by Marion Nestle

Currently browsing posts about: ADA(American Dietetic Association)

Mar 18 2015

Dietitians in turmoil over conflicts of interest: it’s about time

My e-mail inbox is filled with items about the Academy of Nutrition and Dietetics (AND, formerly the American Dietetic Association).  Its “seal of approval” on Kraft cheese singles (as discussed in an earlier post) was embarrassing—so embarrassing that it was discussed by Jon Stewart: “The Academy is an Academy in the same way this [Kraft Singles] is cheese” (the clip starts at 4:37).

The Onion also had some fun with this.

But now there is even more about how food companies buy the opinions of dietitians.

Candice Choi writes about how Coca-Cola pays dietitians to promote its drinks as healthy snacks (for an example of one of the paid posts, click here).  She explains that the dietitians

wrote online posts for American Heart Month, with each including a mini-can of Coke or soda as a snack idea. The pieces — which appeared on nutrition blogs and other sites including those of major newspapers — offer a window into the many ways food companies work behind the scenes to cast their products in a positive light, often with the help of third parties who are seen as trusted authorities.

Ms. Choi quotes a Coca-Cola spokesman:

“We have a network of dietitians we work with,” said Sheidler, who declined to say how much the company pays experts. “Every big brand works with bloggers or has paid talent.”

Other companies including Kellogg and General Mills have used strategies like providing continuing education classes for dietitians, funding studies that burnish the nutritional images of their products and offering newsletters for health experts. PepsiCo Inc. has also worked with dietitians who suggest its Frito-Lay and Tostito chips in local TV segments on healthy eating.

These are individual actions.  But at last the dietetic membership is objecting to the Academy’s partnership with Kraft.

  1. They have started a Change.org petition to #RepealTheSeal.
  2. The President of the New York State AND chapter (NYSAND), Molly Morgan, sent out a note in support of the petition.

Thank you to the many of you that have expressed your concern and disappointment about the Academy of Nutrition and Dietetics partnership with Kraft. This issue has been reviewed carefully by the NYSAND Board of Directors and the entire board is in support of actively taking steps to share our members concerns. Below are the action steps that NYSAND is taking:

–       Last week (March 11, 2015) the NYSAND Sponsorship Task Force recommendations were received and yesterday (March 16, 2015) at the March NYSAND Board of Directors meeting the Sponsorship Task Force recommendations were reviewed. Please stay tuned for more updates and note that a motion will be forth coming this week for the board to take the next step in addressing sponsorship for NYSAND.

–       Today (March 17, 2015) a letter was sent to the Academy president and emailed to several Academy leaders expressing the views that our members have shared and that as an Affiliate we are not comfortable responding with the talking points provided by the Academy on this issue.

–       Dietitians have started a petition, “Repeal the Seal”; NYSAND will be sharing this on our Affiliate Facebook and Twitter pages and encourages all members who share the concern to sign the petition as well. CLICK HERE to sign the petition.

3.  The AND national CEO, Patricia M. Babjak, sent out this letter to members, also on March 17:

Let me begin by apologizing for the concerns caused by the education initiative with Kraft. The Academy and the Foundation are listening. As a member-driven organization, the Academy’s staff and leadership hear your concerns and welcome your input.

Unfortunately, recent news articles misstated a collaboration as a Kids Eat Right “endorsement” of Kraft Singles, and that it represents a “seal of approval” from Kids Eat Right, the Foundation, or the Academy. It is not an endorsement. It is not a seal of approval. We understand this distinction is of little consequence to many Academy members who are concerned with the perception. We are working on a solution.

In addition, we are working to establish a joint, member-driven Member Advisory Panel. This Panel will work closely with both Boards to:

  • Establish dialogue with members
  • Gather input and give feedback on member issues
  • Make specific recommendations

Recognizing sponsorship as a significant issue of concern among members, the House of Delegates leadership team, who also serve on the Board of Directors, scheduled a dialogue on sponsorship for the upcoming virtual House of Delegates meeting, May 3. We encourage all members to reach out to your delegates and share your thoughts on the benefits of, concerns about and suggestions for the sponsorship program. The Academy and Foundation Boards are looking forward to your input.

Applause to members who are speaking out.

As I said in an interview with TakePart:

The food companies have learned from tobacco and drugs and other industries like that how to play this game…Let’s confuse the science, let’s cast doubt on the science, let’s shoot the messenger, let’s sow confusion.

But since everyone has to eat, the food industry has been given a pass on its pay-to-play practices….

The capital N news…is that dietitians are fighting back at last.

I hope they join Dietitians for Professional Integrity and insist that the leadership respond to their concerns.

AdditionA dietitian sends this communication from the Executive Board of the California Dietetic Association to members about the Kraft situation:

We would like to direct your attention to what the California Dietetic Association (CDA) has done to address our own issues surrounding sponsorship. We heard your concerns regarding CDA Annual Conference sponsorship and we have listened. We voted and McDonalds was not invited as a sponsor in 2015. This decision has impacted our finances; however, we believe it was important to respond to our member feedback. In addition, an ad hoc committee approved by the CDA executive board, reevaluated the sponsorship guidelines. The new sponsorship policy will be posted soon on www.dietitian.org.

Mar 13 2015

Dietitians put seal on Kraft Singles (you can’t make this stuff up)

As reported in today’s New York Times, the Academy of Nutrition and Dietetics (AND, formerly the American Dietetic Association) has licensed its Kids Eat Right seal to—get this— Kraft Singles.

But no, AND says, this is not an endorsement.  Kraft is merely a “proud supporter of” AND’s Kids Eat Right program.

As the Times understates the matter,

Over the last few years, the academy been criticized from some of its members and health advocates over what they contend are its overly cozy ties to industry.

Kraft is well known as a sponsor of AND.  Such seals are usually money-raising gimmicks.

I’m wondering if “proud supporter of” means that Kraft pays AND for use of this seal. If so, I’d like to know what the seal costs.

AND members: do any of you know?

Recall the debacle over the Smart Choices logo some years ago.

The press had a field day with the Smart Choices logo on Froot Loops.  As Rebecca Ruiz at Forbes puts it, “the uproar over the program has conveyed a definitive message to industry: Don’t try to disguise a nutritional sin with a stamp of approval.”

Somehow, Kraft and AND seem to have missed this lesson.

Additions: Andy Bellatti sends these links to a statement from Sonja Connor, AND’s president and the website describing the program.

Thanks to Yoni Freedhoff for sending this explanation:

 

AND

And this enlightening note from ABC News:

The academy…said the appearance of the logo on the processed cheese product is not an endorsement or seal of approval. It’s more like an ad for Kids Eat Right, according to the academy, though, in a reversal of how most ads work, Kraft paid the advertiser — the academy — an undisclosed amount to place the logo.

Feb 18 2015

And now a word from our sponsors: The Dietitians Association of Australia

Michele Simon’s latest investigative report deals with sponsorship by food corporations of the Australian Dietetics Association.


cover

 

Consistent with her previous report on corporate sponsorship of the American dietetic association (now The Academy of Nutrition and Dietetics), this one finds that the Dietitians Association of Australia (DAA):

  • Is sponsored by Meat and Livestock Australia, Nestlé, Unilever, Dairy Australia, and the Egg Nutrition Council
  • Is a partner in the “Nestlé Choose Wellness Roadshow”
  • Has important members who work for Kellogg and PepsiCo
  • Has a spokesperson who is paid by Coca-Cola to present his research denying a connection between sugars and obesity
  • Displays recipes from corporate sponsors with branded products despite policies against such things
  • Is believed to have stripped a dietitian of her earned credential for speaking out against such conflicts of interest [*but see additional comments below].

The DAA offers its corporate sponsors the following benefits:

  • Credible, independent, expert partner for nutrition communications
  • Unparalleled opportunity to inform the Australian public through members and the DAA profile
  • Access to members and interest groups for advice
  • Information and expert advice on all nutrition and health issues
  • Opportunities to sponsor DAA programs

This is a good deal for food and beverage corporate sponsors.

It’s not such a good deal for DAA members.  At best:

  • They appear in conflict of interest.
  • Their advice appears bought.
  • They lose credibility.

As Simon concludes:

The health of all Australians depends upon the independence of the nutrition profession and its leadership’s ability to operate free of conflicts of interest and be the nutrition leaders they claim to be, free from sponsorship money.

*Additions:

February 19:  Dr. Sara Grafenauer APD PhD of the DAA wrote me an e-mail detailing charges of error in this account.  She also wrote to Michele Simon.   Food company sponsorship of nutrition professional societies deserves far more critical attention than it usually gets and I am glad to see this debate.

February 20: Dr. Grafenauer writes again: “Thank you for considering our concerns however, with all due respect, the following statement is factually incorrect and should be removed:

  • Is believed to have stripped a dietitian of her earned credential for speaking out against such conflicts of interest.

DAA’s credential, Accredited Practising Dietitian (APD) is very important to the association and its members. It has rigorous processes around its maintenance and integrity and would never be used for purposes other than it is designed (for such as ‘gagging’ a member as is suggested here). There is no basis for this potentially defamatory statement and DAA will take whatever steps are necessary to defend the credential.”

Nov 4 2014

Souvenirs from the Dietitians’ annual meeting

The annual meeting of the Academy for Nutrition and Dietetics, formerly the American Dietetic Association, always provides an incredible exhibit of products from food companies—the latest in dietetic junk food and food company nutritional spin.

Knowing how much I enjoy these things, and that I am working on a book about food advocates and the soft drink industry (Oxford University Press, September 2015), several of my colleagues brought back souvenirs.

Functional foods (with “healthy” ingredients above and beyond what occurs naturally)

  • For Keurig brewing machines, a container of Fibersol Cran-Raspberry flavored instant tea mix, with soluble fiber added (is tea really a significant source of soluble fiber?).
  • MealEnders.com’s chocolate mint signaling lozenges, “an antidote to overeating.”  If you feel that you are overeating, suck on one: “take control, curb appetite, get results” (if only).
  • A 6-ounce can of Kao Nutrition’s black coffee with 270 mg polyphenol (coffee chlorogenic acid), naturally present because the coffee was not brewed at high temperature (well, coffee is a plant extract, after all).

Swag

  • A pen with a pull-out section that gives the potassium content of commonly consumed foods (these come in other versions too, apparently).

Soda company propaganda

  • A brochure from PepsiCo’s Nutrition Team, HydrateNow.  Gatorade, it points out, is 93% water (and the other 7%, pray tell?.
  • A pamphlet from PepsiCo on Calorie Balance: “many things influence your everyday nutrition.  For maintaining a healthy weight, the most important factors are how many calories you eat and the total calories you use up”  (but if those calories happen to be empty?).
  • A PepsiCo brochure on Diet Beverages for People with Diabetes (but it still is advertising Pepsi).
  • A list of PepsiCo drinks that meet the USDA’s nutrition standards for schools (a long list, alas).
  • A scientific paper, “What is causing the worldwide rise in body weight,” sponsored by Coca-Cola (Coke’s answer: lack of physical activity, of course.)
  • A poster from the American College of Cardiology, “Striking an energy balance,” sponsored in part by Coca-Cola.   It says: “Drink water or no- or low-calorie beverages” (it does not say you should Drink less soda”).
  • A pamphlet on National School Beverage Guidelines sponsored by Coca-Cola, PepsiCo, Dr Pepper Snapple, and the American Beverage Association:  “The beverage industry committed to bold change and then made it happen.  Working with our school partners, we transformed the beverages available to students” (yes, but it doesn’t explain that public pressure forced them to do this).
  • A Coca-Cola pamphlet, Balancing Act.  This gives five easy ways to burn 100 calories: playing soccer 13 minutes, briskly walking 15 minutes, climbing stairs 10 minutes, jumping rope 9 minutes, gardening 19 minutes (based on a 150 lb person).  Funny, it doesn’t mention that one 12-ounce Coke is 140 calories.
  • A FamilyDoctor.org pamphlet, Healthy Eating for Kids, from the American Academy of Family Physicians and the American Dietetic Association, distributed with a grant from Coca-Cola.  It lists healthy eating habits—family meals, be active, limit screen time, stay positive, etc (but—surprise—does not suggest that your kid might be healthier not drinking sugar-sweetened beverages).

Treasures, all.  I really love this stuff.  Thanks.

Oct 20 2014

Food professionals’ relationships with food companies: a Q and A

In the past few weeks, I’ve been sent several questions asking my opinion of food professionals’ relationships with food companies.   I thought I would deal with them at one time (all are edited for succinctness and clarity):

Q.  I am a food science student looking into career options in the food industry. I love food science and truly believe that processing food is a good idea that can positively impact the planet and its people.  I want to do something worthwhile,, but I still need to eat.  Can’t the food industry be changed from the inside? Can’t you advise good companies, people, or places where I could start my search? 

A.  I have met social entrepreneurs who strongly believe that businesses can be ethical, do good, and still make heaps of money.  Maybe so.  If you are going to try that route, I think it essential that the company be family or cooperatively owned, and not publicly traded.  You might take a look at food companies incorporated as Benefit Corporations. These are now authorized in about half the states to consider the interests of all stakeholders, not just shareholders, when making decisions.  They are different from B corporations certifying companies that meet certain sustainability criteria.

Many companies work hard to reduce their environmental impact.  But the real question is what they are doing about health impact.  Are they going overboard on health claims?  Are they marketing to children?  These are questions I’d want to ask.  In your shoes, I’d start by looking at companies making products that you like, feel good about, and would be proud to be associated with.   And then take a closer look at how the companies operate.   Working for food companies is always a good learning experience, but if you really want to change the world, you might be better off with a nonprofit agency.

Q.  I’m a graduate student in nutrition and I would like to know what recommendations you may have for students to navigate conflicts of interest with food companies when beginning a career.  I intend to pursue an academic career but am concerned that my credibility as a scientist could be compromised by my participation in industry-funded publications and research. 

A.  It’s great that you are asking such questions. From the standpoint of ethics, that’s an important first step.  You should most definitely publish your research, no matter how it is funded.  Be sure to disclose potential sources of funding bias and conflicts of interest.  While you are doing your research, you can take special care to control for potential biases—conscious and unconscious—in your study design, conduct, and interpretation to ensure that they are not influenced by the funder.  In searching for jobs, you might consider those in academia, government, and NGOs that are less likely to require you to compromise principles.  Finding such jobs may not be easy, but you will be OK if you are always ethically transparent and as straightforward about biases as it is possible to be.

Q.  Do you believe that relationships between the food industry and nutrition professional organizations like the Academy of Nutrition and Dietetics (AND) and the Association for Nutritional Science (ASN) are problematic? Why?

A.  Sponsorship by food product makers puts nutrition professionals in conflict of interest.   Nutritionists ought to be advising clients and the public about what to eat to stay healthy and prevent chronic disease.  This necessarily means promoting consumption of some foods but discouraging consumption of others.  Nutritionists cannot speak truth to clients and protect corporate sponsorship at the same time.  If nothing else, food industry sponsorship gives the appearance of conflict of interest and makes AND and ASN appear as arms of food company marketers.  But it also affects—or appears to affect–AND ’s and ASN’s positions on key issues in nutrition and health.  Overall, financial relationships between these organizations and their food industry sponsors undermines the credibility of their positions on food issues.

Q.  What sort of changes do you think the Academy needs to make in order to make food industry relationships more beneficial to its members and the public overall?

A.  Nutrition and food professional organizations need to establish a firewall between corporate sponsorship and content or opinion.  This requires setting up rigorous guidelines for what food companies can and cannot expect from their donations.  They should not, for example, be permitted to sponsor content sessions at meetings, not least because opinions expressed at sponsored sessions rarely appear objective.  The organizations should have complete control over how and where corporate donations and company logos are used.

Q.  How can relationships between health professionals and the food industry be beneficial for public health overall?

A.  The role of health professionals is to give the best advice possible about diet and health.  The role of food companies is to provide profits to shareholders.  These goals are not the same and are only rarely compatible.  In my experience, people who want to work for food companies to change corporate culture from within do so from good motives, but soon discover that corporate imperatives take precedence over health goals. If health professional organizations want their advice to be taken seriously, they must establish and adhere to rules and guidelines designed expressly to protect their integrity.

Q.  I read your post on the revolving door,  It seems to me that your underlying premise is the notion that any company that makes food is indicted as part of the big evil food conspiracy. Surely, you can’t really believe that. 

A.  Of course I don’t. But food companies are not social service agencies.   Their job—their legal responsibility—is to continuously expand sales and distribute ever-increasing profits to shareholders.   If they can do this and promote health at the same time, more power to them.  But people would be healthier eating food, not food products.  In our present system, products are far more profitable and the focus on them is rarely works in the interest of public health.

Food and nutrition professionals need to make a living.  Unfortunately, jobs in industry pay better–and sometimes a lot better–than jobs in government or NGOs.  That’s the real dilemma that underlies all of these questions.

Jan 24 2013

An open letter to Registered Dietetians and RDs in training: response to yesterday’s comments

My post yesterday about Michele Simon’s report on food company sponsorship of the Academy of Nutrition and Dietetics (AND) elicited a wealth of thoughtful comments.  These are well worth careful consideration.

Many express disappointment that I would suggest that corporate sponsorship might influence their thinking or practice, that other nutrition professionals have equal or better education, that I singled out AND when other nutrition and health organizations also accept food industry funds, or that I am unsympathetic to their plight (they are required to be AND members whether or not they agree with its policies).

Let me clarify:

On the effects of corporate sponsorship: I don’t know a single individual who thinks that taking money from food companies influences personal opinion or practice, but research on the effects of drug—and food—company sponsorship demonstrates otherwise.    At the very least, sponsorship gives the appearance of conflict of interest.  Individuals and organizations who accept sponsorship from soda companies, for example, can hardly be expected to advise the public to drink less soda.

On education: my point here is not that dietetic education is inadequate but that other nutritionists without such training may be equally qualified to advise the public about diet and health.

On other organizations:  That other nutrition and health organizations accept funds from food companies has long been a point of discussion on this blog (click on Partnerships).  I am especially concerned  about the practices of the American Society of Nutrition, to which I belong.  Its embarrassing role in the Smart Choices fiasco was an example of why nutrition professional organizations should avoid getting involved in such alliances.

On sympathy: I have plenty.  Food company sponsorships create painful dilemmas for nutrition professionals and each of us must figure out our own way to deal with them.  I have written about my own struggles with this issue in Food Politics and elsewhere.

I especially appreciate the comments from those of you engaged in your own struggles with this issue within AND.  You have your work cut out for you.  Here, for example, is the response of your president, Dr. Ethan Bergman, to Simon’s report. He writes [and see addition below]:

There is one indisputable fact in the report about the Academy’s sponsorship program: We have one. And for the record, I support the Academy’s sponsorship program, as does the Board of Directors and our members.

Let me make it clear that the Academy does not tailor our messages or programs in any way due to influence by corporate sponsors and this report does not provide evidence to the contrary.

…As members of a science-based organization, I encourage you to not take all information you see at face value, always consider the source (in this case, an advocate who has previously shown her predisposition to find fault with the Academy) and seek out the facts.

My interpretation: ignore the message because the messenger is not one of us.

As nutrition professionals, we ignore such messages at our peril.  If we want the public to trust what we say, our views cannot be perceived as compromised by financial ties to food companies.

What you can do.  If, as some of you noted, you oppose corporate sponsorship and would like to do something about it, here are a few suggestions:

  • Let your voice be heard: write letters, post blogs, send tweets.
  • Make it clear to colleagues and clients that you oppose current policies on corporate sponsorship.
  • Provide evidence that your organization can do just fine without the money.
  • Join committees and groups within your organization; say what you think.
  • Organize petition campaigns.
  • Run for office; run a slate for office.

If you want the policy to change, work for it.

But don’t be discouraged if nothing much happens right away.  Change takes time.  Keep at it.

Thanks to all of you for taking this issue so seriously.  Let’s keep working together to find ways to keep food company money out of our professional lives.

Addition, January 25: a reader, Craig, points out that Coca-Cola gave Dr. Bergman the opportunity to carry the torch at last summer’s Olympic games.  A news story about this event quotes Dr. Bergman on the Academy’s partnership:

I think the philosophy that Coca Cola has through its Live Positively campaign, and our philosophy at the academy, is about trying to improve the nation’s health through better nutrition and fitness so this fits in well with our cause.

 

Jan 22 2013

New study: Big Food’s ties to Registered Dietitians

Michele Simon, president of Eat, Drink, Politics, an industry watchdog consulting group, has just published an exposé of the close financial relationships between food and beverage companies and the Academy of Nutrition and Dietetics (AND, formerly the American Dietetic Association).

Her hard-hitting report, And Now a Word from Our Sponsors: Are America’s Nutrition Professionals in the Pocket of Big Food? provides ample evidence that partnerships and alliances with Big Food make it impossible for AND members to convey clear and accurate messages about nutrition and health.

When she talks about nutrition professionals, she doesn’t mean me.  I have a PhD (in molecular biology, although long lapsed) and a master’s in Public Health Nutrition.  She means AND members.  AND represents more than 70,000 individuals who mostly hold credentials as Registered Dietitians (RDs).

To qualify, they had to complete a bachelor’s degree that included a specified set of courses and a 6-month clinical internship.  I once tried to get credentialed as an RD after I completed a qualifying internship but I had never had a practical course in food service management.  That lack was a deal breaker.

Never mind.  Here’s what Simon’s report is about:

And here are a small selection of her observations and conclusions:

  • AND collected $1.85 million in sponsorship funds in 2011, a relatively small percentage of its $34 million income.
  • Companies such as Coca-Cola, Kraft, Nestlé, and PepsiCo offer approved continuing education courses to AND members.
  • Two of the messages conveyed by one of Coca-Cola’s courses: sugar is not harmful to children, and federal nutrition standards for school meals are too restrictive.
  • More than 20% of speakers at AND’s annual meeting have financial ties to Big Food companies, although most were not disclosed.
  • A survey found 80% of members to believe that sponsorship implies an AND endorsement of the sponsor’s products.
  • A majority of AND members believe that three current sponsors are unacceptable: Coca-Cola, Mars, and PepsiCo.

If you want to see how sponsorship plays out in practice, take a look at her photographs of the exhibit hall at the 2012 AND annual meeting.  She also provides photos taken elsewhere at the meeting.  And here’s the New York Times’ take on it.

As a trade association for Registered Dietitians, AND—as I discussed in Food Politics—has as its primary goal to position RDs as the leading source of nutrition information for patients, clients, and the public.

As you might imagine, I’ve always had a bit of trouble with that goal.

For one thing, nutritionists with master’s and doctoral degrees are likely to know more than RDs about nutrition science and to think more critically about it.

For another, that self-interested goal creates an image problem.  RDs might be accepted as more credible sources if their primary goal was to improve the nutritional health of the American people.

Their advice also would be more credible if AND were not so heavily linked to food and beverage corporations, especially those whose products contribute to poor health.

Let’s hope this new report gets AND members talking about how to change some current AND policies.

Oct 12 2012

The latest in dietetic junk food

The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) has just concluded its annual meeting and exhibition.

I was unable to attend but colleagues have been sending photos and giving me products or other objects collected at the exhibition.  This exhibition is always worth a look.  It typically features displays by food companies (Big Food and small) giving away samples of what I love to call “dietetic junk foods” in order to encourage dietitians to recommend them to clients.

Thanks to my NYU colleague, Lisa Sasson, for alerting me to these entertaining examples.

First: sugar-supplemented Stevia:

Next: The National Confectioners Association has a handy guide to moderate candy consumption:

Then: Frito-Lay (owned by PepsiCo) ‘s new Gluten-Free chips.

Potato chips did not ever contain gluten, but never mind.   They remind me of products offered during the low-carb craze a few years ago, like the ones I photographed when working on What to Eat in 2005.

Eat healthfully and enjoy the weekend!

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