by Marion Nestle

Currently browsing posts about: Soft drinks

Jun 16 2016

Today’s big news: the Philadelphia soda tax vote

The Philadelphia city council votes sometime today on whether to pass a soda tax, with most—but not all—of the revenues targeted to pre-kindergarten education.  I’m getting on an airplane pretty soon and will miss the vote, but it is widely assumed to pass.

The decision is up to the city council.  Although the soda industry spent more than $4 million on public relations to urge the council to vote no, and promised to fund the first year of pre-K, its efforts don’t seem to be working.

To put this in context: Sodas are an easy target for public health measures.  Nobody needs them, they are candy in liquid form, and they have no nutritional value.   But it seems as though their makers are willing to spare no expense to stop any city that attempts to tax them.  The total in Philly is $4.9 million by the latest rumors.

Americans are highly likely to support taxes that are earmarked for social purposes, as the Philly tax mostly is.

Every other city council can see that Berkeley gets more than a million a year for discretionary child health programs.  Philadelphia is a bigger city and will get more, but is using it to fill budget holes as well as Pre-K.  I’m guessing lots of places will figure out that they can do this too.

At the very least, the soda industry will be willing to donate huge amounts of money to get city councils to delay or block measure, as it did in Philadelphia.

This vote is worth watching closely (you can do that here).  I’m sorry to be missing it but will try to catch up with it later.

References

Politico’s deep dive is here.

 

May 5 2016

More on corporate funding of nutrition research: exchange of letters

In January this year, JAMA Internal Medicine published my Viewpoint on corporate funding of nutrition research: science or marketing.

Richard Kahn, former chief scientist and medical officer of the American Diabetes Association, wrote a letter in reply (see below for more about him**).  The journal published his letter, along with my response, in its current issue.  Here’s what I said.

In Reply Dr Kahn requests evidence that nutrition research funded by food companies is of lesser quality than studies funded by independent agencies or performed by investigators with nonfinancial conflicts of interest. Concerns about such issues are relatively recent; few published studies address them directly. Instead, concerns about industry sponsorship of nutrition research derive from comparisons with the results of studies of funding by tobacco, chemical, drug, or medical device companies. This research typically finds industry-sponsored studies to report results more favorable to the products of the sponsor than studies not funded by industry. It identifies subtle rather than substantive differences in the quality of this research; industry-funded studies are more likely to underreport unfavorable results and interpret neutral results more positively.1 When results are negative, they are less likely to be published.2

Between March 2015 and March 2016, I identified 166 industry-funded nutrition research studies and posted and discussed them on my blog.3 Of these, 154 reported results favorable to the interest of the sponsor; only 12 reported contrary results. The few studies systematically examining the influence of industry funding on nutrition research tend to confirm results obtained from other industries. For example, a systematic review comparing industry-funded and nonindustry-funded trials of probiotics in infant formula reported no association of funding source with research quality. Industry-funded studies, however, seemed more likely to report favorable conclusions unsupported by the data.4

Dr Kahn states that sponsored studies often specify that the funder had no role in the study. Only recently have some journals required such statements, and I am unaware of research on the extent of this practice or authors’ adherence to it. Among the 166 industry-funded studies that I reviewed, few disclosed involvement of a sponsor.

Dr Kahn asks whether industry funding is any more biasing than career self-interest or intellectual passion. Unlike industry funding, self-interest and passions are intrinsic to every scientist who conducts research, are a matter of public record, cannot be eliminated, and have not been shown to consistently bias research results in the same ways as industry funding.5 Fortunately, nutrition societies and research institutions are developing policies to manage financial relationships with industry.6 Such policies hold promise for preventing financial conflicts of research in nutrition research.

1. Lundh  A, Sismondo  S, Lexchin  J, Busuioc  OA, Bero  L.  Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2012;12:MR000033. PubMed

2. Rising  K, Bacchetti  P, Bero  L.  Reporting bias in drug trials submitted to the Food and Drug Administration: review of publication and presentation. PLoS Med. 2008;5(11):e217. PubMed   |  Link to Article

3. Nestle  M. Food Politics Blog. http://www.foodpolitics.com/. Accessed March 2, 2016.

4. Mugambi  MN, Musekiwa  A, Lombard  M, Young  T, Blaauw  R.  Association between funding source, methodological quality and research outcomes in randomized controlled trials of synbiotics, probiotics and prebiotics added to infant formula: a systematic review. BMC Med Res Methodol. 2013;13:137. PubMed   |  Link to Article
5. Bero  L.  What is in a name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol. 2014;67(11):1239-1241. PubMed   |  Link to Article 
6. Charles Perkins Centre. Engagement with Industry Guidelines 2015. University of Sydney, 2015. https://intranet.sydney.edu.au/perkins/research-support/engaging-with-industry.html. Accessed March 2, 2016.
**Richard Kahn is infamous in my circles for supporting the positions of the sugar and soda industries while with the American Diabetes Association and now.  I wrote about what he said in an interview with Corporate Crime Reporter in my book What to Eat (pages 355-356).  Recently, The Russells (of CrossFit) had a lot more to say about Kahn’s ongoing opposition to public health measures.
Apr 26 2016

Soda Politics gets Presidential: Sanders v. Clinton on soda taxes

Talk about soda politics! I can hardly believe it but soda taxes have become an issue in the Democratic primary campaign.

This started when Hillary Clinton came out in favor of Philadelphia Mayor Jim Kenney’s proposed soda tax.

I’m very supportive of the mayor’s proposal to tax soda to get universal pre-school for kids. I mean, we need universal pre-school. And if that’s a way to do it, that’s how we should do it.

Given the Clinton Foundation’s long-standing relationship with Coca-Cola, this was unexpected.

In short order, Bernie Sanders distanced himself from her position:

I do not support Mayor Kenney’s plan to pay for this program with a regressive grocery tax that would disproportionately affect low-income and middle-class Americans. I was especially surprised to hear Hillary Clinton say that she is “very supportive” of this proposal. Secretary Clinton has vowed not to raises taxes on anyone making less than $250,000 per year. For reasons that are not clear, she has chosen to abandon her pledge by embracing a tax that targets the poor and the middle class while going easy on the wealthy. That approach is wrong for Philadelphia, and wrong for the country.

This, in turn, induced Paul Krugman, who seems to have little love for Sanders anyway, to weigh in:

It does seem worth pointing out that progressivity of taxes is not the most important thing, even when your concern is inequality. Notably, Nordic countries — very much including Denmark, which Sanders has praised as a model — rely heavily on the VAT, which is a regressive tax; but they use that revenue to pay for a strong social safety net, which is much more important.

If we add in the reality that heavy soda consumption really is destructive, with the consequences falling most heavily on low-income children, I’d say that Sanders is very much on the wrong side here. In fact, I very much doubt that he’d be raising the issue at all if he weren’t still hoping to pull off some kind of political Hail Mary pass.

Soda tax proponents wish that Sanders had better understanding of the health issues.

Proponents say Diabetes is regressive.

Here’s information from the table from Soda Politics on framing the soda-tax debate (see page 385).

OPPONENTS SAY ADVOCATES SAY
Taxes are a blunt instrument of government intervention. Taxes can encourage healthier food choices while generating needed revenue.
No compelling evidence links sodas to obesity or other health problems. Research sponsored by independent agencies, not soda companies, clearly links soda consumption to overweight and poor health.
Soda taxes are regressive. They disproportionately hurt poor people. Diabetes is regressive. Obesity and diabetes disproportionately hurt poor people.
Governments should stay out of personal choice. Governments should protect the health of citizens.
Soda choice is a matter of personal responsibility. Taxpayers fund health care costs. Obesity and diabetes are matters of social responsibility.
Soda companies are already making healthful changes to their products. Soda companies heavily market sugary beverages.
Soda sales have declined while obesity rates remain high; Sodas cannot be responsible for obesity. Obesity rates are stabilizing as soda sales decline. Sales of some other sweetened beverages are increasing. All should be taxed.
Sodas are not cigarettes or alcohol; They do not cause the same level of harm. The health effects of sodas increase health care costs for everyone.
Soda taxes lead to unintended consequences; Decreases in consumption will be offset by other sources of calories. Cigarette taxes decreased smoking; Let’s try taxing sodas and see whether it works.
Everyone opposes nanny-state soda taxes. Soda taxes linked to health programs have strong bipartisan support from public health organizations, city officials, and policy centers.
Apr 1 2016

Weekend reading: CSPI’s Carbonating the World

Center for Science in the Public Interest has produced a new report:

It’s a lavishly illustrated and well documented investigative report into soda company marketing in developing countries.

Here’s an example of the documentation, enough to explain why Coke and Pepsi are pouring billions of dollars into bottling plants and marketing in India:

 

Capture

For anyone interested in the nutrition transition from undernutrition to overnutrition in developing countries, this report is a must read.  Actually, it’s a must read for anyone who cares about diet and health.  If you do nothing else, look at the marketing illustrations from Nepal, Indonesia, or Nigeria.  They tell the story on their own.

Mar 21 2016

The UK soda tax: a tipping point?

Wonder of wonders, the UK’s Chancellor of the Exchequer, George Osborne, has put a soda tax into his new budget initiative (see BBC account, the video and text of Osborne’s speech, and the Treasury department’s fact sheet on the soda tax).

Here’s how the tax is supposed to work:

Shocking: Many of Britain's most sugary drinks contain more that the daily recommended amount for one person

Osborne says the tax will bring in £520 million ($732 million) in the first year, and he intends to use it to fund more sports in schools.

But it goes into effect in April 2018.  This is to give the industry time to reformulate products with less sugar.  But—the delay also gives the industry ample time to block the tax.

Public Health England supports the tax (see statement).

But the soda industry wasted no time reacting to this bad news.

  • Coke, Pepsi, and other soft drink companies strongly objected.
  • The immediate result: a fall in their stock prices.
  • The immediate reaction: Sue the government.  On what grounds?  Discrimination.  The tax does not affect sugary juices, milkshakes, or processed foods.

New tax: Soft drinks with more than 5g of sugar will be taxed at 6p per can or carton and drinks with more than 8g of sugar will be taxed at 8pm, which if passed on to the consumer means a can of Old Jamaica ginger beer will go up from 58p to 66p

The makers of artificial and alternative sweeteners think this will be a win for them.

Will the tax help reduce obesity?  On its own, that would be asking a lot.

Jamie Oliver, the British chef who favors the tax, says of course it won’t work on its own.  It needs to be accompanied by six additional actions (food labels, better school food, curbs on marketing to kids, etc.).

Why are soda companies so worried about this?  It could be catching.

Will the UK tax stick?  Watch Big Soda pull out every stop on this one.

And think about what they are doing to fight soda taxes when you read or hear that soda companies want to be part of the solution to obesity.

Feb 22 2016

Energy drink marketing, Australia style

Alexandra Jones, of the University of Sydney’s George Institute for Global Health, was kind enough to forward the promotional activities of V, a New Zealand energy drink, on college campuses during orientation week.

These, to say the least, got my attention.

According to the company’s promotional materials (take a look!), it wants colleges to agree to let it:

  • Put used textbooks into college libraries that V carves out with V-shaped holes.
  • Give prizes including free product, cash, and “life-hack” recommendations such as “sneak booze into anywhere by hollowing out a baguette.”
  • Appoint brand ambassadors to hand out sample cans like “an energetic Christmas charity drive”
  • Conduct ongoing activities throughout the academic year including sending “sneaky ninja staff” into campus libraries to hide V promotions and prizes among the “less helpful, less exciting actual books.”

Here’s how:

We’re going to take an elephant-load of used textbooks and cut a V-shaped hole in the pages.  We’ll put in fake V cans with a super mysterious mystery prize in it.  Most of the time it’ll be free Vs.  Sometimes it’ll be a fistful of cash, but they’ll always have a life-hack recommendation with it.  For example, if it’s a beginner’s Spanish book, the hack says,”¿le gustaria ir a cenar?” is how you say, “would you like to go to dinner,” in Spanish.  As the hot girl/guy in your class and use this $500 for some fancy tapas and sangria (Spanish food).

I suppose this is meant to be funny and $500 ought to be enough for a good dinner, even at inflated Sydney restaurant prices.

Will librarians be amused?

The faculty, understandably, is not.

The campaign has been pitched to Sydney Uni.  Will the university agree to it?

The mind boggles.

Addition, Feb 25: Here’s an article about this.

Jan 11 2016

The 2015 Dietary Guidelines’ hidden advice about sugary drinks: definitely there, but hard to find 

I’m indebted to Maria Godoy of NPR’s The Salt for pointing out where in the new 2015 Dietary Guidelines you can find advice about cutting down on sugary drinks.  As she puts it, this is easy to miss.

Here’s my wonky analysis.

In my post about the 2015 Dietary Guidelines, I noted that they are unambiguous about the need to reduce added sugars to 10% or less of calories.  But what they say about cutting down on sugary drinks—the leading source of sugars in US diets—is buried deep in the text.  Fortunately, Deborah Noble of slowfoodfast.com has performed a great public service by producing the 2015 Dietary Guidelines in a searchable pdf format.Here’s where to find advice about cutting down on sugary drinks:

The Executive Summary: See under “Cross-Cutting Topics of Public Health Importance:”

Similarly, added sugars should be reduced in the diet and not replaced with low-calorie sweeteners, but rather with healthy options, such as water in place of sugar-sweetened beverages.

Figure 2-10 explains:

The major source of added sugars in typical U.S. diets is beverages, which include soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters.

Reading the Figure tells you that beverages comprise a whopping 47% of added sugars (closer to half if you add in sweetened milks, teas, and coffees).  The text following the Figure says:

Shift to reduce added sugars consumption to less than 10 percent of calories per day: Individuals have many potential options for reducing the intake of added sugars. Strategies include choosing beverages with no added sugars, such as water, in place of sugar-sweetened beverages, reducing portions of sugar-sweetened beverages, drinking these beverages less often, and selecting beverages low in added sugars.

Strategies?  How about just saying: “Cut down on sugary drinks” or “Drink water instead of sugary drinks.”

Figure ES-1 in the Executive Summary illustrates the 2015-2020 Dietary Guidelines for Americans at a Glance.  All it says is:

Limit calories from added sugars…Consume an eating pattern low in added sugars…Cut back on food and beverages higher in these components to amounts that fit within healthy eating patterns.

Figure 3.2 shows Implementation of the Guidelines through MyPlate: “Drink and eat less…added sugars,” but nothing about sugary drinks.

This circumspection is weird.  Clear, straightforward advice to cut down on sugary beverages has plenty of historical precedent.

Both Figures ES-1 and 3.2 are most certainly derived from a USDA graphic on the MyPlate website (dated January 2016).  This says flat out:

Drink water instead of sugary drinks.

This statement, in turn, derives from:

  • The precepts issued with the 2010 Dietary Guidelines in January 2011
  • The statements issued with the MyPlate graphic in June 2011

myplate

  • The USDA’s May 2012 tip for making better beverage choices.

The 2015 DGAC (Dietary Guidelines Advisory Committee) repeatedly urged limits on consumption of sugar-sweetened beverages.  Statements like this one, for example, appear throughout the document:

To decrease dietary intake from added sugars, the U.S. population should reduce consumption of sugar-sweetened beverages.

Why did the USDA and HHS writing committee choose to waffle about his point?

This cannot be an accident.  It must be deliberate.  And it can have only one explanation: politics.

Oct 20 2015

Uh oh. Big Soda lobbyists weaken Mexican soda tax

Yesterday, I received this ALERT from health advocates in Mexico:

Big Soda negotiates behind doors with PRI to reduce Mexican SSB tax to 5% for drinks with 5 grams of added sugars per 100ml– Public health advocates denounce conflict of interest and speak out in defense of the tax

Yesterday Mexico’s Congressional Finance Committee proposed and voted in favor of an alarming measure to reduce the rate of the current 10% sugar-sweetened beverage tax to 5% on products with 5 grams of added sugar or less per 100 milliliters. The measure was pushed through committee vote with a reservation from only one political party and moves on to a vote in the lower house within the next 24-48 hours. Beverages with more than 5 grams of added sugar per 100 milliliters would continue to be taxed at 10% (1 peso per liter).

A columnist in one of Mexico’s most prominent dailies indicates that this negotiation between the FEMSA Coca-Cola bottling company and the PRI political party (current administration and majority vote holder in Congress and Senate) came about after attempts at a food and beverage industry negotiation with the PRI, seeking to reduce Mexico’s SSB and snack taxes. The columnist says Bimbo (&the food industry) was eventually excluded from this negotiation to focus on an attainable goal of reducing the SSB tax. (See column in Spanish: http://www.dineroenimagen.com/2015-10-19/63221 )

After several recent press conferences and an act in Congress “to trap” industry lobby mosquitos (Oct 6), continuing to call for an increase to a 20% SSB tax in accordance with national and international expert recommendations, and warning the public and decision makers of industry lobby, today civil society advocates –the Nutritional Health Alliance and ContraPESO– published a full page ad in Mexico’s most important daily asking whether legislators are on the side of public health or soda industry interests and calling on them not to cede to the industry lobby.

In the ad (see translation below and image attached), advocates warn that the most currently consumed 600 ml sugary drink on the Mexican market that has 5 grams of sugar per 100 milliliters contains 30 grams of sugar, above the WHO’s new guidelines for healthy living.

The language of the initiative to reduce the tax recognizes the SSB tax as a public health measure and the progress made, yet proceeds to reduce the tax far below the expert recommended rate, representating a setback to Mexico’s landmark tax.

FYI: Although Mexico’s lower house of Congress (Chamber of Deputies) holds authority over final budget decisions on income, Mexican legislative process entails that the budget package, once voted in the lower house, passes to the Senate for review and a vote, before passing back to the lower house for final approval.

TO SUPPORT MEXICAN ADVOCATES:
Tweet indignation over industry back-door negotiation and support for the current tax and need for an increased tax: #ImpuestoAlRefresco
Press interviews: contact comunicacion@elpoderdelconsumidor.org
If you or your association can emit a declaration or letter of support, send to:
comunicacion@elpoderdelconsumidor.org
desarrolloinstitucional@elpoderdelconsumidor.org

PUBLIC HEALTH ADVOCATES IN MEXICO – Ad in Reforma newspapers OCT 19, 2015 – IN DEFENSE OF MEXICAN SSB TAX. Translation:
Members of Congress:

Have you let yourselves be bitten by the sugar-sweetened beverage lobby mosquitos?:

Do you serve soda industry or public health interests?

– The tax on sugar-sweetened beverages is 10% (1 peso) and not 20% (2 pesos) per liter as recommended by international and national organizations.

– The proposal to lower the tax to 5% to beverages with 5 grams or less of sugar per 100 milliliters acquiesces to soda industry interests, which are the parties mainly responsible for the collapse of public health in Mexico.

– The most consumed 600 milliliter drink in Mexico has 5 grams of sugar for every 100 milliliters contains 30 grams of sugar (6 spoonfuls).

– This surpasses the 25 grams (5 spoonfuls) that the World Health Organization establishes as a maximum amount of added sugars per day in order to preserve one’s health. (1)

– Sugar is not an essential nutrient and there is solid evidence showing that its consumption is harmful to health, contributing to overweight, obesity and caries, serious public health problems in Mexico.

Sugar-sweetened beverages kill more Mexicans a year than organized crime. (2)

Whose side are you on?

DO NOT GIVE IN TO INDUSTRY PRESSURE!

Show that you work to protect the public health of the Mexican population and not Big Soda’s profits.

We demand that the special tax be preserved and increased to 20% for ALL SUGAR-SWEETENED BEVERAGES, as recommended by international and national organizations.

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