by Marion Nestle

Currently browsing posts about: Soft drinks

Mar 17 2011

Soda companies vs. soda taxes: breathtaking creativity

I keep telling you.   You can’t make this stuff up.  Try these for food politics–in this case, soda politics–in action.

Beverage Association gives $10 million to Children’s Hospital of Philadelphia (CHOP)

From the Philadelphia Inquirer blog (March 16):

In keeping with a controversial pledge to made last year to City Council as part of an effort to ward off Mayor Nutter’s steep tax on sugar-sweetened beverages, the soft-drink industry will donate $10 million to the Children’s Hospital of Philadelphia to fund research into and prevention of childhood obesity.

The three-year grant is funded by a new organization, the Foundation for a Healthy America, created by the American Beverage Association, the national trade group representing manufacturers and bottlers. The ABA was instrumental in lobbying Philadelphia City Council to reject Nutter’s proposal to tax sugary drinks at 2-cents per ounce as a way to cut consumption and raise money for the general fund.

In a press release Wednesday, CHOP insisted that it will “retain absolute clinical and research independence,” as the source of its funding for the research is likely to come under attack from those wary of the beverage industry’s influence. That includes funding for clinical studies to be submitted to peer-reviewed publications.

Atkins Obesity Center publishes review of effects of soft drinks on obesity

In a delicious irony, the latest review of this topic comes from the Atkins Center at Berkeley.  Yes, the Atkins Diet Atkins, the one that promotes high-fat, low-carbohydrates, and has everything to gain from proving that sugars are bad for you.

With that duly noted, set the irony aside.  The review was funded by independent agencies and organizations.  Let’s take its results at face value.

The reviewers looked at five kinds of evidence: secular trends, mechanisms, observational studies, intervention trials and meta-analyses.  All supported the idea that

The currently available evidence is extensive and consistently supports the hypothesis that sweetened beverage intake is a risk factor for the development of obesity and has made a substantive contribution to the obesity epidemic experienced in the USA in recent decades.

Sweetened beverages are an especially promising focus for efforts to prevent and reduce obesity for two reasons: (i) the evidence supporting the association between sweetened beverage intake and excess weight is stronger than for any other single type of food or beverage; and (ii) sweetened beverages provide no nutritional benefit other than energy and water.

Coca-Cola funds North Carolina School of Public Health campaign against Childhood Obesity

Isn’t that nice of them?  The apparently unironical slogan of the campaign : “Everything in moderation.”

Robert Wood Johnson Foundation report, “F as in Fat”, features piece by PepsiCo’s CEO

Melanie Warner, writing on bNET, explains that the RWJ Foundation is usually scrupulously independent but that putting Pepsi’s PR piece into its document makes no sense.

A third of the way into the report, up pops a bizarre “personal perspective” from PepsiCo’s (PEP) CEO Indra Nooyi in which she details the many ways her company is working to make America healthier. “Helping consumers by building on our portfolio of wholesome and enjoyable foods is not just good business for PepsiCo -– it’s the right thing to do for people everywhere,” Nooyi chirps in a two-page soliloquy that reads like a press release and touts everything from Pepsi’s pledge to reduce the sodium in its products by 25% by 2015 to its reduced sugar drinks like Trop50 and G2. No other food company is mentioned, just Pepsi.

[This inclusion]…also ties into the ongoing debate about what role the food industry should play in helping Americans slim down. Are food companies trusted partners who are committed to fundamental changes, or is getting people to eat healthier versions of processed food really a whole lot of Titanic deck chairs?

As the research linking soft drinks to obesity gets stronger and stronger, it is no wonder that the Beverage Association is buying off city councils, and soft drink companies are eager to position themselves as helping to solve the problem of childhood obesity, not cause it.

Do these actions remind you of any other industry’s behavior?  Cigarette companies, anyone?

Mar 14 2011

Latin America vs. soft drinks

Today’s New York Times has a story about how Mexico is trying to improve school food in an effort to help prevent childhood obesity.

By all measures, Mexico is one of the fattest countries in the world, and the obesity starts early. One in three children is overweight or obese, according to the government. So the nation’s health and education officials stepped in last year to limit what schools could sell at recess. (Schools in Mexico do not provide lunch.)

The officials quickly became snared in a web of special interests led by Mexico’s powerful snack food companies, which found support from regulators in the Ministry of the Economy. The result was a knot of rules that went into effect on Jan. 1.

“What’s left is a regulatory Frankenstein,” said Alejandro Calvillo, Mexico’s most vocal opponent of junk food, particularly soft drinks, in the schools. “They are surrendering a captive market to the companies to generate consumers at a young age.”

By all reports, schools in many Latin American countries sell candy and soft drinks in lieu of real food.  Kids pretty quickly get used to the idea that those foods mean lunch, and eating them is normal.  Never mind the effects of such diets on teeth—dental decay is increasing rapidly—and body weights.

By coincidence, I just received a paper from Brazilian investigators documenting the way soft drink companies are funding physical education activities in that country.  That’s one way to deflect attention from aggressive marketing in schools and other venues.

Last year, Coca-Cola, Pepsi-Cola, and Kraft reported rising profits from overseas sales.  With the U.S. market for their products flat or declining, companies are looking to developing markets for increased sales.  Obesity is sure to follow.

Feb 13 2011

New York City’s tough anti-soda campaign

I just got off a subway car adorned with posters advertising the New York City Health Department’s “Are you pouring on the pounds?” campaign.  They are riveting.

They make a simple point, but one that is not always understood:  Soft drinks contain sugar, and lots of it.

Lots of sugar—all those packets—will make you fat.

The campaign also includes a tough video.

New York City’s Health Department is taking on the city’s high rates of heart disease and type 2 diabetes in every way it can.

Take a look.  What do you think?  Will this work?

Feb 10 2011

Do diet sodas really cause stroke? I’m dubious.

I’ve been asked repeatedly this week to comment on the huge press outcry about a study that links diet sodas to an increased risk of stroke and heart disease.

I have not seen the study and neither has anyone else. It is not yet published.

It was presented at the American Stroke Association’s International Stroke Conference 2011.  The American Heart Association has a short summary on its website.  And Rosie Mestel has an excellent account in the Los Angeles Times.

Here’s what I can glean from the limited information available:

  • The study started in 2003.  It was designed to determine risk factors for heart disease and stroke in a multi-ethnic New York City population.
  • It used a food frequency questionnaire to ask about 2,500 people how often they drank diet sodas (among many other questions).
  • Nine years later, it assessed rates of stroke and heart disease.
  • The result: people who said they habitually drank diet sodas had a 60% higher rate of stroke and heart attacks.
  • They had a 48% higher rate when the data were controlled for contributing factors: age, sex, race, smoking, exercise, alcohol, daily calories, and metabolic syndrome.

That is all we know.

Does this study really mean that “diet soda may not be the optimal substitute for sugar-sweetened beverages for protection against vascular outcomes,” as the lead author is quoted as saying?

As Rosie Mestel puts it:

It’s worth noting, as some scientists did, that this is a link, not proof of cause and effect. After all, there are many things that people who slurp diet sodas every day are apt to do – like eat a lousy diet — and not all of these can be adjusted for, no matter how hard researchers try. Maybe those other factors are responsible for the stroke and heart attack risk, not the diet drinks. (Those who drink daily soda of any stripe, diet or otherwise, are probably not the most healthful among us.)

Leaving questions about the accuracy of dietary information obtained by questionnaire, the study raises more important questions:

  1. Could this finding simply be a statistical result of a “fishing expedition?”  The food frequency questionnaire undoubtedly asked hundreds of questions about diet and other matters.  Just by chance, some of them are going to give results that look meaningful.  The increase in stroke risk seems astonishingly high and that also suggests a need for skepticism.
  2. What is the mechanism by which diet sodas lead to stroke or heart disease?  I can’t think of any particular reason why they would unless they are a marker for some known risk factor for those conditions.

Please understand that I am no fan of diet sodas.  I don’t like the metallic taste of artificial sweeteners and they are excluded by  my “don’t eat” rule: never eat anything artificial.

But before I believe that this study means that artificial sweeteners cause cardiovascular problems, I want to see a study designed to test this particular hypothesis and a plausible biological reason for how diet sodas might cause such problems.

Jan 5 2011

Pepsi’s answer to “eat natural”: snackify beverages and drinkify snacks

Over the holidays, Pepsi announced two changes to its products.

“All Natural” Frito-Lay: First, the company announced that half its Frito-Lay chips would now be made with “all natural” ingredients.

“Natural,” you may recall, has no regulatory meaning.  Companies pretty much get to define for themselves what the word means, provided what they say is “truthful and not misleading.”

By “natural,” Pepsi means removing MSG, artificial colors, and other chemical additives from some—but by no means all—chips and other snacks.  This is a good start, but Cheetos and Doritos?  Not a chance.

As to worries that the word “natural” is a calorie distractor and might encourage overeating, a Pepsi spokesperson said: “It’s meant to say: made with natural ingredients….It’s not meant to say: eat more.”  Really?  I’m not convinced.

Tropolis Squeezable Fruit: Next, Pepsi announced the latest innovation in kids’ products: Tropolis pouches of squeezable fruit.

I learned about Tropolis from a reporter at the Wall Street Journal, Valerie Bauerlein, who forwarded Pepsi’s press release:

Each fun-flavored 3.17 fl oz (90g) pouch provides a smooth blend of real squeezable fruit, is a good source of fiber, and offers 100 percent of the recommended daily value of vitamin C – all for less than 100 calories.

Tropicana Tropolis is made with no added sugars, artificial sweeteners or high fructose corn syrup; and no artificial flavors, colors or preservatives.

“Fun-flavored” is a euphemism for sugar.  The press release explains what’s not in the product.  So, what does it contain? It took some doing to find out, but it arrived eventually along with some further background information from Pepsi:

The issue is kids aren’t getting enough fruit, so Tropicana Tropolis is trying to help solve that problem in a fun, nutritious way…Studies show that families are not getting enough fruit and vegetables in their diets, and the health experts we talked to (registered dietitians and pediatricians) when developing Tropolis also raised this issue.

As you might imagine, I was not one of the experts they talked to.  Here are the ingredients:

  • Grape World: Apple puree, filtered water, banana puree concentrate, fibersol-2 fiber (maltodextrin), grape juice concentrate, apple juice concentrate, lemon juice concentrate, natural flavor and ascorbic acid (vitamin C).
  • Cherry World: Apple puree, filtered water, banana puree concentrate, fibersol-2 fiber (maltodextrin), apple juice concentrate, cherry juice concentrate, lemon juice concentrate, natural flavor and ascorbic acid (vitamin C).
  • Apple World: Apple puree, filtered water, banana puree concentrate, fibersol-2 fiber (maltodextrin), apple juice concentrate, lemon juice concentrate, natural flavor and ascorbic acid (vitamin C).

Translation: “Juice concentrates” is another euphemism for sugar.  You don’t believe me?  See the list of sugar euphemisms in the 2005 Dietary Guidelines (Table 14).

My translation: this is watery apple and banana sauce, artificially thickened, sweetened with fruit sugars, flavored with additives, and with added vitamin C.

As Valerie Bauerlein’s Wall Street Journal account explains,  this product is about expanding Pepsi’s profits in the “better-for-you” category as captured in a quotation that is sure to become a classic.

Ms. Nooyi [Pepsi’s CEO] has said she wants to build the nutrition business to $30 billion from $10 billion by 2020.…We see the emerging opportunity to ‘snackify’ beverages and ‘drinkify’ snacks as the next frontier in food and beverage convenience,” Ms. Nooyi said.

I ’m also quoted in her article (I did the interview while stranded in Miami trying to get back to snowbound New York):

Marion Nestle, a professor of nutrition at New York University, said that the fruit concentrates are simply sugar. “They start out with real food, so let’s give them credit for applesauce and mashed-up bananas,” but “the rest of it is sugar,” she said. “Kids would be better off eating an apple or a banana.”

PepsiCo said Tropolis should get kids to eat more fruit, which is what’s most important.

Tropolis raises my favorite food philosophy question: Is a “better-for-you” product necessarily a good choice?  Is this a good way to get kids to eat more fruit?

You decide.

Dec 17 2010

Food corporations buy silence from “partners”

Does corporate social responsibility pay off for corporations?  Indeed it does.  Corporate money buys silence, if nothing else.

William Neuman of the New York Times provides a perfect example of how corporate sponsorship gets precisely what it is intended to do.

In this particular case:

  • The corporations are soda companies, Coke and Pepsi.
  • The social responsibility is donations of millions of dollars to a good cause.
  • The cause is Save the Children, a group devoted to child health and development projects internationally and domestically.
  • The intention?   Get Save the Children to stop advocating in favor of soda taxes.

Not long ago, Save the Children was a strong advocate for soda taxes.  Now it is not.  How come?  The group’s website explains:

about a minute ago we said, Corporate donors support us but do not pressure us. Our focus is children not soda tax policy. Back to saving more children now.

The Times, however, suggests a different explanation:

executives at Save the Children were seeking a major grant from Coca-Cola to help finance the health and education programs that the charity conducts here and abroad, including its work on childhood obesity.The talks with Coke are still going on. But the soda tax work has been stopped….In interviews this month, Carolyn Miles, chief operating officer of Save the Children, said there was no connection between the group’s about-face on soda taxes and the discussions with Coke. A $5 million grant from PepsiCo also had no influence on the decision, she said. Both companies fiercely oppose soda taxes.

A mere coincidence?  I don’t think so.  This is a clear win for soda companies, just as was Coca-Cola’s sponsorship of the educational activities of the American Academy of Family Physicians. You can bet those activities do not involve telling parents not to give sodas to their kids.

Is this a win for Save the Children?  The Times reports that the Robert Wood Johnson Foundation, which funds some of the group’s anti-obesity initiatives, is disappointed.  Evidently, its $3.5 million donation wasn’t enough to convince the group to continue its anti-soda activities.

In the meantime, soda taxes continue to stay on the radar as a weight control strategy.  A new study in the Archives of Internal Medicine suggests that soda taxes could lead to a small but potentially significant weight loss.

According to FoodNavigator’s report about the study,the authors say that applying such taxes throughout the United States could generate a billion dollars or more.  It quotes lead researcher Eric Finkelstein: “Although small, given the rising trend in obesity rates, especially among youth, any strategy that shows even modest weight loss should be considered.”

This kind of study is a challenge to soda companies.  Watch Coke and Pepsi continue donations to charitable and health groups and watch those groups say not one word about the contribution of sodas to obesity.  Cigarettes, anyone?

Nov 18 2010

Soft drinks as a solution to childhood malnutrition? I don’t think so.

Here is another one you can’t make up.  An article in Pediatrics, entitled “Malnutrition and the role of the soft drink industry in improving child health in sub-Saharan Africa,” advocates for fortifying soft drinks with micronutrients (vitamins and minerals).

Oddly, it does this after explaining how consumption of soft drinks actually”perpetuates problems of undernutrition in children, pregnant women, and other vulnerable populations in the developing world.”   Why?  Because in “sub-Saharan Africa, for example, distribution of soft drinks and other beverages produced by soft drink companies is extensive, and consumption is high given the extensive poverty in this part of the world.”

The authors justifiably complain about how little attention has been paid to the ways in which soft drink companies perpetuate malnutrition.

But instead of suggesting public health measures to counter the well documented effects of soft drinks on rising rates of obesity or on tooth decay rates among children in developing countries, the authors want soft drink companies to add vitamins and minerals to the drinks.

The Bill Gates foundation recently partnered with Coca-Cola in Uganda to increase production and distribution of mango and passion fruit juice as a way to stimulate production of local mango and passion fruit juice and meet Coca-Cola’s demand for
increased fruit to stimulate sales; however, such a partnership should also ideally involve micronutrient fortification, because Coca-Cola estimates that this partnership will extend sales in coming years. The World Economic Forum recommends fortification of food and beverages by private companies as an approach to reduce malnutrition, to
boost a productive workforce, and to stimulate the global economy.

Translation: Coca-Cola’s economy.

Fortunately, colleagues in Brazil have written a letter in response: “Can the soft drink industry prevent child malnutrition?  No way.”

What the impoverished populations of Africa, Asia and Latin America need, are the means with which to lead a decent life. These include secure local food systems and supplies, access to safe water and adequate sanitation, decently resourced primary health care services, ability to produce and prepare meals from immediate and local resources, universal primary education, and empowered mothers and other caretakers. Substantial reduction of child undernutrition can be achieved in a relatively short period of time with improved income distribution, population and community self-determination, and public investments in public goods such as education, health, social security, water supplies and sanitation.

What they do not need is more Coca-Cola.

Or, for that matter, Pepsi Cola, which tried the same ploy earlier this year (see previous post).

Sales of Coke and Pepsi are declining in the United States.  What better way to protect sales than to foist these products on the poor populations of emerging economies.

We need to be exporting health, self-determination, and democracy, not sugary drinks.

For shame!

Nov 2 2010

The food movement’s new frontier: “ultra-processing”

In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes “The big issue is ultra-processing.”  Because his Commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.

The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.

Monteiro makes it clear that all foods and drinks are processed to some extent.  Fresh apples are washed and, sometimes, waxed.  Drinking water is filtered.  Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:

  • Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
  • Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt.  These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
  • Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).

The purpose of Type 3 ultra-processing is to create:

durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration (‘long shelf life’), to be transportable for long distances, to be extremely palatable (‘high organoleptic quality’) and often to be habit-forming. Typically they are designed to be consumed anywhere – in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.

Monteiro argues: “the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world.”

As evidence, he notes that ultra-processed products as a group are:

  • Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
  • [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
  • Relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy.
  • Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
  • Available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
  • The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.
  • Promoted by lightly regulated or practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being of children.

Overall, he says:

Their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.

His groups the main points of his argument in three theses:

  • Diets mainly made up from combinations of processed ingredients and unprocessed and minimally processed foods, are superior to diets including substantial amounts of ultra-processed products.
  • Almost all types of ultra-processed product, including those advertised as ‘light’, ‘premium’, supplemented, ‘fortified’, or healthy in other ways, are intrinsically unhealthy.
  • Significant improvement and maintenance of public health always requires the use of law. The swamping of food systems by ultra-processed products can be controlled and prevented only by statutory regulation.

Lest there be any confusion about the significance of this proposal for public health nutrition, an accompanying editorial (unsigned but assumed to be by Geoffrey Cannon) poses a serious challenge: “Nutrition science: time to start again.”

This editorial is about the significance of food processing, and in particular of ‘ultra-processed’ food and drink products. It is also about the nature, purpose, scope and value of nutrition science, which as conventionally taught and practiced, is now widely perceived to have run into the buffers or, to change metaphor, to have painted itself into a corner.

The editorial argues that nutritionists’ focus on nutrients, rather than foods, has led to the assumption that if foods contain the same nutrients, they are the same—even though it is never possible to replicate the nutritional content of foods because too much about their chemical composition is still unknown.

This notion is an exquisite combination of stupidity and arrogance, or else of intelligence and cunning. For a start, similar results can only be of those chemical constituents that are at the time known, and actually measured.

These are important ideas, well worth consideration and debate.  I am struck by their relevance to the latest survey of soft drink availability in American elementary schools.  Despite the efforts of the Clinton Foundation and the voluntary actions of Coca-Cola and Pepsi-Cola, the availability of soft drinks to young school children increased from 49.% to 61% just in the year from 2006-07 to 2008-09.  Soft drinks, in Monteiro’s terms, are ultra-processed.  Doing something about them requires statutory regulation.

Consideration of the effects of ultra-processing might help us look at what we feed our kids in a more constructive way.  This is important work.

Addition: I should have mentioned that Monteiro’s approach is consistent with that of the people (including me) who worked with the Strategic Alliance in Oakland, CA to write Setting the Record Straight: Nutritionists and Health Professionals ” Define Healthful Food.

The Alliance is California’s network of food and activity advocates, we’ve developed a definition of healthy food that asserts that truly healthful food comes from a food system where food is produced, processed, transported, and marketed in ways that are environmentally sound, sustainable, and just.

If you agree with Setting the Record Straight, you can endorse it on the Strategic Alliance’s website.

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