean beef every day for lunch and dinner.
The BOLD diet has become the centerpiece of industry efforts to promote beef as heart healthy food.
And its development, The Star found, illustrates just how closely Big Beef is tied to both academic researchers and to the health professionals who advise people on what to eat. It also suggests just how sophisticated industry strategy has become for gaining beef some leverage in the federal Dietary Guidelines.
The BOLD diet is a direct response to another diet plan with a catchy acronym, DASH (Dietary Approaches to Stop Hypertension), that has become a mainstay of doctors and dietitians who want to lower their patients' blood pressure or cholesterol.
One of DASH's recommendations calls for curbing consumption of red meat.
The Star found that after DASH made its way into the federal Dietary Guidelines in 2005, Big Beef started plotting BOLD.
Doctors and dietitians were pushing people "toward choosing a dietary pattern that looked like DASH," McNeill of the cattlemen's association told members of the industry during a Jan. 19 webinar on BOLD that The Star accessed online.
"Why couldn't we also have, for lack of a better word, a 'beefy' (DASH) diet?" she suggested.
The Dietary Guidelines for Americans, first published in 1980 and updated every five years by the USDA and the Department of Health and Human Services, may be the nation's most influential food document.
The Guidelines are used to determine nutrition standards for school lunch programs, how much assistance is provided through food stamps, and what goes on food product labels. They're also used to write educational materials for schoolchildren and the curriculum of doctors and registered dietitians.
"They are the basis of everything where nutrition guidance is needed," said Robert Post, deputy director of the USDA's Center for Nutritional Policy and Promotion.
Big Beef set out to make the new guidelines friendlier to the industry.
Planning for BOLD began in 2006 "so that we can be prepared for future dietary guidelines and future advocacy," McNeill explained during the webinar. They're aiming for the next revision of the guidelines in 2015.
The Star found that to get the science it needed to back up a BOLD diet, the cattlemen's association approached Penny Kris-Etherton, a prominent Penn State University nutrition expert who had been on the association's dietary guidelines committee in 2000.
The cattlemen administer most of the research and promotion efforts funded through the industry's Beef Checkoff Program.
"We knew that she was open to beef," McNeill said during the webinar. "We went to her as a checkoff and said can you help us design a rigorous study of DASH and compare a beefy DASH diet to the DASH diet?"
Penn State researchers engineered BOLD to include amounts of calories, fat, cholesterol and fiber comparable to those in DASH.
But where the DASH diet skimps on beef, different versions of BOLD average 4 to 5.4 ounces per day. That means meatballs or chili for lunch and beef fajitas or pot roast for dinner.
Kris-Etherton put 36 people with above-normal blood cholesterol levels on a series of diets: BOLD, DASH and something called a "healthy American diet," which was low in beef but had more fat and less fiber than the other diets.
The researchers found that, compared to a healthy version of a typical American diet, BOLD diets lowered cholesterol just as well as DASH. BOLD diets with the most beef also lowered blood pressure.
Kris-Etherton said that the source of her funding doesn't affect how she conducts her research.
"As a scientist I wouldn't do that. I design studies that make sense, that follow dietary recommendations," she said.
There will be more findings coming out of the BOLD research, McNeill said, "to keep this story alive for longer than just the study of the day."
There have been plenty of skirmishes between Big Beef and federal officials who try to suggest that people eat less meat, including a recent a dust up over a "Meatless Monday" endorsement by the USDA that the industry managed to squelch. When the USDA released its Eating Right Pyramid for the first time in 1991, the beef industry wasn't comfortable with meat wedged near the top of the pyramid next to dairy, and just below fats, oils and sweets.
Shortly after the pyramid was announced, representatives of the National Cattlemen's Beef Association confronted newly appointed USDA secretary Edward Madigan at a meeting that had been scheduled well in advance.
"The beef people were after me," Madigan recalled. "This cowboy stands up and says, 'Where the hell did this come from?' "
The USDA quickly pulled the pyramid. After a flood of protests from health and advocacy groups, it was re-released the following year with minor revisions. Meat's position on the pyramid didn't change.
The first version of the Dietary Guidelines in 1980 advised people to "avoid too much fat, saturated fat and cholesterol."
"The goal, frankly, was to tell people to eat less meat," said Carol Tucker-Foreman, a consumer advocate who was then USDA assistant secretary for food and consumer services.
Beef producers, who didn't want the government telling people to avoid eating anything, realized that and mounted a counteroffensive.
"The Cattlemen went after the department and me," Tucker-Foreman recalled. "We were attacked as anti-farmer, as anti-food. They were infuriated that USDA was involved with it."
Soon after the guidelines appeared, then-Missouri Sen. Tom Eagleton, who was up for re-election, called Tucker-Foreman to her office.
"He was just furious. He pretty much made it clear to me that he was being beaten up by the cattlemen in Missouri, who were quite powerful. They were all over him because of the Dietary Guidelines. Much of it was stated to me as 'why are you doing this in an election year?' " she said.
When it comes to the Dietary Guidelines, Big Beef hasn't been so pugnacious in recent years, Tucker-Foreman said, but just as effective.
"They've very subtly gotten exactly what they want in them over the years," she said.
The guidelines have always emphasized eating lean meat and limiting consumption of fats, but they were slow to offer advices about specific foods.
It wasn't until the 2010 guidelines that these connections were made more explicit. The guidelines now include advice to substitute some of the meat in your diet with fish and seafood. And unlike the 2005 Guidelines, which talked about the DASH diet in general terms, the 2010 version makes it clear that DASH means eating less red meat.
As federal food programs have become tied more closely to the Dietary Guidelines, the panels of experts who write the recommendations "seem to be doing more for the public than the industry's bidding," Tucker-Foreman observed. "I think they've grown more and more responsible."
And more tied to scientific research, often paid for by food industries, The Star found.
In recent years, the cattlemen's association and state beef councils have funded nutrition scientists at more than a dozen universities, including the University of Colorado, Cornell, Tufts, Purdue and the University of Arkansas. In its 2011 fiscal year, the association budgeted $1.2 million for nutrition research and had committed about $504,000 of it to studies.
Dependence on industry may lead to biased research, said Lenard Lesser, a researcher at the Palo Alto Medical Foundation Research Institute.
When Lesser reviewed scientific articles about the health effects of soft drinks, juice and milk, he found that those funded by industry were almost eight times more likely to have favorable conclusions than the reports with no industry funding.
Lesser thinks food industries are likely to sponsor only studies destined to produce positive results, "and there are definitely ways to design a study to get a positive result."
Heather Leidy, an assistant professor of nutrition and exercise physiology at the University of Missouri in Columbia, said the Beef Checkoff Program had no say in how she conducted her research. A beef program grant helped pay for her research on how girls made it through the day when they skipped breakfast or started with a high-protein meal.
Leidy's study ended up showing that the girls ate fewer high-fat snacks in the evening when they had a high-protein breakfast of an egg and beef burrito or an egg waffle with a beef sausage patty compared with when they skipped breakfast or just had a bowl of cereal.
But no matter what the results, Leidy said, the Checkoff Program doesn't control what she publishes about her work.
"It can have a positive connotation. It can have a negative connotation. They know that," Leidy said. "They chose to do with it what they want as far as giving it to consumers."
However, one consequence of food industry funding is reluctance among nutrition researchers at universities to speak out on controversial issues, said Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health. Willett saw that happen when he tried unsuccessfully to rally his colleagues to oppose a powerful manufacturer.
"They were all silenced," he said.
The Star found that the Beef Checkoff Program also invests heavily in the nation's dietitians. Indeed, it spent close to $700,000 in its 2011 fiscal year to reach dietitians and others who influence what we eat.
The National Cattlemen's Beef Association and the checkoff program have been loyal sponsors of the dietitians' professional society, the American Academy of Nutrition and Dietetics, appearing regularly on the list of major donors − $10,000 or more annually − to its foundation.
In 2000, the academy's foundation gave the cattlemen its "Corporate Award for Excellence" in recognition of its long financial support and its work with dietitians.
Big Beef has good reason to seek them out. Registered dietitians are the health professionals who provide nutrition advice to the media, schools, hospitals and patients who have chronic conditions, such as heart disease or diabetes and have to watch their diets closely.
And it seems to be working.
Nestle, the professor of nutrition and food studies at New York University, said that the "dietetics profession has completely sold out to the food industry. The (food) companies are shameless and the dietitians eat it up."
The Star found that, even before the Penn State BOLD study made it into print on Jan. 1, the National Cattlemen's Beef Association had conceived a marketing campaign: The "BOLD Strategy" to "disrupt conventional thinking about beef and heart health," according to the association's webinar presentation. As soon as BOLD was published by the American Journal of Clinical Nutrition, press releases went out from the cattlemen's association, Penn State and the nutrition journal. The study was quickly picked up by the Reuters news service and a WebMD blogger. The online version of Shape magazine posted an article by one of the BOLD researchers.
The message the cattlemen were getting out, said Julie Sodano, the organization's food and nutrition communications director, is that "contrary to conventional wisdom, beef can be good for heart health."
On Valentine's Day this year, Kris-Etherton presented BOLD during a cattlemen's webinar for dietitians that provided them with continuing education credit.
"Because beef is a source of saturated fat, in many health professionals' minds it has been translated to the following message: You can't include red meat and beef in particular on a blood-cholesterol-lowering diet because you won't be able to meet saturated fat targets," she said. "You'll see today that's not the case."
Nutrition experts such as Nestle and others are quick to point out, however, that there's really nothing special about the cattlemen's BOLD plan. Any well-balanced diet that's low in fat and has the right amount of calories will be better than what most Americans eat. It's not surprising that BOLD might have health benefits.
"So much about what healthy diets are about is proportion," Nestle explained. "From my standpoint, I wish everyone would just relax and eat less."
The cattlemen's association also is involved in several dozen regional seminars per year for dietitians and other health professionals. One was held in May in Kansas City, Kan., when the Kansas, Missouri and Nebraska beef councils sponsored a three-day "Nutrition Adventure" for several dozen dietitians from about 10 states.
A visit to a cattle ranch near Tonganoxie, Kan., and a beef and wine pairing class at Kansas City's Pierpont's restaurant in Union Station were on their itinerary. Another recent seminar took New York University students and dietitians to a farm in the scenic Hudson Valley for a talk about the beef industry and a hay ride through the rolling hills."I think it's important to stress that the academy doesn't support any companies, products or services," said Jeannie Gazzaniga-Moloo, a member of the nutrition faculty at California State University in Sacramento and a spokesman for the American Academy of Nutrition and Dietetics. "All the propaganda out there by (the food) industry is not going to sway us."
About 5 percent of the academy's $33.9 million in revenues came from various food industry sponsors, not just beef, during the fiscal year that ended May 31, 2011.
Even Kris-Etherton is concerned that her message about a healthy, balanced diet may "get all mixed up" if people interpret the BOLD findings for lean beef as a license to eat any and all beef.
"What is the main beef people eat? High-fat hamburgers," she said. "Look at all the monster burgers out there with cheese and bacon, and 22-ounce Porterhouse steaks."
Yet that's something suggested by the cattlemen's association's own market research.
"Lean serves as a 'halo' word for beef, increasing the consumer's comfort in eating beef frequently," according to a recent cattlemen's report. Like companies that offer both light and higher fat ice cream, "smart marketers sell a lean product, and an indulgent product."
All of which exasperates nutrition researchers such as Barry Popkin at the University of North Carolina.
"Why don't they sell just lean beef? We'd be a hell of a lot healthier," Popkin said. "But that's not happening. They don't want to do that. Their business is to sell more beef."
Big Beef's fight to rebuild its public image isn't only being fought in academia and research laboratories. In recent years it has spilled over into the nation's courtrooms and state legislatures, where the industry is confronting criticism of food and production methods.
In September, Beef Products Inc. sued ABC News and several whistle-blowers for allegedly maligning its lean finely textured beef product, described as "pink slime" in news reports earlier this year.
The $1.2 billion suit was originally brought under South Dakota's "veggie libel" law, which makes it illegal to disparage "agricultural food products." The suit is pending.
South Dakota is one of at least 13 states with "veggie libel" laws, along with Alabama, Arizona, Colorado, Florida, Georgia, Idaho, Louisiana, Mississippi, North Dakota, Ohio, Oklahoma and Texas.
The laws were pushed by the American Feed Industry Association. The nonprofit trade group calls itself the "world's largest organization devoted to the business, legislative and regulatory interests of the U.S. animal feed industry and its suppliers."
The American Feed Industry Association distributed drafts of model veggie libel bills to numerous states.
The "pink slime" case is "exactly the kind of situation these laws were designed to address," said Steve Kopperud, a senior vice president at the association.
He said the goal behind the legislation was to force activists to think twice about their attacks on the food industry and to hold animal rights groups accountable for their claims, Kopperud said.
The laws prohibit "knowingly make any materially false statement about an agricultural product" and allow food producers to recover damages.
Texas' law was used to sue Oprah Winfrey in 1998 over statements made on her talk show by an animal rights activist, and Winfrey's statement that the comments "just stopped me cold from eating another burger."
Winfrey spent millions fighting the suit and finally won when the court ruled that the beef industry hadn't proved its case, although critics contend the ruling left the issue of its constitutionality murky.
Janet Riley, a vice president at the American Meat Institute, acknowledged that on their face, such laws may sound "counterintuitive" for a meat industry that is trying to be more transparent with consumers.
But Riley added, "Look what happened with lean finely textured beef. We should be able to reasonably expect fair treatment, and this industry did not get fair treatment on lean finely textured beef at all."
Big Beef's battle to reclaim its place on America's dinner table is hardly over.
To be sure, the Tostis are still eating beef in Framingham; it's served at some family gatherings. However, health concerns have kept it from recapturing that central place it used to have in their diets.
Daughter Barbara Tosti eats beef two or three times a month. Usually though, it's fish or chicken.
Her sister, Paula Cuneo, serves beef regularly once a week. "My husband is not crazy about red meat. He feels healthier when he has salmon, instead of steak tips, which I love," she said.
One of their brothers is married to a vegetarian. "Poor thing, he's so thin," Barbara Tosti said. Another brother is always on a diet. And the third is married to the daughter of a doctor, so they watch what they eat.
For their parents, Joe and Dorothy Tosti, it's that decision everyone faces between what might be good for us, and what's really good.
"Now, my choices are more scallops, fish," Joe said. "I might as well eat something that helps me."
"He's so saintly," Dorothy answered. "And I'm so devilish. I order the most expensive steak on the menu."
(c)2012 The Kansas City Star (Kansas City, Mo.)
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