by Marion Nestle

Currently browsing posts about: Soft drinks

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!

Nov 3 2012

Tuesday’s election: Food politics at issue

My monthly (first Sunday) Food Matters column in the San Francisco Chronicle deals with the implication of Tuesday’s election for food politics.

Q: Neither of the presidential candidates is saying much about food issues. Do you think the election will make any difference to Michelle Obama’s campaign to improve children’s health?

A: Of course it will. For anyone concerned about the health consequences of our current food system, the upcoming election raises an overriding issue: Given food industry marketing practices, should government use its regulatory powers to promote public health or leave it up to individuals to take responsibility for dealing with such practices?

Republicans generally oppose federal intervention in public health matters – witness debates over health care reform – whereas Democrats appear more amenable to an active federal role.

The Democratic platform states: “With prevention and treatment initiatives on obesity and public health, Democrats are leading the way on supporting healthier, more physically active families and healthy children.”

Policy or lifestyle?

In contrast, the Republican platform states: “When approximately 80 percent of health care costs are related to lifestyle – smoking, obesity, substance abuse – far greater emphasis has to be put upon personal responsibility for health maintenance.”

At issue is the disproportionate influence of food and beverage corporations over policies designed to address obesity and its consequences. Sugar-sweetened beverages (sodas, for short) are a good example of how the interests of food and beverage corporations dominate American politics.

Because regular consumption of sodas is associated with increased health risks, an obvious public health strategy is to discourage overconsumption. The job of soda companies, however, is to sell more soda, not less. As a federal health official explained last year, policies to reduce consumption of any food are “fraught with political challenges not associated with clinical interventions that focus on individuals.”

Corporate spending

One such challenge is corporate spending on contributions to election campaigns. Although soda political action committees tend to donate to incumbent candidates from both parties, soda company executives overwhelmingly favor the election of Mitt Romney.

As reported in the Oct. 12 issue of the newsletter Beverage Digest, soda executives view the re-election of President Obama as a “headwind” that could lead to greater regulation of advertising and product claims, aggressive safety inspections and characterizations of sodas as contributors to obesity. In contrast, they think a win by Mitt Romney likely to usher in “more beneficial regulatory and tax policies.”

As for lobbying, what concerns soda companies is revealed by disclosure forms filed with the Senate Public Records Office. Coca-Cola reports lobbying on, among other issues, agriculture, climate change, health and wellness, and competitive foods sold in schools. PepsiCo reports lobbying on marketing and advertising to children. Their opinions on such issues can be surmised.

But Coca-Cola also says it lobbies to “oppose programs and legislation that discriminate against specific foods and beverages” and to “promote programs that allow customers to make informed choices about the beverages they buy.”

Lobbyists

Soda companies have lobbied actively against public health interventions recommended by the White House Task Force on Childhood Obesity in 2010 and adopted as goals of Michelle Obama’s Let’s Move campaign to end childhood obesity within a generation.

Implementation of several interventions – more informative food labels, restrictions on misleading health claims, limits on sodas and snacks sold in schools, menu-labeling in fast-food restaurants, and food safety standards – has been delayed, reportedly to prevent nanny-state public health measures from becoming campaign issues.

To counter New York Mayor Michael Bloomberg’s 16-ounce cap on soda sales, the industry invested heavily in advertisements, a new website and more, all focused on “freedom of choice” – in my mind, a euphemism for protecting sales.

Soda tax

Although the obesity task force suggested that taxing sodas was worth studying, the American Beverage Association lobbied to “oppose proposals to tax sugary beverages” at the federal level. The soda industry reports spending more than $2 million to defeat Richmond’s soda tax ballot initiative Measure N, outspending tax advocates by 87 to 1.

In opposing measures to reduce obesity, the soda industry is promoting corporate health over public health and personal responsibility over public health.

Supporters of public health have real choices on Tuesday. I’m keeping my fingers crossed that Let’s Move will get another chance.

Nov 1 2012

Energy drinks: Why deregulation is not such a good idea

Concerns that highly caffeinated Monster Energy drinks might be responsible for the recent deaths of at least five young adults are, as I see it, a direct result of deregulation of food oversight.

Here’s my version of the history leading up to the present situation:

  • In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), which in essence deregulated dietary supplements, permitted them to be labeled and regulated as supplements, not foods, and removed much of FDA’s authority over their contents and health claims.
  • The dietary supplement industry, as I explain in Food Politics, wrote much of the key language of this law.
  • When the FDA tried to enforce its food rules for supplements, the courts ruled in favor of manufacturers on First Amendment grounds.
  • Because rules for supplements are less restrictive than those for foods, some manufacturers prefer labeling their products as supplements.
  • Monster Energy drinks are labeled as supplements, removing them from much of FDA’s authority.

The results of DSHEA, in this case, are explained by the New York Times:

But while the F.D.A. regularly makes adverse event reports about drugs and medical devices publicly available, it does not do so for dietary supplements like energy drinks. Because of that policy, consumers had no way of knowing of the complaints about Monster Energy drinks before incident reports were released by the F.D.A. in response to a formal Freedom of Information Act request.

Also, while supplement makers have been required since late 2007 to alert the F.D.A. to possible product-related deaths and injuries, Monster Beverage submitted just one such report to the agency over the last four years, agency officials said.

Most likely because of their high caffeine content, sales of energy drinks are rising rapidly, as shown in this graphic from the Times:

Booming sales means booming profits, and the makers of energy drinks are under pressure to cash in.  That sometimes means cutting corners or not always matching contents to labels.

For example, a Consumer Reports investigation of the caffeine content of energy drinks identified some discrepancies.

Caffeine levels per serving ranged from about 6 milligrams to 242 milligrams per serving—and some containers have more than one serving. The highest level was in 5-hour Energy Extra Strength; the lowest in the seemingly oxymoronic 5-hour Energy Decaf…By comparison, an 8-ounce cup of coffee has about 100 milligrams; a 16-ounce Starbucks Grande, 330 milligrams.

Five of the 16 products that list a specific amount of caffeine…had more than 20 percent above their labeled amount on average in the samples we tested. On the other hand, one…had caffeine about 70 percent below the labeled amount.

Consumer Reports noted one other key point: the FDA considers caffeine as GRAS (Generally Recognized As Safe) and does not require amounts to be listed on labels.

A representative of the Monster Beverage Corporation explained that his company does not list caffeine levels “because there is no legal or commercial business requirement to do so, and also because our products are completely safe, and the actual numbers are not meaningful to most consumers.”

Consumer Reports points out that Monster drinks—like those of 16 other products—warn against use by children, pregnant or nursing women, and people sensitive to caffeine, and recommend a daily limit.

Whether the Monster Energy drinks are really responsible for the reported deaths will not be easy to establish.  One victim, age 14, is said to have consumed two 24-ounce Monster drinks containing 240 mg caffeine each within a day or two.

That energy drinks are labeled as supplements ties the FDA’s hands in dealing with such products.

Here are some suggestions to consider:

  • Label energy drinks with standard Nutrition Facts panels.
  • Require amounts of caffeine to be stated on the label.
  • Limit the amount of caffeine that can be included in soft drinks.

Two Senators (Durban and Blumenthal)—not for the first time—are pushing the FDA to investigate.  Good idea.  I can only speculate about why the FDA isn’t responding, but I’m guessing that this issue, like so many others, is too controversial to take up during an election campaign.

Soon, please.

Oct 18 2012

The New England Journal takes on the food industry

Last week’s New England Journal of Medicine weighs in with several commentaries and research articles.  Some of these were published earlier in online versions:

And this week, it has another on using tax strategies to promote public health.

It looks to me as though the health establishment is finally catching on to what obesity is really about and giving serious thought to what to do about it.  This is important work.

Oct 16 2012

Big Soda to Bloomberg: We’ll see you in court

Mayor Bloomberg’s cap on soda sizes at 16 ounces has elicited a hard-hitting, Friday-afternoon (let’s hide it if we can), but otherwise well organized cease-and-desist lawsuit from the soft drink industry.

The suit, New York Statewide Coalition of Hispanic Chambers of Commerce et al. v. The New York City Department of Health and Mental Hygiene et al., is represented by Latham & Watkins, a law firm that often represents the American Beverage Association (ABA), the leading soft-drink trade group and one of the plaintiffs in this case.

Other plaintiffs are the Teamsters Local 812, the Korean-American Grocers Association of New York, the National Association of Theatre Owners of New York State, and—-no surprise—the National Restaurant Association.

These groups are all concerned that the soda cap might encourage people to reduce soda sales (its point, after all).  This would drive down profits for stores, concession stands in movie theaters, restaurants, and the people who distribute sugary beverages.

The basis of the suit includes these complaints [with my comments]:

  • The Board of Health does not have the legal authority to cap soda sizes at 16 ounces (only the City Council does): “This case is not about obesity in New York City,” the plaintiffs wrote in the opening sentence of the suit. “This case is about the Board of Health, appointed by the mayor, bypassing the proper legislative process for governing the city.” [Legal experts think that cities do have the authority to regulate public health, witness smoking bans, helmet laws, and seatbelt requirements]
  • The cap is a ban on personal freedom. [Nobody is stopping people from buying more soda if they want it]
  • Most New Yorkers oppose the soda cap. [Perhaps because of the extraordinarily expensive campaign conducted by the soda industry]
  • The cap is “arbitrary and capricious,” because it applies only to some businesses and targets only certain types of beverages: “Delis and hotdog stands are barred from selling a 20-ounce lemonade, but the 7-Eleven a few feet away remains free to sell Big Gulps.”  [The rule applies to all businesses over which the city has jurisdiction, so there is nothing arbitrary about it] 

This lawsuit is clearly about profits, not health.  Let’s hope the Court throws it out.

The first 14 of the documents are available in a zip file here (but only for the next week or so).

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