by Marion Nestle

Currently browsing posts about: Soft drinks

Aug 22 2016

Catching up on soda politics

My book, Soda Politics, came out not quite a year ago but so much has happened since then that it’s been hard to keep up with everything that’s happening in campaigns to discourage consumption of sugar-sweetened beverages.

Fortunately, Healthy Food America’s Casey Hinds puts out a daily roundup of sugar and soda news (you can sign up for it and HFA’s other materials here).

A few recent items of particular interest:

USA Today’s editorial, “soda taxes fall flat

More effective ways already are being used to change people’s diets. The best use of government authority is to empower people with the information they need to make healthier choices.

The editorial comes with a poll, still up.  You can vote on it here.  At this moment only 183 votes have come in, 51% strongly in favor of the editorial opinion.

Jim Krieger of Healthy Food America did a counterpoint

The time has come to tax sugary drinks like we tax tobacco. The analogy is powerful: As with tobacco, rock-solid evidence shows habitual use harms health. Sugary drinks are a prime culprit in rampant health problems — diabetes, obesity, and heart, dental and liver disease – that cut lives short and drive up health care costs.  Tobacco taxes have reduced smoking, while raising money to make lives better. Taxing sugary drinks would do the same

This too has a poll on which you can still vote.  Only 92 votes have come in, and only 38% strongly agree.

Americans don’t like taxes.  Even so, either this issue doesn’t generate much interest or it’s just August and too hot to think about such things.

 

The beverage industry spent $10.6 million to oppose Philadelphia’s soda tax initiative

The soft drink industry does not like taxes and seems willing to put fortunes into opposing them.

The Philadelphia City Council passed the tax anyway.  I keep thinking of all the good things nearly $11 million could do for public health.

Melbourne’s The Alfred Hospital reduces sugary drink consumption

The hospital did an experiment to see if they could shift the mix of drinks purchased from sugary to less sugary.  They did this by increasing the price of sugary drinks and hiding them under counters.  Sales of sugar-sweetened beverages sales fell by 36,500 drinks in a year.

I don’t get it.  Why not just stop selling them altogether?

That’s it for this August Monday.  Stay cool.  More to come.

Addition, August 23

A reader from New Zealand writes to say that “all of its hospitals no longer sell sugary sodas and some are also beginning to remove juice and artificially sweetened beverages due to their acidic nature and detrimental impact on oral health.”

Aug 2 2016

The latest in soda advocacy

Two items in the case against excessive consumption of sugary beverages:

More ties to Coca-Cola at CDC

Carey Gillam, the research director for U.S. Right to Know, has been busy delving through e-mails between officials at the Centers for Disease Control and Prevention (CDC) and Coca-Cola.

Her previous story was followed by that official’s retirement.

This one identifies another CDC official with “a history of promoting and helping lead research funded by Coca-Cola.”

I’m quoted in the article:

Officials of public health agencies run the risk of cooptation, capture, or conflict of interest when they have close professional ties with companies whose job it is to sell food products, regardless of the effects of those products on health.

Calls for warning labels

Dean Schillinger, a doctor at UCSF and CSPI’s Michael Jacobson have co-authored an article in JAMA calling for warning labels on advertisements for sugary drinks—something that is being tried in San Francisco, albeit in the face of legal challenges.

So far, the courts have upheld the warning labels.    The authors conclude:

Implementing such policies could benefit all US residents, but could especially benefit socioeconomically vulnerable populations, including children, some of whom are exposed to a disproportionate volume of SSB advertising and often purchase these products at high rates and experience the greatest risk of chronic diseases. The decision in American Beverage Association (ABA) et al v City & County of San Francisco, if upheld by the appellate court, provides a pivotal legal precedent that could influence public health policy at local, state, and national levels related to communicating the health risks inherent to SSBs and other products.

Jul 20 2016

How did Philadelphia pass a soda tax?

I’m at the Summer Academy in Global Food Law and Policy in Getxo, Spain speaking about Soda Politics and was happy to see Healthy Food America’s analyses of how Philadelphia passed a soda tax.

Jim Krieger starts out with a reminder that all cities are different and all politics is local, but in this case Philadelphia did an outstanding job on the

  • Political path: a budget proposal to be passed by the City Council
  • Timing: end of budget speech while still a new mayor
  • Framing: source of revenue to fund pre-K
  • Community base: a coalition
  • Financial support: Bloomberg and Arnold foundations
  • Media buzz
  • An effective champion in Mayor Jim Kenney  

All of these are essential elements in any advocacy campaign.

Casey Hinds, also of Healthy Food America, focuses on why Mayor Kenney’s messaging was so effective.  She quotes from his

This last interview is particularly inspiring.  He knew what he was doing, and why.

KENNEY: It never was a grocery tax. From my perspective and my opinion, their miscalculation is that they thought the people were stupid and that they would totally eat the idea of a grocery tax. In the end, diet [beverages] became part of it because it was part of the negotiation to get us the nine votes or the 13 votes we needed. It was always about sugar-sweetened beverages. It was never about anything else. I think people recognize that this was a way to generate significant revenue without raising their real estate taxes, without raising their wage taxes, without raising business taxes, because those are all the taxes that we’ve always [used] to fund education.

…BOTTEMILLER EVICH: So when the other cities, states, call you, what are you going to tell local officials about going down this road?

KENNEY: Tie it to initiatives that the public wants. Build a coalition around those initiatives. And just continue to grow the coalition and don’t worry about the big money. It’s clear now that the big money isn’t all it’s cracked up to be.

We need more politicians like this.

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.

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