Food Politics

by Marion Nestle
Oct 27 2016

Resources for food advocates

Some new resources for food system advocates have just come my way.  Use and enjoy!

  • Food Tank and the James Beard Foundation have issued their third annual Good Food Guide, a searchable guide to 1,000 food nonprofit advocacy organizations.  You can download the guide here.
  • Healthy Food America offers a Sugar Overload Calculator.  This is a mini-game that kids (or adults) can play to guess the sugars in commonly consumed foods.  Most will surprise.  Some will be a big surprise.
  • Healthy Food America also has Maps of the Movement, illustrating where soda tax initiatives are underway in the United States.   Can’t wait to see how they do on November 8.
  • The World Cancer Research Fund International’s NOURISHING framework is a terrific introduction to policy approaches to promoting healthy diets and reducing obesity.
  • The Fund also has a useful graphic about the importance of policy approaches to obesity.  I ran across it on Twitter: 

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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.

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Oct 25 2016

Comments wanted: FDA guidance on structure/function claims for infant formula. Deadline: November 8

The FDA wants to tighten up the rules for labels and advertising of “structure/function” claims on infant formulas.  It has proposed “guidance” and asks for comments on it.

This is a good proposal and needs all the support it can get.

Background

“Structure/function” claims were allowed by the Dietary Supplement Health and Education Act of 1994.  These are pseudo health claims that are really about marketing, not health.  Example: this brand of infant formula “supports digestion.”

All infant formulas must meet FDA nutritional requirements and there is no meaningful difference in any of them.  Structure/function claims market one brand over another.  Worse, they make infant formulas seem better than breast milk and help to discourage women from breastfeeding.

In September, the FDA announced that it was proposing draft guidance for industry, entitled “Substantiation for Structure/Function Claims Made in Infant Formula Labels and Labeling.”  This says that the infant formula industry must actually produce evidence that the claims do what they say.  Formula makers must substantiate structure/function claims with “competent and reliable evidence,” preferably from clinical research.

Infant formula makers would much rather not bother.

This proposal deserves enthusiastic support.  If you agree with it, please write the FDA and say so.

ChangeLab Solutions has filed a position paper on this topic with the FDA—excellent background reading.

It also has developed a template letter, which you can adapt and send.

But even a shorter statement that you think structure/function claims should not be used to market infant formulas without real science behind them would help.

Here’s the quick one I sent in.  Feel free to copy.  But individual letters carry more weight.

How to do this?

  • Go to the FDA docket website: look for ID: FDA-2016-D-2241.
  • Go to the first of the two FDA documents listed there.
  • Click on “Comment Now!”
  • Fill in the Comment box by saying you are commenting on FDA-2016-D-2241.
  • Upload your letter
  • Following the instructions for the required items (the others are voluntary)

The FDA documents

Oct 24 2016

Rethinking nutrition policy in developing countries

I recently coauthored an editorial on international development.  It appeared first in French, and now in English in Ideas for Development, a blog coordinated by the French Agency for Development.

Rethinking nutritional policies in developing countries taking into account the double burden of malnutrition

By , Marion Nestle, and

The world now experiences two forms of malnutrition which may seem contradictory: “undernutrition” (which includes micronutrient deficiencies) and “overnutrition” (obesity and its health consequences).The problem of malnutrition in developing countries is approached by most aid bodies (donors, international organisations and NGOs) and governments solely from the angle of undernutrition. And yet in these countries, the complex and multi-faceted challenge which malnutrition now presents can justifiably be called the double burden of malnutrition. In addition to the continuing problem of undernutrition there are now major issues linked to overnutrition and its associated illnesses.

Rapid nutrition transition

The stereotyped image of skeletal young children with protruding bellies saved by souls of goodwill in sub-Saharan Africa is still too widespread. Severe acute malnutrition still persists of course, especially among the victims of extreme poverty, natural catastrophes and wars. Naturally, this deadly disease must continue to be addressed and treated, as numerous NGOs are doing.

The treatment of malnutrition should focus not only on severe malnutrition in children. Less severe malnutrition, going back to life in the foetus and resulting from malnutrition in women even prior to their pregnancy, continues to contribute to stunting, which affects 23.8% of all children under the age of 5 throughout the world.

In parallel with acute and chronic undernutrition, the “nutrition transition” in low-income countries, driven by globalisation, urbanisation and technological progress and linked to “overnutrition,” leads to a swift increase in obesity and other chronic diseases – mainly diabetes and cardiovascular diseases. Nutrition transition is the term used to describe the progressive Westernisation of eating patterns, typified by a sharp increase in the consumption of animal fats and processed foods all over the world, combined with an increasingly sedentary lifestyle. It is easy to see how this transition encourages the increase in overweight and obesity.

Today, undernutrition alone is not the major issue; the greatest problem is the double burden of undernutrition and overnutrition. According to estimates from 129 countries with available data, 57 experience serious problems of both undernutrition in children and overweight in adults[i]. And Africa is not exempt from this double burden where undernutrition and overweight are undeniably linked. In West Africa, 50% of women of child-bearing age are anemic while at the same time 38% are overweight and 15% are obese. For the whole of sub-Saharan Africa, 40% of children have stunted growth characteristic of chronic undernutrition, while 7.5% of adults suffer from obesity. Malnutrition early in life increases the subsequent risk of chronic diseases in places where obesity is encouraged by the environment. Obesity is now on the increase among children in all developing countries. The World Health Organization (WHO) reports that between 1990 and 2015 the number of overweight or obese African children doubled from 5 to 10 million. 

The responsibilities of the industrial food system

It is often said that communication aimed at changing food habits is the best way to prevent obesity, a problem reserved for rich people in low-income countries. This cliché contains three errors:

  • The first is the claim that preventing nutrition-related chronic relies entirely on the capacity of individuals to make appropriate choices regarding food, physical activity or lifestyle. This claim ignores the well-documented effects of the food system and the socio-cultural factors which play a determining role and which influence the choice of individuals.
  • The second error is to believe that significant changes cannot be made to the eating practices of limited-income groups in the absence of an increase in resources. Yet several studies show the opposite, whether they are about exclusive breastfeeding for the first six months of life and improved complementary feeding, or else hygiene measures and supplies of drinking water.
  • The third error is to consider that obesity continues to be only a problem of the rich in low-income countries. Obesity is escalating and affecting growing numbers of not so well-off people, particularly in cities.

When analysing the impact of the food system, it is necessary to account for the agri-food industry (Big Food). On a world-wide scale Big Food is primarily responsible for the nutrition transition” towards processed food. “Globalised” industrial food is gradually replacing traditional cooking and locally produced foods, with ultra-processed foods’ (food-like substances as Michael Pollan calls some of them) undeniable appeal for city-dwellers and young people as these products are strongly associated with Western-style fast food and heavily promoted by the media. This appeal is reflected in profound changes in consumption trends in developing countries. Global sales of highly processed foods increased by 44% from 2000 to 2013, but only by 2% in North America as opposed to 48% in Latin America and 71% in Africa and the Middle East.

So what is the problem? Industrial food products (and drinks) are often a nutritional disaster: rich in calories, sugar, fat and salt, but low in essential nutrients and fiber. Even more, these products are relatively inexpensive, often less expensive than more nourishing local food products.

Changing the food environment

What is the explanation for the popularity of these “globalized” food products? Part of the answer lies in extremely effective advertising. Anyone travelling in Africa, for example, will see campaigns to promote salty stock cubes to replace traditional spices and vegetables. “Social marketing” efforts to change eating behaviour must be as forceful as these adverts, with commensurate budgets.

One idea is to impose a tax on soft drinks or other highly processed foods and use the revenues to finance cutting-edge nutrition education campaigns. This is what the United Kingdom has recently decided to do by taxing soft drinks.

It is especially important to rethink the nutrition programs created by NGOs and financed by international aid. Correcting the nutrition of malnourished mothers or children is only part of the problem.

A wider vision is needed to recognize the threat to world health posed by nutrition-related chronic diseases.

To cope with this new challenge, it will be important to address many determinants of health – education, social disparities, housing, and culture – as well as the food environment. The latest report on global nutrition1 points out the excellent return on investment of nutrition interventions (16 for 1), and challenges governments and decision-makers to identify and implement strategies that target the double burden of malnutrition. If this is not done, it will be difficult to reach the nutrition objectives set by the WHO for 2025 (see below). Solutions do exist, however, as can be seen from places such as Ghana, Brazil, or the state of Maharashtra in India, which have had encouraging results in fighting malnutrition in all its forms.

Global nutrition targets for 2025

  • Reduce the number of children with stunted growth by 40%
  • Reduce and keep the prevalence of acute malnutrition in under-five children (low weight) under 5%
  • Avoid any increase of overweight in children
  • Reduce the prevalence of anemia in women of child-bearing age by 50%
  • Increase exclusive breastfeeding for babies less than 6 months old by 50%
  • Reduce low birth weights by 30%
  • Avoid any increase in the prevalence of overweight, obesity and diabetes in adults.

The opinions expressed on this blog are those of the authors and do not necessarily reflect the official position of their institutions or of AFD.

[i] Global Nutrition Report 2016 www.globalnutritionreport.org
Oct 21 2016

Weekend reading: a how-to for sustainable food systems

Darryl Benjamin and Lyndon Virkler.  Farm to Table: The Essential Guide to Sustainable Food Systems for Students, Professionals, and Consumers.  Chelsea Green, 2016.

 

Oct 19 2016

Coca-Cola Europe’s policy agenda, courtesy of WikiLeaks

Ninjas for Health posts this graphic from someplace in the emails leaked to DCLeaks (it’s good they are going through them so we don’t have to).  

The Ninjas point out that Coke divides the policies into three categories based on likelihood of happening and impact on sales:

  • Fight back
  • Monitor
  • Prepare

The policy with the biggest impact greatest likelihood of materializing?  Increased soda taxes.

No wonder soda companies are fighting back against them.

Nancy Huehnergarth pointed out in an email that a ban on advertising to children under the age of 12 shows up in the “Prepare” category, even though soda companies insist that they do not advertise to young children.

It’s interesting to see what Coca-Cola thinks has a high likelihood of happening: Protectionism against sugar imports, mandatory environmental labels, emission reduction targets, and the mysterious “provisions for lobbying.”

The company has a lot to worry about, apparently.

Oct 18 2016

Pepsi to reduce sugar in its drinks? Really?

PepsiCo, yesterday, announced that it had launched its sustainability report with an agenda for 2025. 

The sustainability promises look good, but reporters called me for comments only on the first goal in its Products agenda:

  1. At least two-thirds of Pepsi’s global beverage portfolio volume will have 100 calories or fewer from added sugars per 12-ounce serving.

For the record, the other Product goals are:

  1. At least three-quarters of its global foods portfolio volume will not exceed 1.1 grams of saturated fat per 100 calories.
  1. At least three-quarters of its global foods portfolio volume will not exceed 1.3 milligrams of sodium per calorie.

The reporters’ questions assumed that Pepsi plans to reduce the sugar in its full-sugar beverages.

Maybe, but that’s not clear from the press release or the report.

Here’s what I want to know:

  1. The baseline: What proportion of Pepsi drinks already have fewer than 100 calories per 12 ounces?  Pepsi makes loads of beverages that meet that target—Gatorade, bottled waters, diet sodas.
  2. The marketing plan: Will the marketing dollars shift from full-sugar to lower-sugar options?

I ask, because Pepsi’s track record on sugar reduction is not encouraging.  In 2009, Pepsi set a goal to reduce the average amount of added sugars in its drinks by 25% by 2020.

The result?  An increase in average sugars of 4% so far (Pepsi got into trouble with investors who wanted marketing focused on full-sugar beverages).

Pepsi’s sustainability report says the company is working hard to find ways to reduce sugars and “these efforts could yield significant progress.”   Let’s hope they do.

The report also explains how the company plans to reach its lower-sugar goal:

  • Reformulating
  • Creating new low-and no-calorie drinks
  • Making smaller sizes
  • Boosting promotion of lower-calorie drinks

I hope the company does these things, despite its unfortunate record on sugar promises.  We need to wait and see whether the company delivers on this one.

But I’m thinking: Surely this announcement must be designed to head off the ongoing soda tax initiatives.  Pepsi is pouring millions of dollars into fighting the taxes directly and through its membership in the American Beverage Association.

Pepsi wants to have things both ways: to appear to promote healthier beverages while it is fighting public health measures to reduce soda intake.

Let’s give the company the benefit of the doubt and hope it delivers on its promises—while doing everything we can to get those taxes passed.

Here’s one of the articles that quotes me:

The last time Pepsi tried to position itself as doing something for health, its investors got very upset,” Marion Nestle, a professor in the Department of Nutrition, Food Studies & Public Health at New York University, said in an email. In 2012, investors got mad at PepsiCo CEO Indra Nooyi for focusing on getting revenue from healthy products, Business Insider reported.

“[PepsiCo] will continue to do everything it can to promote its most profitable products,” Nestle said. “These, alas, tend to be the ones with full sugar.”

Oct 17 2016

The FDA’s new strategic plan: open for public comment

I am late getting to the FDA’s July announcement of the release of its work plan for the next ten years, Foods and Veterinary Medicine (FVM) Program’s Strategic Plan for fiscal years 2016-2025.

The FDA organized the plan under goals for:

  • Food safety
  • Nutrition
  • Animal health
  • Organizational excellence

The FDA based the plan on basic principles:

  1. Public health is the first priority
  2. Partnerships are the key to success
  3. Scientific expertise and research are the foundation
  4. The program is committed to operating openly and transparently

Comments can be submitted on the strategic plan at any time.  Instructions for how to do so are here.

One possibility is to ask for further details.  The plan does not say how the FDA will accomplish the objectives, how much it will cost to achieve them, or whether it has adequate funding for everything it does (hint: it doesn’t).

Some of what it wants to do is puzzling.  For example, one Nutrition objective is this:

2.1: Provide and support accurate and useful nutrition information and education so consumers can choose healthier diets consistent with the Dietary Guidelines for Americans and other evidence-based recommendations.

I assume this refers to Nutrition Facts labels and menu labels, but one of its sub-objectives is:

Strategy 2.1d: Promote collaboration with stakeholders, including industry, consumer, and public health groups, to enhance consumer nutrition education directed towards age and demographic groups with specific needs.

I wish the report said more about this.  Surely the FDA is not suggesting that the food industry take responsibility for nutrition education?  I hope not.

The documents:

 

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