Food Politics

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?

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.

In April, the Institute of Medicine published a study concluding that salt poses so serious a health hazard that the FDA should start regulating it as a food additive.

Last week, Mitchell Moss produced a lengthy piece in the New York Times, “The hard sell on salt,” detailing the food industry’s resistance to salt reduction:

The industry is working overtly and behind the scenes to fend off these attacks, using a shifting set of tactics that have defeated similar efforts for 30 years, records and interviews show. Industry insiders call the strategy “delay and divert” and say companies have a powerful incentive to fight back: they crave salt as a low-cost way to create tastes and textures. Doing without it risks losing customers, and replacing it with more expensive ingredients risks losing profits.

Now we have Judith Shulevitz’s piece in The New Republic, “Is salt the new crack?”  She concludes:

We need to stop ingesting all these substances in ludicrous amounts…We need to be taught not just what’s in processed food, but how historically anomalous its manufacture and our consumption of it are. We need to understand the mechanisms that addict us to it. We need to relearn how to prepare real meals, and we need to start rethinking the social dynamics of that chore (it can’t just be up to wives and mothers anymore). It’s pretty hard to imagine the government conducting that education campaign, but, 20 years ago, it may have been just as hard to imagine the “truth campaign” that exposed the tobacco industry’s marketing techniques and the transformation of social norms that made it déclassé to smoke.

As I keep saying (see previous posts), the salt issue is one of personal choice.  If I want to eat less salt, I cannot eat processed foods or restaurant foods because that’s where 80% of the salt in American diets comes from.  As Moss explains, PepsiCo cannot make Cheetos without salt.  I can just say no to Cheetos, but eating out is a challenge.

No, salt is not the new crack, but I’m glad that changing food social norms is becoming part of the national conversation.

Thanks to Nicholas Kristof of the New York Times (“New alarm bells about chemicals and cancer“) for telling readers about a report on chemicals and cancer just released by the President’s Cancer Panel.

I had never heard of this panel – appointed during the Bush Administration, no less – and went right to its 2008-2009 annual report.

The Panel says that the “risk of environmentally induced cancer has been grossly underestimated,” that “nearly 80,000 chemicals [are] on the market in the United States, many of which are…un- or understudied and largely unregulated,” and that “the public remains unaware…that children are far more vulnerable to environmental toxins and radiation than adults.”

evidence suggests that some environmental agents may initiate or promote cancer by disrupting normal immune and endocrine system functions. The burgeoning number and complexity of known or suspected environmental carcinogens compel us to act to protect public health, even though we may lack irrefutable proof of harm.

I’m guessing this report will cause a furor.  Why?  “Lack irrefutable proof” means that the science isn’t there.  In this situation, the Panel advises precaution.  Check out these examples selected from the recommendations:

• Parents and child care providers should choose foods, house and garden products, play spaces, toys, medicines, and medical tests that will minimize children’s exposure to toxics.  Ideally, both mothers and fathers should avoid exposure to endocrine-disrupting chemicals.
• It is preferable to use filtered tap water instead of commercially bottled water.
• Exposure to pesticides can be decreased by choosing…food grown without pesticides or chemical fertilizers [translation: organics] and washing conventionally grown produce to remove residues.
• Exposure to antibiotics, growth hormones, and toxic run-off from livestock feed lots can be minimized by eating free-range meat [translation: don't eat feedlot meat].

Expect to hear an uproar from the industries that might be affected by this report.  The American Cancer Society (ACS) doesn’t like it either, since the report implies that the ACS hasn’t been doing enough to educate the public about this issue.  The ACS said:

Elements of this report are entirely consistent with the recently published “American Cancer Society Perspective on Environmental Factors and Cancer”…Unfortunately, the perspective of the report is unbalanced by its implication that pollution is the major cause of cancer, and by its dismissal of cancer prevention efforts aimed at the major known causes of cancer (tobacco, obesity, alcohol, infections, hormones, sunlight) as “focussed narrowly”…it would be unfortunate if the effect of this report were to trivialize the importance of other modifiable risk factors that, at present, offer the greatest opportunity in preventing cancer.

ACS says the Panel does not back up its recommendations with enough research [but see May 14th note below].  Maybe, but why isn’t ACS pushing for more and better research on these chemicals?   However small the risks – and we hardly know anything about them – these chemicals are unlikely to be good for human health.   Doesn’t precaution make sense?  I think so.

Addition, May 7: Here’s Denise Grady’s take on the report from the New York Times: “Cancer society criticizes federal panel as overstating risks.”

Addition, May 14: I received a note from Michael Thun,  retired Vice President for Edemiology & Survey Research of the American Cancer Society requesting a clarification of my statement.  He says:

I hope that you can correct your report to say that ACS actually is pushing for more and better research, and has never discouraged people who choose to eat organic food from doing this. The only thing we object to is unsupported claims that the effect of current level of pollution on cancer has been “grossly underestimated”.

In 1996, I chaired an ACS committee writing dietary guidelines for cancer prevention and worked with Dr. Thun on our report.  I’d take his word for this.

National Home Office | American Cancer Society, Inc.







Food companies interested in doing something meaningful to prevent childhood obesity are in a bind.  Preventing obesity usually means staying active; eating real, not processed, foods; and reserving soft drinks and juice drinks for special occasions.  None of this is good for the processed food business.  At best, food and beverage companies can make their products a bit less junky and back off from marketing to children.  In return, they can use the small changes they make for marketing purposes.

Perhaps as a result of Michelle Obama’s campaign (see yesterday’s post), companies are falling all over themselves – and with much fanfare – to tweak their products.

GROCERY MANUFACTURERS ASSOCIATION (GMA):  By all reports, GMA members applauded Mrs. Obama’s remarks.  GMA says its member companies are already doing what she asked.

Parke Wilde, a professor at the Tufts School of Nutrition (and food policy blogger), gave a talk at that meeting in a session dismissingly titled,  “The New Foodism.”  His comment:

I enjoyed hearing Michelle Obama’s talk, which was well written and delivered and fairly forceful in places. In my afternoon panel, I said grocery manufacturers would find some threatening themes in books and documentaries promoting local and organic and sustainable food, but that there is also much of substance and value. Then, Susan Borra [Edelman Public Relations] and Sally Squires [Powell Tate Public Relations] in the next session said that grocery manufacturers are frequent subjects of unfair criticism and have nothing to apologize for.

Take that, you new foodists!

MARS must think it knows more than the FDA about how to label food packages.  It is developing its own version of front-of-package labels. It volunteered to put calories on the front of its candies; its multi-pack candies ay 210 calories per serving on the front.  That number, however, remains on the back of the small candy store packs.  Mars’ new labeling plans use the complex scheme used in Europe.  I’m guessing this is a bold attempt to head off what it thinks the FDA might do – traffic lights.

KRAFT announces that it is voluntarily reducing the sodium in its foods by 10% by 2012.  Kraft’s Macaroni & Cheese (SpongeBob package) has 580 mg sodium per serving and there are two servings in one of those small boxes: 1160 in total.  A 10% reduction will bring it down to 1050 mg within two years.  The upper recommended limit for an adult is 2300 mg/day.

PEPSICO announced “a voluntary policy to stop sales of full-sugar soft drinks to primary and secondary schools worldwide by 2012.”  In a press statement, the Yale Rudd Center quotes Kelly Brownell saying that “tobacco companies were notorious for counteracting declining sales in the U.S. with exploitation of markets elsewhere, particularly in developing countries:”

it will be important to monitor whether the mere presence of beverage companies in schools increases demand for sugared beverages through branding, even if full-sugar beverages themselves are unavailable…This appears to be a good faith effort from a progressive company and I hope other beverage companies follow their lead…this announcement definitely represents progress [Note: see clarification at end of post].

According to PepsiCo, this new policy brings its international actions in line with what it is already doing in the U.S.  The policy itself is voluntary, uses words like “encourage,” assures schools that the company is not telling them what to do, and won’t be fully implemented until 2010.  It keeps vending machines in schools and still allows for plenty of branded sugary drinks: Gatorade, juice drinks, and sweetened milk for example.

Could any of this have anything to do with Kelly Brownell’s forceful endorsement of soda taxes?

LOBBYING: The Center for Responsive Politics says food companies spent big money on lobbying last year, and notes an enormous increase in the amount spent by the American Beverage Association (soda taxes, anyone?).  For example:

How to view all this?  I see the company promises as useful first steps.  But how about the basic philosophical question we “new foodists” love to ask: “is a better-for-you junk food a good choice?”

OK.  We have the Public Relations.  Now let’s see what these companies really will do.

Addendum: I received a note clarifying Kelly Brownell’s role in the PepsiCo press release from Rebecca Gertsmark Oren,Communications Director,The Rudd Center for Food Policy and Obesity,Yale University:

The Rudd Center did not work with PepsiCo on their initiative to stop sales of full-sugar beverages in schools worldwide, nor did we jointly issue a press release. A statement released by Kelly Brownell in response to PepsiCo’s announcement was simply intended to commend what appears to be a step in the right direction. As Kelly’s statement also mentioned, there is still plenty of work to be done. It’s also worth noting that the Rudd Center does not take funding from industry.

I keep reading that the economy is getting better but I think anyone who says this must be talking about fat cats on Wall Street.   As for everyone else, take a look at the shocking piece about the Food Stamp program that the New York Times ran on its front page on Sunday.

More than 36 million Americans qualify for and get Food Stamps, an increase of 30% or so in just the last two years.  The Food Stamp program, says the Times, helps feed nearly 13% of American adults and 25% of children.

The Food Stamp program, now called Supplemental Nutrition Assistance Program, or SNAP, is one of several food assistance programs run by the USDA.  SNAP is an entitlement program, meaning that anyone who meets income eligibility requirements can get benefits.  Even so, only two-thirds of people eligible for the program apply for and get the benefits.  What recipients get is a credit card to use at grocery stores.  The cards were worth an average of $101 per month in 2008 for individuals, and $227 for households.

SNAP participants can use the money to buy foods, seeds, and food plants.  They cannot use the cards for alcohol, tobacco, pet food, supplements, paper goods, or hot prepared foods.

So what’s going on?  Nearly 15% of American households, up a couple of percentage points this year, are considered “food insecure,” meaning that they cannot count on a reliable, legally obtained source of food from one day to the next.  Surprise!  The uptick in SNAP participation exactly parallels the uptick in jobs lost.

What do you have to do to qualify for Food Stamps?  For a family of four, your household must make less than $2,389 per month gross, or $1,838 net and meet certain other requirements.  An individual can’t make more than about $1,000 a month.   These days, 36 million Americans make less than that or otherwise qualify for food assistance, and their numbers are rising rapidly.

This doesn’t look like an improving economy to me.  Or am I missing something?

Someone whom I do not know, Zhiqi Yin, sent this message to this site in two places today:

I saw this on Twitter. “I am so sick of food Nazis like Marion Nestle who makes lots of money criticizing others. Marion, disclose who is paying you and $ you make.”  Kindly tell your audience when can we expect to see your financial disclosure telling us how much you make from writing books critical of the food industry, money you receive from speaking and other engagements, and grant and consulting money and your sources? Thank you.

Despite its unfriendly tone, the question is an important one in an era when opinion is so easily bought and sold, and evidence so increasingly demonstrates the influence of corporate funding on the outcome of tobacco, drug, and food research.

The purpose of food company influence is of course to increase sales and profits. In contrast, the goals of public health are to improve dietary intake and other health behaviors so that people will live longer and more active and productive lives.  Those of us devoted to public health, however, often find that our goals conflict with those of sales and profit.

As I explained in my book, Food Politics, I am in an unusual position for an academic researcher and I take the resp0nsibility that comes with this position quite seriously.  I am a tenured professor at New York University, a job that requires teaching, research, and public service (of which this blog is part).  For doing these things, I receive a full, hard-money salary that allows me to remain independent of corporate influence and gives me the freedom to write and speak as I think.   I do not need grants to do my research and writing.  I accept honoraria from some speaking engagements (these take substantial preparation and travel time), compensation for some writing assignments (ditto), and occasional royalties from sales of my books (which take years to research and write).  To fulfill my professorial obligations, I do not need to consult for pay or accept honoraria from food companies or other for-profit enterprises.

I wish that my books were best sellers.  I wish everyone would read them and think hard about what they say.   And I wish that more nutrition academics and professionals could be independent of corporate influence.

I am able to take full responsibility for what I think, say, and write.  I am paid to say what I think, not what someone else wants me to think or because what I write or say will help sell food products.   This is indeed a privilege and I am grateful for it.

OK, so Bill Marler is a class action lawyer* who makes his living from suing companies that produce unsafe food. I’ll grant that he has a vested interest but I admire the way he never loses sight of the harm done to innocent adults and children.  Cookie dough has a warning label on the package and everyone knows you are not supposed to eat raw cookie dough.  If you eat it, it’s your fault if you get sick, right?  See what he has to say about that one.

In Marler’s view, the warning label on commercial raw cookie dough should read something like this:

THE FDA INSPECTION MEANS NOTHING. THIS PRODUCT MAY CONTAIN A PATHOGENIC BACTERIA THAT CAN SEVERELY SICKEN OR KILL YOU AND/OR YOUR CHILD. HANDLE THIS PRODUCT WITH EXTREME CARE.

And, he asks, “Where is the multi-million dollar ad campaign to convince us of the dangers of uncooked cookie dough, like we do for tobacco?”

I would add a few further questions: What are we going to have to do to get a real food safety system in this country?  By real food safety system, I mean one that requires production of all foods – from farm to table – under science-based food safety plans (HACCP with pathogen reduction), overseen by a single federal agency that unites and rationalizes the current functions of USDA and FDA.

Everyone knows how to produce food safely or a lot more safely than is being done now.  If companies don’t bother, it’s because they don’t have to. You don’t like this?  Complain to Congress!

*Correction: See Mr. Marler’s comment below.  He says he mostly represents individuals.   I do apologize for the error.

You would think that the labeling of organic wine would be simple, but you would be so wrong.  Just for fun, here’s who does what in the federal government when it comes to food and beverages.  For the most part:

• USDA does meat and poultry
• FDA does everything else
• Except alcohol, which is done by the Alcohol and Tobacco Tax and Trade Bureau (TTB)
• Except that USDA does all organic food
• Except for organic wine, sort of
• Problem solved: USDA and TTB have made a deal.  TTB will do organic wine
• Except that USDA has just changed the rules

Got all that?

I won’t try to reproduce the rules for organic wines; they look too much like what I’ve just written.  Take a look at judge for yourself.  I’m just happy that all this has been straightened out.

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.