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The following comes to us from Yahoo News (used with permission)…
From Yahoo—Finance, Sugar and Heart Disease
The food industry has funded research in an effort to influence nutrition science and health policy for more than half a century, new research out Monday has found.
It’s no secret that industry funds such efforts today: An investigation in June, for example, showed how the National Confectioners Association worked with a nutrition professor at Louisiana State University to conclude that kids who eat sugar are thinner than those who don’t.
An article by University of California-San Francisco researchers, published Monday in JAMA Internal Medicine, shows how far back such efforts go: In 1965, the Sugar Research Foundation, the precursor to today’s Sugar Association, paid Harvard scientists to discredit a link now widely accepted among scientists—that consuming sugar can raise the risk of cardiovascular disease. Instead, the industry and the Harvard scientists pinned the blame squarely, and only, on saturated fat.
Using correspondence from medical library archives as well as reports, symposia notes and other documents, the researchers traced SRF’s concerns over sugar’s link to heart disease to 1962, when its scientific advisory board issued a report concluding that “research developments in the [coronary heart disease] field should be watched closely.”
By July 1965, after more research supporting the link had been published, SRF’s research director John Hickson was knocking on Harvard’s door, looking for scientists to refute the findings.
He found them.
That summer, Fredrick Stare, chair of the nutrition department in Harvard’s School of Public Health and by then also an ad hoc member of SRF’s scientific advisory board, began overseeing two Harvard colleagues in what was dubbed Project 226.
For a total of $6,500—or $48,000 in this year’s dollars—paid by the SRF, those scientists would publish their own research, consisting of a review of the previously published research papers, hand-selected by Hickson, linking sugar to coronary heart disease.
A few days before submitting the draft of their review for publication, they sent it to Hickson, who was pleased. “Let me assure you this is quite what we had in mind and we look forward to its appearance in print,” he wrote.
In 1967, their two-part review appeared in the New England Journal of Medicine. It concluded that there was “no doubt” that to prevent coronary heart disease, the only dietary precaution to take was to reduce consumption of cholesterol and saturated fat. In other words: Don’t worry about sugar.
To make their point, the Harvard researchers found fault with each individual study linking sugar to coronary heart disease, instead of focusing on the consistency of the findings across them all. One study, they said, should be discounted because it used greater doses of sucrose than found in a typical American diet. Another had found that substituting legumes for sugar led to major improvements in serum cholesterol levels—but the Harvard scientists argued such a move wasn’t feasible. They discounted studies for using fructose or glucose instead of sucrose, or using rats instead of humans.
At the same time, they were much less critical of studies linking heart disease to other dietary factors. The lack of evidence confirming links between dietary cholesterol and saturated fat and elevated serum cholesterol levels was unimportant, they said.
It’s not that the studies implicating sugar were perfect, said Cristin Kearns, who led the research for the JAMA Internal Medicine. It’s that, compared to those implicating fat, they were measured with a different yardstick.
“It is always appropriate to question the validity of individual studies,” Kearns said in an email. “However, the authors applied a different standard when they critiqued the studies linking sugar to CHD than they did to the studies implicating saturated fat and to those indicating that polyunsaturated fats could prevent CHD. The authors did not critically evaluate those studies. In fact, the authors overstated the consistency and quality of those studies.”
In a commentary accompanying the JAMA Internal Medicine article, Marion Nestle, a nutrition and public health professor at New York University and the author of Food Politics: How the Food Industry Influences Nutrition and Health, called the findings a “smoking gun” showing how those who fund research can heavily influence its findings.
The 1967 two-part review, she noted, had listed funding from the Nutrition Foundation but hadn’t noted that it was supported by the food industry or the SRF specifically.
In a statement Monday, the Sugar Association said that “the Sugar Research Foundation should have exercised greater transparency” but that it “is challenging for us to comment on events that allegedly occurred 60 years ago, and on documents we have never seen.”
It also called it a “disservice that industry-funded research is branded as tainted.”
Harvard University did not immediately respond to a request for comment.
But the emphasis on saturated fat over sugar, as illustrated in the Harvard scientists’ 1967 review, would have serious implications for dietary advice on heart health for decades to come, Nestle wrote in her commentary accompanying the JAMA article.
“For decades following the funded review,” she wrote, “scientists and dietary guidelines focused on reducing saturated fat as the primary strategy for coronary heart disease prevention.” Advice to eat sugar only in moderation was usually linked only to preventing tooth decay.
In 1980, when the first U.S. government dietary guidelines were published, the advice focused on reducing total fat, saturated fat and dietary cholesterol for coronary heart disease prevention. (In 1977, the federal government had originally proposed advising cutting back on the specific foods with dietary cholesterol and saturated fat—eggs, dairy, and meat—but thanks to industry lobbying, that didn’t happen, either.)
Nestle and Kearns both called for more independent research—but according to Nestle, that solution might not be simple.
“I, for example, have been told repeatedly that since I wrote Food Politics, I am ineligible to serve on federal advisory committees because I am too biased. What this tells me is that people who on principle refuse to take food industry funding are excluded from the candidate pool,” Nestle said in an email. “But people who do take industry funding are considered acceptable as long as they disclose their financial ties appropriately which, unfortunately, many do not.”
© 2015 Nancy Appleton & G.N. Jacobs
Somewhere in our list article (141 Reasons Sugar Ruins Your Health) we clearly state that sugar suppresses the immune system. What does immune suppression look like? How is it measured? More importantly, how long has the data been available to health professionals to use as one more reason to convince their clients and patients that consuming less sugar is always preferable to a high sugar diet?
Answering the last question first, we cribbed some numbers presented here from an article dated 1964 written by three dentists. Doctor Appleton also cited a similar study from 1973 in her original book Lick the Sugar Habit. So assuming that medical professionals have a reason to read articles from past decades and conduct the reproducibility studies required to confirm a hypothesis, we have had upwards of 50 years of data saying sugar suppresses the immune system.
A primary measure of the immune system’s function is the phagocytic index. Take blood. Put it in a Petrie dish with bacteria that leukocytes (white blood cells) will eat. Wait about an hour. Stain the leukocytes for viewing in a microscope. Count up the first 100 leukocytes in the dish. The germs eaten by the leukocytes will be visible in the microscope using the stain. The average number of germs per leukocyte is calculated and named the phagocytic index. Higher is always better. Normal fasting glucose measures between 75 and 95mg/100cc and the normal range of fasting phagocytic index is 14 to 16. A non-diabetic person that fasts for 12 hours will usually have phagocytes that kill between 14 and 16 foreign invaders each.
In the 1964 study, Drs. Ernest Kijak, George Faust and Ralph Steinman conducted a study on both diabetic and non-diabetic subjects taking blood for purposes of testing the relationship between glucose and the phagocytic index. For the 45 diabetics in the study, the researchers merely took fasting glucose readings because high glucose levels are the normal state of being. The results were grouped on the table in ascending order of blood glucose levels expressed in milligrams.
Thus, the 13 people deemed only slightly diabetic (128mg/100cc-172mg/100cc) had fasting phagocytic indices grouped into an interesting almost bell curve starting at four and ending at three. Two outliers dented the bell shape (a common graphical representation of standard distribution in statistics). One patient with a blood glucose of 134mg/100cc spiked upwards with a phagocytic index of twelve. Another with a blood glucose level of 150mg/100cc had a phagocytic index of one, despite the previous patient having an index of four and the succeeding patient an index of five.
At the higher end of the table where blood glucose ran very high (174mg/100cc-380mg/100cc) the nonexistent graph generated from the numbers on the table would look like a constantly descending line with very few outliers. Of the 22 patients with severe blood glucose levels only four had phagocytic indices greater than one, none of whom had a blood glucose level greater than 280mg/100cc. The top patient with a blood glucose level of 380mg/100cc had a phagocytic index that barely registered at 0.1. This meant this patient’s leukocytes ate approximately one bacteria cell per 10 white blood cells!
The researchers observing this general trend downward naturally concluded that the phagocytic index decreases the higher the blood glucose level. But, knowing the first question would be about the applicability of data about diabetics to non-diabetics, the researchers pulled in at least 9 normal people. These patients were given a fasting blood test and the same blood test 45 minutes after ingesting a measured dose of glucose. Pay attention, what follows are the results that matter!
The first patient was given a dose of 100 grams of glucose and two were given 75g. The middle four were given doses of 50g of glucose. The bottom two got 25g each. Of these nine patients, seven had a starting index of 14 and the other two had a 10 and 12 respectively. All showed some form of decrease in their index numbers regardless of the dose.
The 100g patient started with blood glucose of 78mg/100cc and ended with 182mg/100cc. His or her phagocytic index tanked from 14 to one. The higher dose patients all had indices that dropped precipitously to more than half of the value from the fasting test. For the two patients given 25g, the drops were less steep. One seemed to be the anomaly of the sample with a blood glucose rise of barely 10 units and a phagocytic index decrease from 12 to 11. The other’s blood glucose rose 20mg/100cc and saw an index decrease from 14 to nine. Again, the researchers concluded that more glucose results in less immune system activity.
In 1973, researchers took up the thread that sugar and other sweet foods adversely affect the immune system. They tried glucose. They tried sucrose. They tried fructose. They tried honey. They tried orange juice and they tried the complex carbohydrates found in breads and other grain products. Possibly guided by the 1964 article that revealed less sugar is better, they fed the subjects the same 100-gram dose of each tested substance, as they wanted to find out if changing the refined sweetener had any affect.
Here’s what the study found; starch was the only food on the list that didn’t lower the phagocytic index by significant and scary amounts. According to the researchers, the effect was generally immediate after ingesting sugar and began to improve slightly 2 hours after eating the sweetened food. In many cases it took between a day and a half and three days for the subject’s phagocytic index to return to the norm established in the overnight fast. The scientists concluded that refined sweeteners suppress the immune system, but that the complex carbohydrates in bread, tortillas, potatoes and other similar foods do not.
Why don’t more people seem to know about sugar’s affect on the immune system? There have been plenty of articles on sugar and diabetes, sugar and cancer and so on. The publication dates have been evenly spread out over the previous five decades and the research is ongoing in these other areas. But, the doctor hasn’t seen a citation for an article concerning any aspect of sugar’s effects on the immune system dated later than 1979. Somewhere along the line people stopped doing this research. Let’s hope this changes…soon!
 Kijak, E., G. Foust, and R.R. Steinman. “Relationship of Blood Sugar Level and Leukocytic Phagocytosis.” J. So. CA Dental Assoc. Vol. 32:349-351,1964
 Sanchez, A, et al. “Role of Sugars in Human Neutrophilic Phagocytosis.” Am. J. Clin. Nutr. Vol. 26;(11):1180-1184, Nov 1973
© 2014 Nancy Appleton Ph.D & G.N. Jacobs
We might have reached the tipping point in combatting the excessive sugar in the American diet that increasingly leads to diabetes, heart disease, cancer and a whole lot of ways to commit suicide (blatant plug). Veteran newswoman, Katie Couric, just released her documentary Fed Upthat may finally be the first real shot at curbing the abuses of the Processed Food industry. The Climate Change camp had An Inconvenient Truth that changed the nature of the discussion that most of the opposition couldn’t deny Climate Change, but rather assert – It’s a natural process and human industrial activity has nothing to do with it. We have Fed Up. And, yes, you really should see the movie. Ms. Couric and her team carefully researched the recent history of how Big Food fought tooth and nail (possibly even harder than Big Tobacco) to prevent anything like sensible legislation concerning the food we eat. The industry jumped on Senator George S. McGovern and his committee, The Senate Select Committee on Nutrition and Human Needs, in 1977. Once he’d failed to enact a dietary target of 10-percent of calories coming from sugar and similar substances instead of the Food Lobby’s 25-percent proposal, the bloodletting wasn’t done. Somebody abolished the committee within weeks of the hearing (not depicted in the movie). We have no word whether the Food Industry pulled levers with Congress and/or the Carter Administration to kill the committee or if Sen. McGovern did it himself to save political capital for the next fight. Speaking of Food Industry victories, we have to toss this firecracker – the government mandated food label has never listed a number for sugar in terms of a Recommended Daily Percentage. Yes, the label tells you how much total sugar in grams, but did not render that number into a percentage so the consumer can tell how much sugar to eat in a day. It is claimed that there is no scientific consensus on sugar, but both the filmmakers and us have cited the American Heart Association’s targets of 6-9 Teaspoons per Day (less than one soda) with nauseating regularity. The label will soon change to make a distinction between naturally occurring sugar and added sugar, but there will still not be a percentage on the label. These two incidents are signposts in a decades long process where we thought (or believed the Food Industry lie? We need to see internal company documents in discovery for a lawsuit) that fat causes obesity. However, the competing opinion with quite a bit more science behind it says that sugar causes obesity, diabetes, heart disease and even cancer. And we have the intervening 37 years of our own eyeball evidence that more people in general and children specifically, who have all eaten lean, are just a lot fatter than they used to be. Robert Lustig M.D (interviewed in the film) has long asserted that when the Food Industry agreed to cut fat in the 1980s from their processed foods it meant that the industry had to add sugar, mostly fructose, (asserted to have doubled in many foods with the new recipes) because foods with fat removed suddenly taste like cardboard. Sugar can get the consumer to eat anything, even a massively salty drink like Gatorade. He and the other speakers confidently paint a picture of an industry that uses the same playbook of deny, deny, deny, call Government regulation an example of The Nanny State and then throw all kinds of money at key legislators. And like it says on the shampoo label repeat as necessary. The experts all made the point that the Agriculture Department has spent the last 37 years caught between two diametrically opposed missions: promote the sale of American foodstuffs and regulate the American diet, especially for kids. The filmmakers also include the Federal Trade Commission and its failure to regulate food advertising on children’s TV shows making the point that kids see ads and may become customers for life to an industry that only cares about selling more food. The filmmakers used a visual bludgeon to make their point, showing clips from many ads. And they made a comparison to the general success of the anti-smoking lobby that progressively banned cigarette TV ads and then decades later won a landmark judgment in court. Ms. Couric pointedly asked what would happen if a celebrity that pitched for Coke and Pepsi also had to do a pro whole foods PSA on an equal time basis? She asked if a warning label reading Warning: this product is addictive and has been linked to diseases like… Meanwhile, Ms. Couric and team chose to highlight four kids from four seemingly typical American families who are amazingly obese. They went on the yo-yo of lose some gain it all back or even more within six months. They cried on camera. More importantly, they led us to their school cafeteria’s which happened to be ones that have succumbed to the national trend where school food has been outsourced to food companies serving ready made treats (the film really went after pizza) that can be heated up instead of cooked on site. And the filmmakers made a point of showing every Coke vending machine on each campus they could find. Sugar is everywhere at school. The four families and their obese kids ended up being a microcosm of the obesity epidemic. The parents were all fat. One bit the bullet and got a gastric bypass at 13. Another lost a lot…and then gained it all back a few months after the cameras stopped rolling. The other two seemed to be doing better. But, we the viewers may not have gotten the full skinny on the addiction elements of the obesity problem; we (the staff of Nancy Appleton Books) felt that while the addictive properties of the modern diet needed as much of a bludgeon that Ms. Couric used on the policy side of the film. We’re just not sure how we would’ve done it without treating four obese kids like a certain Soviet Ambassador to the UN during the Missile Crisis – “Don’t wait for the translation…” So maybe Fed Up is exactly what it needs to be. All of the experts and children serve to make one simple point – most of the problem goes away if we find the time and basic nutritional knowledge to resume cooking real food at home! Real food comes out of the ground or (vegans should put their fingers in their ears and hum, now) meat from the closest thing possible to a freshly killed free-range animal. The film showed at the end that at a local level some change is happening, a local school principal will toss Coke and Pepsi off campus and parents with knowledge have fought with letter campaigns to make changes in the cafeteria. There is hope.
© 2014 G.N. Jacobs
Would you know how to read a Coca-Cola label or the similar labels on any other food product sold in America? Well, don’t feel bad, even I had had to look it up when the new labels were mandated in 1994[i].
Yes, picking on Coca-Cola by presenting two versions of the 20-ounce bottle label and our favorite whipping boy, the 12-ounce aluminum can, is an intentional act. The reason: until very recently the Coke label defined the single most glaring technique for continued confusion of consumers: the section at the top of the main label box demonstrating the “official” Serving Size and Servings per Package sold to consumers.
Before I hook that fish in a barrel, I’ll backtrack and briefly describe the label that Congress and FDA enacted for all food items sold in the United States. We start with two parts: the Nutrition Facts box and the Ingredient List (see Fig. A).
The Nutrition Facts box starts at the top separated from the rest of the data in the box by a thick printed bar that tells how many servings are in the package and what the recommended serving size is. Then the next section down lists Amount per Serving for Calories, Total Fat (sometimes with sub-headers for Saturated Fat, Trans Fat, etc.), Sodium, Total Carbohydrates (with sub-headers for Sugars and Dietary Fiber) and lastly Protein. Interestingly enough, Calories and Sugars can be listed without referencing the Percentage of Daily Values (%DV), which is a percentage that measures how much is in the product versus how much various experts say you should have (for Sugar, Sodium, etc.) or how much you need (for Vitamins and Minerals) based on a 2,000-calorie/day diet. Typically, the lower half of the Nutrition Facts box is given over to nutrients like Vitamin C, Vitamin A, Iron and Calcium. Coke doesn’t have any of these nutrients and so the label reads not a significant source of Vitamin A, Vitamin C, Iron, Calcium or Dietary Fiber. The box at the very bottom of the box presents text that reminds the consumer that all calculations should be based on the 2,000-calorie diet, also defined by experts. The percentages in the lower section are given so the consumer can choose to eat more instead of limiting intake like with the ingredients listed on the upper part of the section.
The Coke labels show an interesting progression from the very bad old days to almost normal days. The first 20-ounce bottle label (see Fig. B) shows two listings depending on how much Coke is consumed. The Standard Serving is 8-fluid ounces (240 mL) with 2.5 servings/bottle. The whole bottle (listed under This Package) is 20-fluid ounces (591 mL) and one serving. The similar label from a 20-ounce bottle bought at a gas station (tax deduction! See Fig. C) in the center picture only gives the same values for the whole bottle (original formula Coke is same regardless of the label).
These distinctions become important when I assert that Coca-Cola used to game the labeling law to their advantage (pity that I couldn’t find an older 20-ounce label). The trick they pulled in the bad old days would be to only list the 8-ounce serving size nutrition information on the label. The 8-ounce serving size weighs in at 27 grams of sugar and the consumer might think I haven’t had too much sugar, today. I’ll buy a bottle. And promptly drink the whole bottle.
That the label posted on Coca-Cola’s website shows both and the label from an actual bottle only shows the listing for Serving Size (1 bottle) validates the efforts of many nutrition experts fighting to make the mandated label not be a pack of lies designed to trick shoppers into consuming more Coke. These trends also explain why the modern Coke labels on all packages also prominently displays in a large readable font the total calories – 240/20-ounce bottle and 140/12-ounce can. (See Fig. D) Enough people complained about the previous regime that tolerated such intentional confusion and Coke caved. Bravo!
In a recent development (Feb. 27, 2014), the FDA and the Obama Administration have announced new labeling regulations that will make it harder for food manufacturers to pull off the Serving Size scam. Apparently, all three major networks carried the story with NBC using it as the lead on a night when portents of severe weather and a brewing international crisis should’ve dropped it to the back of the broadcast. The summary of the changes: an across the board reduction of the number of servings per container listed on the label and clearer labeling for added sugars (sugar added during production over and above sugar native to the raw food ingredients).
This means that the generic 20-ounce soda bottle specifically mentioned in the NBC broadcast, as previously having 120 calories and 10 teaspoons of sugar per serving with two servings listed will now by law be relabeled to 240 calories and 20 teaspoons of sugar per 1 serving, the bottle. Hopefully, this more honest labeling will open more consumers’ eyes.Well, nothing can be done about Coca-Cola getting to claim that they voluntarily changed their labels ahead of the new regulation. The NBC broadcast also used a generic pint of ice cream, which was previously labeled as 4 servings, but will now list 2 servings. I’ve eaten full pints on bad days, but again it’s a start.
NBC’s version of the story included reminders from diet experts about limiting added sugars by listing the big diseases: heart disease, diabetes and so forth as being caused by too much sugar in the diet. The report included the supermarket lobby saying they support any new labeling requirements that reflect actual science, possibly a stall tactic to see if their lobbyists can do anything about it. However, the end of the report included a tidbit about a major university including accurate labels in the cafeteria and seeing a 7-percent reduction in consumption of foods that might be harmful to students. Forward progress.
But, those that see a food label as an opportunity to confuse the ignorant haven’t given up all their tricks. A good one is that the values given on the label are metric when Americans just never learned the Metric System like we were supposed to forty years ago. The values for sugar are given in grams – 27 grams 8-ounce serving, 65 grams 20-ounce bottle and 39 grams for the 12-ounce can. (See Fig. E)
But, do you know what a gram is relative to measuring units we actually use? Heck, I haven’t played with actual metric units since science class (a really long time ago). I couldn’t tell you what a gram of anything is, because I just don’t weigh or measure very many objects using metric units. But, I do know what a teaspoon is. We all do.
Converting grams of sugar into teaspoons for the American audience is fraught with built-in possible errors starting with grams and teaspoons measure different things: mass v. volume. There is a conversion equation that I haven’t used since high school,so you’ll just have to trust me when I assert a conversion of approximately 4 or 5 grams of solid dry granular sugar to 1 teaspoon. Coke’s “Standard Serving” of 27 grams of sugar comes in at 5 or 6 teaspoons. The full bottle of 65 grams ends up choking us with 13 to 14 teaspoons. The 12-ounce can of Coke hits us with approximately 10 teaspoons of sugar.
Teaspoons of refined sugar become important when we factor in the American Heart Association’s recommendation for daily sugar intake that as of 2009 are 9 teaspoons for men and 6 for women per day[ii]. One can of Coke will blow out our daily sugar limit such that if we were to take it seriously we couldn’t have dessert (if I’m going to take risks with my diet and it’s a choice between pie and a Coke, pie wins every time). I find it interesting that the American food manufacturer will only give the customer the metric measurement without the more accessible English units. We wouldn’t drink so much Coke if they spoke to us in teaspoons in addition to grams or milligrams.
There is another dirty trick that makes use of the Ingredient List section of the food label. By law, ingredients have to be listed in descending order from most to least. Sometimes, a food maker will list several different types of sweeteners (sugar, corn syrup, maltose etc.) to disguise how much sugar is in the food. A good example lurking in the door of your refrigerator: the jar of strawberry jam.
Everybody, whether a brand name or grocery store generic seems to have similar recipes for strawberry jam (See Fig. F and Fig. G) – in order: strawberries, high fructose corn syrup, corn syrup, sugar, fruit pectin and citric acid. Savvy people who read labels might be the only people aware that when three similar sweeteners are clumped together on a label that a very strong possibility exists that the collective amount of sweeteners could be greater than the strawberries in the jam recipe! Certainly, there is no taste difference between high fructose corn syrup, corn syrup and table sugar (sucrose).
The generic label strawberry jam assumes 26 servings of a tablespoon each with 10 grams of sugar each. In this case, perhaps this is a mostly accurate usage of the Servings per Jar feature of the label (at least how I would make PBJs). But, jam and jelly comes in many different sizes, some of which are too small for a Nutrition Facts box, but must still list the ingredients (strawberries, high fructose corn syrup, corn syrup, sugar, fruit pectin and citric acid). The average consumer would suffer a head explosion trying to decipher how much sugar they ate in their restaurant pack at the diner by comparing the tiny pack to a jar of the same brand at the grocery store. In school, it’s called a proportional relationship (ouch!).
The usage on the label of three sweeteners that all taste like sugar to disguise the amount in the recipe seems like a dirty trick that has been made easier by the up to now absence of a numerical value for added sugar. A food manufacturer only had to tell the shopper the total sugar in the jam, not how much came from the strawberries versus the added sweeteners. In the past, I would dare you to call up any food company and ask about added sugar; you’ll be told we don’t discuss our proprietary recipe in such detail. This may change with the new mandate for more clarity about added sugars on the label. We’ll see.
In comparison, Coke’s ingredients are carbonated water, high fructose corn syrup, caramel color, phosphoric acid, natural flavors and caffeine. This simple recipe suggests that Coke, secure in being one of the world’s most recognizable trademarks and the assumption that their customers may not care about sugar intake, may feel less reason to lie about the sugar they sell.
The consumer also needs to know what various nutritional claims mean. Does Sugar Free mean no added sugar at all or does it mean less than .5 grams of sugar? The FDA’s site[iii] and the American Heart Association[iv] say the latter. I encourage everyone to look up the regulations for sugar, fat and so on. Follow the links above or paste the footnotes into your browser.
The label is good from the point of view that any label is better than none, but it seems like the FDA listened to too many food companies and created a system with just enough loopholes to get away with murder. We’ve covered the Serving Size and Number of Servings scam that may be fading into history because activists have finally spoken up loudly enough to be heard asserting that no one actually drinks an 8-ounce soda. The labels need more translation into understandable English units of measurement (teaspoons) and that the consumer should beware of similar classes of food being lumped together on the Ingredient List to disguise that it might be the most plentiful substance in the food. The label comes with a lot of fudge factor to it, but imagine no label at all.