by Marion Nestle

Search results: tobacco

Apr 17 2014

Is Big Food the new Tobacco?

Thanks to Maggie Hennessy at FoodNavigator-USA for her report on a meeting I wish I’d been able to attend—the Perrin Conference on “Challenges Facing the Food and Beverage Industries in Complex Consumer Litigations.”

Hennessey quotes from a speech by Steven Parrish, of the Steve Parrish Consulting Group describing parallels between tobacco and food litigation.

From the first lawsuit filed against [tobacco] industry member in 1953 to mid-1990s, the industry never lost or settled a smoking and health product liability suit. In the mid ‘90s the eggs hit the fan because the industry for all those decades had smugly thought it had a legal problem. But over time, it came to realize it had a society problem. Litigation was a symptom of the disease, not the disease itself.

…When it came time to resolve the litigation, we couldn’t just sit in a room and say, ‘how much money do you want?…A lot had nothing to do with money. It had to do with reining the industry in…We spent so much time early on talking to ourselves about greedy trial lawyers, out-of-touch regulators, media-addicted elected officials and public health people who didn’t know how to run a business. At the end of the day, it didn’t matter. We would have been much better off recognizing these people had legitimate agendas.”

… Maybe there are some parallels, but I urge people not to succumb to the temptation to say, ‘cigarettes kill you, cigarettes are addictive. But mac and cheese, coffee, and Oscar Meyers wieners don’t. That may be true, but there are still risks for the industry.

The article also quotes Michael Reese, plaintiff’s attorney for Reese Richman LLP, talking about the increasingly accusatory tone of media coverage of Big Food: 

There’s this idea, which has picked up steam in the media, that large food companies are manipulating ingredients to hook people on food. It hasn’t been manifest in litigation yet, but we’re seeing it with legislative initiatives, like Mayor Bloomberg in New York City saying sugar hooks people and causes diabetes. We’ve seen some with GMOs, though most of that legislation is about consumers’ right to know. But there’s this overarching concept that Big Food is somehow manipulating our food supply and as a result, giving us non-food.

Sounds like the message is getting across loud and clear.

Thoughts?

Jul 28 2010

Obesity vs. Tobacco: a zero-sum game?

Anti-tobacco advocates have been worried for years that concerns about obesity would draw funding away from anti-smoking initiatives (see previous posts).  Their fears are justified, as described in today’s New York Times and in a recent editorial in the New England Journal of Medicine.

Years of experience have taught anti-smoking advocates that countering the marketing efforts of cigarette companies required constant vigilance.  It also taught them that cigarette companies take immediate advantage of any weakening of resistance to their efforts.

Cigarettes remain the leading cause of preventable deaths among Americans.  Cigarette marketing aimed at children remains a national—and international—public health scandal.

Health should not be a zero-sum game.  Anti-obesity advocates have much to learn from anti-smoking advocates.  How about joining forces to improve the health of Americans?

Jul 1 2010

Food is not tobacco, but some analogies are worth attention

I’ve just read an enlightening paper in the July issue of the American Journal of Public Health (see Note below) about the tobacco industry’s role in and funding of “We Card,” a program ostensibly aimed at discouraging smoking among young people by encouraging retail cigarette sellers to “card” underage buyers.

The paper is an analysis of internal food company discussions about this program in cigarette company documents released as part of the 1998 Master Settlement Agreement.  These documents are now publicly available on the University of  California San Francisco (UCSF) website.

This analysis demonstrates that the actual purpose of tobacco industry support for the program was to make the industry look good (public relations) and to convince legislators and health officials that regulation would be unnecessary.

The industry effectively recruited astonishing numbers of private business, retail, and trade groups (expected) and state health, legal, and police agencies (which should have known better) as partners in this program.  The paper lists these groups in tables that take up nearly five pages.

As the paper explains:

Economic theory predicts that industry self-regulation will achieve social benefits far smaller than those gained from government regulation, although governments increasingly view self-regulation as a means to achieve public goals without public spending. However, industries and governments may have competing agendas, suggesting that public health advocates should be wary of self-regulation strategies…. This program’s success in reaching tobacco retailers and attracting independent allies has made We Card one of the tobacco industry’s major public relations achievements. However, despite industry claims that the program is effective, internal industry evidence suggests that We Card has not reduced tobacco sales to minors and that it was not designed to do so. Instead, We Card was explicitly structured to improve the industry’s public image and to thwart regulation and law enforcement activity.

The authors’ conclusion: “Policymakers should be cautious about accepting industry self-regulation at face value, both because it redounds to the industry’s benefit and because it is ineffective.”

Proponents of food industry self-regulation and of partnerships and alliances with food companies should read this study carefully.

Note: Only the Abstract is available to non-subscribers.  The reference is Apollonio DE, Malone RE, The “We Card” Program: Tobacco Industry “Youth Smoking Prevention” as Industry Self Preservation.. Am J Public Health 2010;100:1188-1201.

Mar 21 2009

Is food the new tobacco?

The Rudd Center at Yale is devoted to establishing a firm research basis for obesity interventions.  Its latest contribution is a paper in the Milbank Quarterly from its director, Kelly Brownell, and co-author Kenneth Warner, an equally distinguished anti-smoking researcher from the University of Michigan.  Its provocative title: The perils of ignoring history: Big Tobacco played dirty and millions died.  How similar is Big Food?

The paper is getting much attention.  A spokesman for the American Dietetic Association, a group well known for its close ties to food companies, emphasizes that food is not tobacco.  Of course it’s not.  But food companies often behave like tobacco companies, and not always in the public interest.  The Milbank paper provides plenty of documentation to back up the similarity.  Worth a look, no?

April 3 update: Evidently, FoodNavigator.com thinks so.  It is asking readers to file 100 word comments on issues raised by the paper by April 8.   And here are the comments.

Mar 2 2017

Don’t we need a millennium development goal for social rank?

Yes, says Martin Tobias’s must-read commentary in The Lancet.

The commentary cites a paper in the same issue arguing that low social rank, meaning “powerless to determine your own destiny, deprived of material resources, and limited in the opportunities open to you,” has a profound effect on lifestyle and life chances.  Its authors base these views on a study of 1·7 million adults followed up for mortality (all cause and by cause) for an average of 13 years.

Even with use of a crude categorisation of social rank based on occupation (professional, intermediate, and unskilled), the study was able to quantify the social gradient in mortality: an approximately 20% increase in risk per unit decrease in rank.

Tobias’ commentary recommends evidence-based strategies to minimize the impact of social hierarchy on health:

Invest in children

  • Early childhood development enrichment programs

  • Intensive parent support (home visiting) programs

  • Enrollment of all children in early childhood education

Get the welfare mix right

  • Regulate markets as necessary

  • Implement income transfer policies that redistribute resources (ie, progressive tax and benefit regimes)

  • Optimize balance between targeted and universal social protection policies through benefit design that minimizes both undercoverage and leakage

  • Eliminate child poverty through monetary and non-monetary support for families with dependent children

Provide a safety net

  • Provide income support or tax credits

  • Provide social housing

  • Subsidize childcare

  • Provide free access to health care (especially preventive services)

Implement active labor market policies

  • Provide job enrichment programs

  • Democratize the workplace (involve employees in decision making)

  • Provide career development and on-the-job training

  • Provide fair financial compensation and intrinsic rewards

  • Promote job security

  • Discourage casualization of the workforce

Strengthen local communities

  • Foster regional economic development

  • Promote community development and empowerment

  • Encourage civic participation

  • Create mixed communities with health-enhancing facilities

Provide wrap-around services for the multiply disadvantaged

  • Coordinate services across government and NGOs

  • Provide intensive case management when necessary

  • Foster engagement of the targeted families and individuals

Promote healthy lifestyles

  • Strengthen tobacco control and addiction services

  • Improve the diet of poor families (eg, through subsidizing fruit and vegetables, community gardens, purchasing co-ops, school meals)

  • Provide green space and subsidized sport and recreation facilities

Ensure universal access to high quality primary health care

  • Subsidize practices serving high need populations

  • Provide additional nursing and social worker support for practices in disadvantaged areas

  • Assist patients with clinic transport and childcare

  • Provide services free at point of use

  • Provide conditional cash transfers (to increase demand for clinical preventive services)

The paper is open access.  Spread it around.  Pick the recommendation you think most important, and get to work!

Dec 20 2016

Industry-funded study says advice to eat less sugar is based on bad science (surprise)

I haven’t posted an industry-funded study for a while, but here’s a good one.  This is a systematic review published in the Annals of Internal Medicine attacking dietary advice to eat less sugar on the grounds that such advice is not scientifically justified.

This one doesn’t pass the laugh test.

What are dietary guidelines supposed to do?  Tell people to eat more sugar?

This review is particularly peculiar:

  • It was funded by the International Life Sciences Institute (ILSI), a food-industry front group.
  • Two of the four authors consult for ILSI, and one of the two is on the scientific advisory board of Tate & Lyle, the British sugar company.
  • The authors admit that “given our funding source, our study team has a financial conflict of interest and readers should consider our results carefully.”  No kidding.
  • It was published by a prestigious medical journal.  Why?
  • It is accompanied by an editorial that thoroughly demolishes every single one of the authors’ arguments.

I can understand why ILSI wanted this review.  Many of its funders make sugary foods and drinks.  They would like to:

  • Cast doubt on the vast amounts of research linking excessive sugar intake to poor health.
  • Discredit dietary guidelines aimed at reducing sugar consumption.
  • Head off regulatory attempts to tax or label added sugars.

In funding this study, ILSI is following the tobacco industry playbook to the letter.  Strategy #1 is to cast doubt on the science.

When the 2015 Dietary Guidelines came out with a recommendation to restrict sugar intake to 10% of calories or less, the Sugar Association called it“agenda-based, not science-based.”  The Annals review says international sugar guidelines do not “meet criteria for trustworthy recommendations and are based on low-quality evidence.”

I detect a theme here.

But I ask again: what are dietary guidelines supposed to do?  We cannot lock up large numbers of people and feed them controlled amounts of sugar for decades and see what happens.  Short of that, we have to do the best we can with observational and intervention studies, none of which can ever meet rigorous standards for proof.  So this review is stating the obvious.

Take a look at the accompanying editorial.  After destroying each of the flawed premises of this review, it concludes:

Industry documents show that the F&B [Food & Beverage] industry has manipulated research on sugars for public relations purposes….Accordingly, high quality journals could refrain from publishing studies on health effects of added sugars funded by entities with commercial interests in the outcome. In summary, our concerns about the funding source and methods of the current review preclude us from accepting its conclusion that recommendations to limit added sugar consumption to less than 10% of calories are not trustworthy. Policymakers, when confronted with claims that sugar guidelines are based on “junk science,” should consider whether “junk food” was the source.

I don’t ever remember seeing a paper accompanied by an invited editorial that trashes it, as this one did, but this incident suggests a useful caution.

Whenever you hear that something isn’t “science-based,” look carefully to see who is paying for it.

The press coverage

Oct 26 2016

Follow up on my WikiLeak: the Australia connection

Marcus Strom of the Sydney Morning Herald in Australia did a follow up to my post, “I’ve been WikiLeaked!”

Recall that a Coca-Cola representative took notes at a talk I gave in Australia and passed them up the chain of command where they got hacked as collateral damage from the ones obtained from Hillary Clinton’s campaign manager, John Podesta.

The notes advised ongoing monitoring of my activities in Australia but also of research conducted by Dr. Lisa Bero, in whose group I was working for a couple of months early this year.

The article begins: 

Coca-Cola has been exposed having a secret plan to monitor research at Sydney University that examines how private companies influence public health outcomes in areas such as obesity.

In a leaked internal email, a paid consultant to Coca-Cola South Pacific writes that a “key action” for the global soft-drinks manufacturer is to “monitor research project outcomes through CPC [Charles Perkins Centre] linked to Lisa Bero’s projects”.

Future monitoring should include planned research on “treatment and prevention of obesity, diabetes and cardiovascular disease”, the email says.
Professor Bero, who works at the university’s Charles Perkins Centre, studies the integrity of industry-sponsored research and how it is used to influence public policy. While in the US, she worked to expose the influence of tobacco companies on health debates. Those methods are now being used to examine how companies like Coke seek to influence public health outcomes.

The reaction: See letters printed in response (you have to scroll way down to find them)

Roberto Mercadé, President of Coca-Cola South Pacific, wrote to object that Coke is not secretly monitoring academics; its monitoring is entirely public:

Readers of the article “Revealed: Coke’s plan to monitor academic” (Herald, October 22-23) may have been left with the impression that Coca-Cola South Pacific somehow engages in the “secret” monitoring of academics at the University of Sydney. Put simply, we don’t. We make no secret of the fact that we keep abreast of research in the health and wellbeing sector, as you would expect of any food or beverage company. The important work being done by the university on the integrity of industry-sponsored research is among the many fields important to us. Finally, in the article the word “monitor” was also used out of context and distorted to mean something other than what it is – our ongoing engagement with academics and experts in health and wellbeing.

Steve Harrison, Balmain

It’s no great surprise that Coca Cola is panicked by research into the cause of diabetes. The consumption of sugar and processed foods looks more and more like a major reason for diabetes, many cancers and other serious diseases. In turn, the company, the food industry and drug companies will all be in big financial trouble when the penny drops that a diet of fresh food is the basis for good health.

If a fraction of the money spent on seeking cures was used to educate people to cut processed food and sugar from their diet we would be a much healthier society. We went through a very similar process with Big Tobacco some years ago, although that was on a smaller scale.

In the words of Hippocrates: “Let food be thy medicine and medicine be thy food.”

Ivan Head, Camperdown

The score? Coke, Zero: Professor Bero, one.

Oct 12 2016

WHO takes action against sugary drinks, urges taxes

The World Health Organization took two actions yesterday to encourage people to cut down on consumption of sugar-sweetened beverages.

It issued a report urging national governments to consider taxes: “Taxes on sugary drinks: Why do it?  

Governments can take a number of actions to improve availability and access to healthy foods and have a positive influence on the food people choose to consume. A major action for comprehensive programmes aimed at reducing consumption of sugars is taxation of sugary drinks. Just as taxing tobacco helps to reduce tobacco use, taxing sugary drinks can help reduce consumption of sugars.

It defines sugar drinks as products that contain added sugar, corn or fruit-juice concentrates and include carbonates, fruit drinks, sports drinks, energy and vitamin water drinks, sweetened iced tea, and lemonade.

It also took immediate action to remove sugary drinks from its Geneva headquarters

The agency explained this action:

The move signifies how seriously WHO is taking its leadership role in implementing policies to improve public health…By implementing this policy WHO is setting a positive example for Member States, other organizations and visitors…WHO vending machines, restaurants and coffee shops will continue to sell water, fizzy water, and unflavoured milks with different fat contents, teas and coffees, and beverages with non-sugar sweeteners (such as diet and zero calorie drinks). Sugar packets for use with tea and coffee will continue to be served.

These actions are getting plenty of attention.

The Guardian pointed out that:

Battle lines are being drawn in Colombia, where a consumer movement is pressing the case for a sugary drinks tax and the industry is fighting back…Last month, the Asociación Educar Consumidores – the consumer organisation which, like its Mexican equivalent, has backing from Bloomberg Philanthropies in the US – produced an educational video to be broadcast on television, warning that drinking too many sugary drinks can lead to diabetes and other diseases.

But after a complaint from Postobón, the Colombian beverage giant, the government’s regulatory agency charged with consumer protection banned any showing of the video on TV, saying it was inaccurate and could confuse the public.

Michael Bloomberg, now a global ambassador for WHO issued a statement.

A growing number of cities and countries – including Mexico – are showing that taxes on sugary drinks are effective at driving down consumption. The World Health Organization report released today can help these effective policies spread to more places around the world, and that will help save many lives.

The International Council of Beverages Associations (ICBA) issued a statement:

ICBA is disappointed that this technical committee’s report advocates the discriminatory taxation solely of certain beverages as a ‘solution’ to the very real and complex challenge of obesity. We strongly disagree with the committee’s recommendation to tax beverages, as it is an unproven idea that has not been shown to improve public health based on global experiences to date.

Healthy Food America says the soda industry has spent $30 million to fight soda taxes, just this year.

WHO has just given its blessing to soda taxes.  Will countries respond?  How much more is the soda industry willing to spend to stop taxes?

Stay tuned.

Other accounts:

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