by Marion Nestle

Currently browsing posts about: Soft drinks

Feb 3 2013

Soda-size cap is a public health issue

Here’s my monthly (first Sunday) Food Matters column from the San Francisco Chronicle. The question (edited) came from a reader of this blog.

Q: You view New York City’s cap on any soda larger than 16 ounces as good for public health. I don’t care if sodas are bad for us. The question is “Whose choice is it?” And what role should the nanny state play in this issue?

A: Your question comes up at a time when the New York State Supreme Court is hearing arguments about whether New York City’s health department has the right to establish a limit on soda sizes.

As an advocate for public health, I think a soda cap makes sense. Sixteen ounces provides two full servings, about 50 grams of sugars, and 200 calories – 10 percent of daily calories for someone who consumes 2,000 calories a day.

That’s a generous amount. In the 1950s, Coca-Cola advertised this size as large enough to serve three people.

You may not care whether sodas are bad for health, but plenty of other people do. These include, among others, officials who must spend taxpayer dollars to care for the health of people with obesity-related chronic illnesses, employers dealing with a chronically ill workforce, the parents and teachers of overweight children, dentists who treat tooth decay, and a military desperate for recruits who can meet fitness standards.

Poor health is much more than an individual, personal problem. If you are ill, your illness has consequences for others.

That is where public health measures come in. The closest analogy is food fortification. You have to eat vitamins and iron with your bread and cereals whether you want to or not. You have to wear seat belts in a car and a helmet on a motorcycle. You can’t drive much over the speed limit or under the influence. You can’t smoke in public places.

Would you leave it up to individuals to do as they please in these instances regardless of the effects of their choices on themselves, other people and society? Haven’t these “nanny state” measures, as you call them, made life healthier and safer for everyone?

All the soda cap is designed to do is to make the default food choice the healthier choice. This isn’t about denial of choice. If you want more than 16 ounces, no government official is stopping you from ordering as many of those sizes as you like.

What troubles me about the freedom-to-choose, nanny-state argument is that it deflects attention from the real issue: the ferocious efforts of the soda industry to protect sales of its products at any monetary or social cost.

The lawsuit against the soda cap is a perfect example. It is funded by the American Beverage Association, the trade association for Coca-Cola, PepsiCo and other soft-drink companies, at what must be astronomical expense.

To confuse the public about corporate profits as a motive, the beverage association enlisted two distinguished civil rights groups – the NAACP and the Hispanic Federation - to file an amicus brief on behalf of its lawsuit.

Never mind that the obesity rate for the communities these groups represent is considerably higher than average in New York City, and that these neighborhoods would benefit most from the soda cap. The amicus brief argues that the soda cap discriminates against them.

The brief, however, neglects to mention that both amicus groups received large donations from soda companies and that the NAACP in particular has a long history of partnership with Coca-Cola.

Financial arrangements between soda companies and ostensibly independent groups demand scrutiny. National and local reporters – bless them – have done just that.

They report, among other connections, that one of the law firms working for Coca-Cola wrote the amicus brief, and that a former president of the Hispanic Federation just took a job with that company.

Last fall, the East Bay Express exposed how the soda industry exploited race issues to divide the electorate and defeat the Measure N soda tax initiative in Richmond. It revealed

that the beverage association not only paid for the successful “grassroots” campaign against Measure N but also encouraged views of the soda tax as racist.

Driven by this experience, the soda industry is repeating this tactic in New York City.

Is a cap on soda sizes discriminatory against groups working for civil rights? Not a chance.

Public health measures are about alleviating health disparities and giving everyone equal access to healthy diets and lifestyles. This makes public health – and initiatives like the soda cap – broadly inclusive and democratic.

If anything is undemocratic and elitist, it is suing New York City over the soda cap.

In funding this lawsuit, the soda industry has made it clear that it will go to any length to protect its profits, even if it means discrediting the groups that would most benefit from this rather benign public health initiative.

Jan 25 2013

Soda industry exploits NAACP and Hispanic Federation in soda cap lawsuit

Who knew that Wednesday’s New York State Supreme Court hearing on the lawsuit filed against New York City’s cap on sodas larger than 16 ounces would turn out to be a debate about race relations?

Let’s be clear.  This lawsuit is about only one thing and one thing only: to protect the profits of Big Soda—mainly, Coca-Cola and PepsiCo.  The lawsuit is funded by their trade association, the American Beverage Association (ABA), at what must be astronomical expense.

But to shift attention away from profit as a motive, the ABA enlisted two organizations of underrepresented groups—the NAACP and Hispanic Federation—to file an amicus brief on behalf of the soda companies.  The brief argues that the soda cap discriminates against citizens and small-business owners in African-American and Hispanic communities.  But it neglects to mention  that both “friends of the court” received funding from soda companies.

The financial arrangements between Big Soda and such groups demand further examination. Fortunately, we have Michael Grynbaum at the New York Times, who explains that:

The obesity rate for African-Americans in New York City is higher than the city average, and city health department officials say minority neighborhoods would be among the key beneficiaries of a rule that would limit the sale of super-size, calorie-laden beverages.

But the N.A.A.C.P. has close ties to big soft-drink companies, particularly Coca-Cola, whose longtime Atlanta law firm, King & Spalding, wrote the amicus brief filed by the civil rights group in support of a lawsuit aimed at blocking Mr. Bloomberg’s soda rules…Coca-Cola has also donated tens of thousands of dollars to a health education program, Project HELP, developed by the National Association for the Advancement of Colored People. The brief describes that program, but not the financial contributions of the beverage company. The brief was filed jointly with another organization, the Hispanic Federation, whose former president, Lillian Rodríguez López, recently took a job at Coca-Cola.

Soda companies have a long history of targeting their marketing efforts to Blacks and Hispanics, as shown in at least one book (and described in one of its reviews).

Last fall, the East Bay Express exposed how the soda industry exploited race issues and used them to divide and conquer in defeating the Measure N soda tax initiative in Richmond, California.

The No on Measure N workers’ paychecks were signed by political consultant Barnes Mosher Whitehurst Lauter & Partners (BMWL), which had been hired by the American Beverage Association….By the time that Big Soda had arrived, the issue of race was already a factor in the campaign. Some opponents of the tax had alleged that it was racist, arguing that it would unfairly harm low-income residents in the city. And the No on Measure N campaign…nurtured that sentiment. Indeed, there is evidence that the beverage association helped keep race at the forefront of the campaign as part of a strategy that exploited Richmond’s existing tensions.

…the beverage industry discovered a winning formula in Richmond last year that it might be able to replicate elsewhere…And if that were to happen, it could drive a wedge through traditional Democratic constituencies in many communities, with blacks and Latinos opposing their longtime political allies — progressives and environmentalists — just like they did in Richmond.

Is a cap on soda sizes discriminatory?  Quite the contrary.

Public health measures like this are about removing health disparities and giving everyone equal access to good nutrition and health.  This makes public health—and initiatives like the soda cap—democratic, inclusive, and anything but elitist.

But I can’t think of anything more elitist, less inclusive, and more undemocratic than suing New York City over the soda cap.

In funding this suit, the soda industry has made it clear that it will go to any lengths at any cost to protect its profitability—even to the point of dragging along with it the very groups that would most benefit from the initiative.

If the American Beverage Association and its corporate members really cared about Black and Hispanic groups, it would stop target marketing,  stop marketing to children, and stop pretending that sugar-sweetened beverages are an important part of active, healthy lifestyles.  It certainly would stop wasting these groups’ time and credibility on anti-public health lawsuits.

Jan 21 2013

Energy drinks: the new frontier for food advocacy?

I am an avid follower of NutraIngredients-USA.com, a daily newsletter for the food industry.  Today, it collects its recent articles on energy drinks in one place.

The makers of energy drinks have managed to get away with positioning these products as healthier alternatives to regular soft drinks.

They also have gotten away with being able to add vitamins and minerals to them that the FDA would not permit in regular Coke or Pepsi.

Unfortunately for them, some manufacturers upped the caffeine to the point where it might be making people sick.  Illnesses among energy drink users have focused attention on these products.

Are energy drinks the new frontier for food advocacy?  I think so, and I’m guessing NutraIngredients-USA does too.

Jan 18 2013

Should sugar-sweetened beverages be regulated? NEJM readers vote yes.

As part of an interactive case study and point-counterpoint on regulation of sugar-sweetened beverages, the New England Journal of Medicine (NEJM) conducted a poll of its U.S. and international readers.  The poll elicited responses from 1290 readers from 75 countries.

Overall, 68% of respondents favored government regulation.

High as this percentage is, the average is much lower than percentages from most countries as a result of one outlier—the United States.

Only 58% of U.S. voters in the poll favored regulation.  Everywhere else in the world, the percent in favor averaged 84%.

These results reminded me of change-in-sales figures from a few years ago:

Americans have reduced soft drink consumption, causing soda companies to focus their marketing efforts overseas.  Trends like these explain Coca-Cola’s new obesity ad campaign and Pepsi’s $50 million deal with Beyoncé. 

In America these days, 58% is an impressive majority.  NEJM readers are likely to be physicians, scientists, and health and health policy professionals. I suspect we will be hearing more about this idea.  Stay tuned for this one too.

Jan 10 2013

Predictions for 2013 in food politics

For my monthly (first Sunday) Food Matters column in the San Francisco Chronicle, I devote the one in January every year to predictions.  Last year I got them all pretty much on target.  It didn’t take much genius to figure out that election-year politics would bring things to a standstill.  This year’s column was much harder to do, not least because the FDA was releasing blocked initiatives right up to the printing deadline.

 Q: I just looked at your 2012 crystal ball column. Your predictions were spot on. But what about 2013? Any possibility for good news in food politics?

A: Food issues are invariably controversial and anyone could see that nothing would get done about them during an election year. With the election over, the big question is whether and when the stalled actions will be released.

The Food and Drug Administration has already unblocked one pending decision. In December, it released the draft environmental assessment on genetically modified salmon – dated May 4, 2012. Here comes my first prediction:

The FDA will approve production of genetically modified salmon: Because these salmon are raised in Canada and Panama with safeguards against escape, the FDA finds they have no environmental impact on the United States. The decision is now open for public comment. Unless responses force the FDA to seek further delays, expect to see genetically modified salmon in production by the end of the year.

Pressures to label genetically modified foods will increase: If approval of the genetically modified salmon does nothing else, it will intensify efforts to push states and the FDA to require GM labeling.

Whatever Congress does with the farm bill will reflect no fundamental change in policy: Unwilling to stand up to Southern farm lobbies, Congress extended the worst parts of the 2008 farm bill until September. Don’t count on this Congress to do what’s most needed in 2013: restructure agricultural policy to promote health and sustainability.

The FDA will start the formal rule-making process for more effective food safety regulations: President Obama signed the Food Safety Modernization Act in January 2011. Two years later, despite the FDA’s best efforts, its regulations – held up by the White House – have just been released for public comment. Lives are at stake on this one.

The FDA will issue rules for menu labels: The Affordable Care Act of 2010 required calorie information to be posted by fast-food and chain restaurants and vending machines. The FDA’s draft applied to foods served by movie theaters, lunch wagons, bowling alleys, trains and airlines, but lobbying led the FDA to propose rules that no longer covered those venues. Will its final rules at least apply to movie theaters? Fingers crossed.

The U.S. Department of Agriculture will delay issuing nutrition standards for competitive foods: When the USDA issued nutrition standards for school meals in January 2012, the rules elicited unexpected levels of opposition. Congress intervened and forced the tomato sauce on pizza to count as a vegetable serving. The USDA, reeling, agreed to give schools greater flexibility. Still to come are nutrition standards for snacks and sodas sold in competition with school meals. Unhappy prediction: an uproar from food companies defending their “right” to sell junk foods to kids in schools and more congressional micromanagement.

The FDA will delay revising food labels: Late in 2009, the FDA began research on the understanding of food labels and listed more relevant labels as a goal in its strategic plan for 2012-16. Although the Institute of Medicine produced two reports on how to deal with front-of-package labeling and advised the FDA to allow only four items – calories, saturated and trans fat, sodium and sugars – in such labels, food companies jumped the gun. They started using Facts Up Front labels that include “good” nutrients as well as “bad.”

Will the FDA insist on labels that actually help consumers make better choices? Will it require added sugars to be listed, define “natural” or clarify rules for whole-grain claims? I’m not holding my breath.

Supplemental Nutrition Assistance Program participation will increase, but so will pressure to cut benefits: Demands on Snap – food stamps – reached record levels in 2012 and show no sign of decline. Antihunger advocates will be working hard to retain the program’s benefits, while antiobesity advocates work to transform the benefits to promote purchases of healthier foods. My dream: The groups will join forces to do both.

Sugar-sweetened beverages will continue to be the flash point for efforts to counter childhood obesity: The defeat of soda tax initiatives in Richmond and El Monte (Los Angeles County) will inspire other communities to try their own versions of soda tax and size-cap initiatives. As research increasingly links sugary drinks to poor diets and health, soda companies will find it difficult to oppose such initiatives.

Grassroots efforts will have greater impact: Because so little progress can be expected from government these days, I’m predicting bigger and noisier grassroots efforts to create systems of food production and consumption that are healthier for people and the planet. Much work needs to be done. This is the year to do it.

And a personal note: In 2013, I’m looking forward to publication of the 10th anniversary edition of “Food Politics” and, in September, my new editorial cartoon book with Rodale Press: “Eat, Drink, Vote: An Illustrated Guide to Food Politics.”

Dec 2 2012

The defeat of California’s soda tax initiatives: lessons learned

My monthly (first Sunday) Food Matters column for the San Francisco Chronicle deals with the aftermath of the defeat of two California soda tax ballot initiatives.

Q: As one who campaigned for the soda tax in Richmond, I’m so discouraged by the millions spent by the soda industry to defeat it there and in El Monte (Los Angeles County). I don’t see how anyone without that kind of money can do anything to reverse obesity and diabetes.

A: Patience. These things take time.

Losing the soda tax campaigns taught health advocates some important lessons, not least that money buys votes. But it also taught that appeals to voter concerns about higher prices, job losses and personal autonomy are more effective than appeals based solely on health considerations.

Nobody likes taxes, and soda taxes are regressive, meaning that they impose a greater burden on the poor. Although the poor drink more sodas and have higher rates of obesity, and are likely to derive the most benefit from drinking less soda, taxes are still a hard sell.

Because dietary choices seem so personal, the influence of the food marketing environment on personal choices is not intuitively obvious. Everyone “knows” that larger food portions have more calories, but that doesn’t stop anyone from eating more calories when confronted with supersize foods or drinks.

The public health route

That’s why public health approaches work better than just telling people to eat less or eat better. The most effective measures change the environment of food choice by encouraging better options with price subsidies or portion-size caps and discouraging unhealthier choices, which is where taxes, bans on toys, and restrictions on marketing come in.

Such measures aim to make healthy choices the default. Most people are happy to live with the default option.

Food companies want their products to be the default. They will always oppose measures that might reduce sales, and they have no lack of resources to do so.

How might public health advocates counter such opposition?

Community approach

The Richmond example suggests the need for public health approaches that are community-based. This means going into communities and asking residents how they view the causes and consequences of their own health problems, and what they think should be done to fix those problems.

Communities set the goals. Advocates help communities achieve them.

This approach is fine in theory, but difficult in practice. Nobody makes food choices in a vacuum. Soda and fast food companies market their products to low-income and minority groups, and make sure their products are inexpensive, readily available and ubiquitously advertised.

To gain traction, food and beverage companies support the activities of community groups, sponsor playgrounds, and place their brand logos on everything they can. My favorite recent example is Coca-Cola’s $3 million gift to Chicago to fund an educational campaign to counter obesity and diabetes (no, I did not make this up).

Community-based campaigns not only can focus on the health consequences of poor diets but also can demonstrate to residents just how food companies put corporate health above public health and engage low-income communities in achieving corporate goals.

Teaching how the food marketing environment works should stimulate plenty of questions about why healthier foods aren’t more widely available in communities – and at affordable prices. It should raise questions about why school lunches aren’t better, and why soda advertising pervades athletic facilities. It should get people thinking about what food and beverage companies are actually doing in low-income communities.

Community-based public health should encourage residents to want to change their food environment.

It should get them thinking about wanting stores to provide healthier foods. Or they might want a farmers’ market, community gardens, better school food, and cooking lessons for their kids.

A method that works

These things really can help change eating behavior. The American Heart Association recently published a massive review – with rankings – of environmental interventions aimed at improving personal diets, physical activity levels, and smoking habits (See Circulation 2012; 126:1514-1563).

The review cites evidence for strategies to improve diets such as media campaigns, price subsidies, school meals and gardens, and restrictions on marketing, as well as taxes as portion caps. Some of these interventions are expensive, but others are not.

A review like this gives advocates plenty to work with.

Soda tax initiatives will not be going away. Neither will other such measures. Community leaders across the country will be continuing to introduce them as a means to reduce health care costs and to generate needed revenue for health-promoting activities.

It’s worth starting now to engage communities in efforts to improve their own health. Next time, engaged communities may be ready to vote for health over corporate interests.

Grassroots efforts take time. It’s too soon to be discouraged.

Marion Nestle is the author of “Why Calories Count: From Science to Politics,” as well as “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at foodpolitics.com. E-mail: food@sfchronicle.com. 

Nov 16 2012

Chicago emulates New York’s public health policies? Not quite.

Chicago’s Mayor Rahm Emanuel is not exactly Michael Bloomberg when it comes to public health approaches to obesity and chronic disease prevention.

In October, he announced that he’d gotten Coca-Cola, PepsiCo, and Dr Pepper Snapple to agree to post calorie information on vending machines in Chicago government buildings (something that they will have to do anyway whenever the FDA ever gets around to issuing final rules for menu labeling).

At the same time, he announced a health competition between Chicago city workers and those in San Antonio with rewards paid by the American Beverage Association through a $5 million gift.  This partnership was widely interpreted as a ploy to stave off the kind of soda tax and cap initiatives proposed by the Bloomberg administration in New York City.

And now, in yet another deal with soda companies, Mayor Emanuel has accepted a $3 million grant from Coca-Cola to pay for a park district program “to fight obesity and diabetes by offering nutrition education as well as exercise classes run by armed forces veterans.”

If the idea of soda companies funding anti-obesity campaigns strikes you as ironic—don’t sodas have something to do with obesity in the first place?— you need to understand Mayor Emanuel’s point of view.

His stated philosophy is that it’s better “to give people personal responsibility and the information necessary to make the right choices about their health than it is to legislate their behavior.”

Maybe so, but when faced with today’s “eat more” food environment, personal responsibility doesn’t stand a chance.

But wait: Isn’t Chicago making an important environmental change?  Its public schools are banning energy drinks.

Well, almost.

The new policy sets nutrition standards for all vending machine food and a la carte items sold in cafeterias and excludes energy drinks—with one exception: Gatorade, a PepsiCo product, “can only be used after students have engaged in a school sports activity.”

Are public health partnerships with soda companies a good idea?  The money is nice and undoubtedly badly needed, but worth the price?  Mayor Emanuel thinks so.

I’m dubious.

Nov 5 2012

Tuesday: Vote with your vote!

Tuesday’s election has huge implications for food politics (see previous post).  I’ve been asked to state an opinion.  In case myviews are not obvious, here’s what I’m voting for and hoping you will too:

  • If you care abou the issues discusssed here: Vote to reelect President Obama.
  • If you live in California, lead the nation: Vote YES on 37 (GMO labels).
  • If you live in Richmond, CA: Vote YES on Measures N and O (soda taxes and where that money will go).
  • If you live in El Monte, CA: Vote YES on Measure H (soda taxes).

It’s great to vote with your fork.  But the food movement needs real votes.

Vote with your vote!

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