by Marion Nestle

Currently browsing posts about: United Nations

Jul 28 2023

UNICEF’s manual on protecting children from food marketing

Increasingly and more urgently concerned about the effects on children of unrestricted marketing of unhealthy foods and beverages, UNICEF and WHO have produced an invaluable manual on why and how governments must act to curb such marketing.

This is a follow up to the UNICEF report I talked about last week on engagement with food and beverage companies and to the WHO recommendations I posted about yesterday.

WHO and UNICEF are on a roll!

The rationale for this publication:

Food and beverage companies play a significant role in shaping children’s food environments, but their objectives are profit driven rather than child centred. They have a vested commercial interest in increasing sales of their unhealthy products and use highly immersive, engaging – and often unethical – marketing techniques to target children and their caregivers.
We know that food marketing harms children. It negatively affects children’s food preferences, purchase decisions and consumption behaviours, ultimately contributing to childhood obesity and diet-related disease. Food marketing also affects household purchasing decisions and the types of foods that are eaten in the home.

Among this report’s key messages:

  • The evidence is clear that food marketing harms children – especially the poorest and most vulnerable.
  • Tackling food marketing is challenging: past experience shows that food companies use loopholes and develop new strategies to bypass restrictions.
  • Voluntary schemes are ineffective in reducing children’s exposure to foodmarketing.
  • Mandatory regulation has the potential to be the most effective path to protecting children from the harmful impact of food
    marketing

Governments must act.  Now.

This exceptionaly timely and important report explains how.

Jul 7 2023

Weekend reading: UNICEF policy on engagement with food and beverage companies

UNICEF does not want its statements to be compromised by conflicted interests with food and beverage companies that make formula or foods for children.

Here’s how UNICEF will be dealing with the food and beverage interests.

This publication explains just how UNICEF intends to avoid conflicts of interest with companies making products that do not promote childrens’ health.

The practices and products of a subset of the F&B industry whose primary business is the production, distribution, marketing and retailing of ultra-processed foods and beverages (UPF) pose particular concern. The companies producing these unhealthy, nutrient-poor UPF – rich in sugar, salt, trans-fats and food additives and preservatives – are major drivers of today’s broken food system and the global epidemic of childhood overweight and obesity and diet-related non-communicable diseases…It is now widely accepted that the practices and products of the UPF industry harm children’s and adolescents’ lives and have become the main commercial determinant of childhood malnutrition and disease.

Evidence shows that direct partnering with the UPF industry (i.e., working with) and voluntary UPF industry initiatives do not translate into large-scale sustainable results in transforming food systems for children. Further, direct funding engagements with UPF industry stakeholders pose a significant reputational risk to the credibility of UNICEF programming and independence as governments’ trusted advisor for policy formulation, normative guidance and programme scale-up for children and adolescents.

UNICEF says it will, among other measures (my emphasis):

  • Continue to advocate for the F&B industry not to be included in public policy making.
  • Continue avoiding all partnerships with F&B industries that violate the Code.
  • Avoid all partnerships with ultra-processed food and beverage (UPF) industries.
  • Exclude Code violators and UPF industries in UNICEF-led business platforms.
  • Engage responsibly with the F&B industry in humanitarian response.

These commitments are a major public health advance.  Let’s hope UNICEF sticks with them.

Jun 30 2023

Weekend reading: Update on the International Code on infant formula marketing

Earlier this week I wrote about the UNICEF-WHO meeting I went to in Geneva on implementing the 1981 International Code governing marketing of infant formulas.

UNICEF has just issued an update: What I [meaning you] Should Know about the Code

This new publication—a one-stop shopping guide to the issues—summarizes UN resolutions on the Code since 1981 as well as subsequent research on breastfeeding and infant formula marketing, most notably the Lancet Commission reports I wrote about earlier.

Incontrovertible evidence demonstrates how inappropriate marketing of infant formulas undermines breastfeeding and can harm children, especially in places that do not have clean water to dilute formulas.

Every country in the world has committed to the Code—the United States was the last holdout.  We do not seem to pay much attention to the Code’s provisions.

Here is one example.  The Code says:I’m not sure how to interpret the “except” phrase, except that our FDA must think that the health claims on a product like this are entirely acceptable, whereas they would not be allowed in many other countries.  [Reference 23 refers to UN General Assembly Resolution 63.23.]

The Code states that infant formulas should not be labeled in any way that suggests formula might be superior to breast milk.  This and the accompanying statement on the product website, would appear to violate that guideline.

Infant formulas do a good job of substituting for the nutrients in breast milk.  Because the FDA tightly regulates their ingredients, they are all pretty much alike, although they vary in price enormously.

The infant formula industry deserves close scrutiny of its marketing practices and this UNICEF publication is an excellent place to begin.

Dec 14 2022

Good news (we need some): Baguettes!

UNESCO, the United Nations Educational, Scientific and Cultural Organization, during the seventeenth session of the Intergovernmental Committee for the Safeguarding of the Intangible Cultural Heritage has incribed on the Representative List of the Intangible Cultural Heritage of Humanity—ta da!—baguette bread.

The traditional production process entails weighing and mixing the ingredients, kneading, fermentation, dividing, relaxing, manually shaping, second fermentation, marking the dough with shallow cuts (the baker’s signature) and baking. Unlike other loaves, the baguette is made with only four ingredients (flour, water, salt and leaven and/or yeast) from which each baker obtains a unique product. Baguettes require specific knowledge and techniques…They also generate modes of consumption and social practices that differentiate them from other types of bread…Their crisp crust and chewy texture result in a specific sensory experience.

The New York Times account points out that this designation comes in the midst of “economic upheavals that include rising prices and the widespread closing of the country’s rural bakeries.”

The decision captured more than the craft knowledge of making bread — it also honored a way of life that the thin crusty loaf has long symbolized and that recent economic upheavals have put under threat. UNESCO’s choice came as boulangeries in rural areas are vanishing, hammered by economic forces like the slow hollowing out of France’s villages, and as the economic crisis gripping Europe has pushed the baguette’s price higher than ever.

* The photo is of Salvador Dali’s Bust of a Woman at MOMA.

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Nov 15 2022

What’s up with food systems at COP27?

COP27 is the term used to refer to the 27th annual United Nations Conference of the Parties of the UNFCCC [United Nations Framework on Climate Change Conference) taking place last week and this week in Sharm el-Sheikh, Egypt.

The New York Times has a COP27 explainer with a Q and A

This may be the 27th such conference, but it is the first to deal with the intersection of food production and consumption with climate change: how climate change affects agriculture and food systems and how agriculture and food systems affect climate change.

For the first time, several pavilions are devoted to food systems, this one specifically.

Food Tank is managing some of the programs at these pavilions.  Its president, Danielle Nierenberg, reports on them daily at this site

The official UN news site is here.

On November 12, agriculture was the theme of the day.   This is explained in a short video. 

Water was yesterday’s theme.

I’ve been trying to follow the events from Nierenberg’s comments and from the occasional article in the New York Times, for example, here (what the fights are about), here (videos of speeches), and here (protest and hunger strikes).

The Food4Climate pavilion’s YouTube channel for live streams and videos is here.

The Rockefeller Foundation is involved in COP27.  It sponsors a food and agriculture pavilion.

The Foundation also has produced a film, Food 2050.  The trailer is here.

I’m particularly interested in this film because Rupa Marya, who is attending the conference, says I’m in it and sent me this screen shot (I’m not in the trailer).

Will anything good come out of this COP27?  I’m inspired by this speech from the head of the World Health Organization.  Bringing these issues to public attention might help.

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Jul 12 2022

The UN releases dismal report on world hunger

FAO and other UN agencies. released the 2022 edition of The State of Food Security and Nutrition in the World (SOFI).

Here’s the video that comes with it: A Tale of Empty Plates.

The report does not mince words:

  • This year’s report should dispel any lingering doubts that the world is moving backwards in its efforts to end hunger, food insecurity and malnutrition in all its forms.
  • The distance to reach many of the SDG 2 [Sustainable Development Goal #2, Zero Hunger] targets is growing wider each year.
  • The intensification of the major drivers behind recent food insecurity and malnutrition trends (i.e. conflict, climate extremes and economic shocks) combined with the high cost of nutritious foods and growing inequalities will continue to challenge food security and nutrition.

As the press release puts it, “The numbers paint a grim picture:”

  • As many as 828 million people were affected by hunger in 2021 – 46 million people more from a year earlier and 150 million more from 2019.
  • …the proportion of people affected by hunger jumped in 2020 and continued to rise in 2021, to 9.8 percent of the world population. This compares with 8 percent in 2019 and 9.3 percent in 2020.
  • Around 2.3 billion people in the world (29.3 percent) were moderately or severely food insecure in 2021 – 350 million more compared to before the outbreak of the COVID‑19 pandemic.
  • The gender gap in food insecurity continued to rise in 2021 – 31.9 percent of women in the world were moderately or severely food insecure, compared to 27.6 percent of men.
  • Almost 3.1 billion people could not afford a healthy diet in 2020, up 112 million from 2019.
  • An estimated 45 million children under the age of five were suffering from wasting….149 million children under the age of five had stunted growth and development due to a chronic lack of essential nutrients in their diets, while 39 million were overweight.

The one bright note:

  • Progress is being made on exclusive breastfeeding, with nearly 44 percent of infants under six months of age being exclusively breastfed worldwide in 2020. This is still short of the 50 percent target by 2030. Of great concern, two in three children are not fed the minimum diverse diet they need to grow and develop to their full potential.

But overall

  • nearly 670 million people (8 percent of the world population) will still be facing hunger in 2030.
  • This is a similar number to 2015, when the goal of ending hunger, food insecurity and malnutrition by the end of this decade was launched under the 2030 Agenda for Sustainable Development.
  • In otherwords, there has been no progress since 2015.

If we want to fix this, we will have to:

  • End the pandemic
  • End wars
  • End climate change
  • End income and social inequalities

There’s our agenda.  That’s all.  Get busy.

Sep 23 2021

TODAY: The UN Food Systems Summit

The long-awaited UN Food System Summit takes place today.  The programme includes announcements from more than 85 heads of state and government.

The UN Food Systems Summit was announced by the UN Secretary-General, António Guterres, on World Food Day in October 2019 as a part of the Decade of Action for delivery on the Sustainable Development Goals (SDGs) by 2030. The aim of the Summit is to deliver progress on all 17 of the SDGs through a food systems approach, leveraging the interconnectedness of food systems to global challenges such as hunger, climate change, poverty and inequality. The Summit will take place during the UN General Assembly in New York on Thursday, September 23. More information about the 2021 UN Food Systems Summit can be found online: https://www.un.org/foodsystemssummit

Despite its focus on food systems approaches, it is highly controversial—as I explained in previous posts.

In preparation for today’s events, Lela Nargi of The Counter provides a thoughtful summary of the issues: “The UN is holding a summit on building a sustainable future for food and ag. Why are so many people upset about it?

The concerns:

  • Who is behind the Summit? [Proponents of industrial agriculture]
  • Who sets the Summit agenda? [Ditto]
  • What is excluded? [Indigenous practices, regenerative agriculture, agroecology]

While watching to see how this plays out, you can take a look at:

Also from The Guardian:

And for why the issue of agroecology is so important, see Raj Patel’s discussion in Scientific American: Agroecology Is the Solution to World Hunger

Marcia Ishii asks: Could FAO’s partnership with CropLife International have anything to do with the disappearance of agroecology from the agenda?

Aug 13 2021

Weekend reading: A call to the UN Food Systems Summit: Ultra-processed foods

I am a co-author on a paper published recently by BMJ Global Health 2021;6:e006885.  The need to reshape global food processing: a call to the United Nations Food Systems Summit.  Authors: Carlos Augusto Monteiro, Mark Lawrence, Christopher Millett, Marion Nestle, Barry M Popkin, Gyorgy Scrinis, Boyd Swinburn.

Because this paper is open access, I reproduce its text below.  The link is to the pdf.

Summary box

  • In the modern, globalised food system, useful types of industrial food processing that preserve foods, enhance their sensory properties and make their culinary preparation easier and more diverse, have been and are being replaced by food ultra-processing.

  • The main purpose of food ultra-processing is to increase profits by creating hyperpalatable and convenient food products that are grossly inferior imitations of minimally processed foods and freshly prepared dishes and meals.

  • In the last decades, obesity, type 2 diabetes and related diseases have become global epidemics, leading the health systems of many countries to or beyond breaking point.

  • Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity, type 2 diabetes and related diseases.

  • The 2021 UN Food System has a unique opportunity to urge countries to implement policy interventions required to reduce ultra-processed food production, distribution and consumption, while simultaneously making fresh or minimally processed foods more available, accessible and affordable.

Introduction

The UN Food Systems Summit is taking place later this year at a crucial time. Food systems are manifestly failing to enhance human health, social equity or environmental protection. One symptom is the pandemic of obesity and related non-communicable diseases with their vast consequences. As we show here, one of the main drivers of this pandemic is the transformation in food processing. In the modern, globalised food system, useful types of food processing that preserve foods, enhance their sensory properties and make their culinary preparation easier and more diverse, have been and are being replaced by deleterious types of processing whose main purpose is to increase profits by creating hyperpalatable and convenient products that are grossly inferior imitations of minimally processed foods and freshly prepared dishes and meals. The Summit has a unique opportunity to confront this calamitous change, and to recommend effective policies and actions to UN agencies and member states.

Processing and industry

The key issue here is the nature, purpose and extent of food processing. It is not processing as such. General criticism of food processing is too unspecific to be helpful. Most foods are processed in some way, and culinary preparations of fresh foods are usually made using processed ingredients. Some types of food processing contribute to healthful diets, but others do the opposite.1

At one extreme are minimal processes which mostly preserve or enhance whole foods, such as drying grains, pulses and nuts, grinding grains into flour and pasta, chilling or freezing fruits and vegetables, pasteurising milk and fermenting milk into yoghurt.

At the other extreme are industrial processes that convert food commodities such as wheat, soy, corn, oils and sugar, into chemically or physically transformed food substances, formulated with various classes of additives into generally cheap to make, long duration substitutes to minimally processed foods and freshly prepared dishes and meals. The result is brand-named sugary, fatty and/or salty food and drink products which typically contain little or no whole food, are designed to be ready-to-consume anytime, anywhere and are highly attractive to the senses or even quasi-addictive. These products, including sweet and flavoured drinks, sweet or savoury snacks, reconstituted meat products and shelf-stable or frozen ready meals and desserts, are identified as ultra-processed foods.2

Criticisms of the food industry as a whole are also a mistake. Most of the very many millions of food farming, growing, rearing, making, distributing, selling and catering businesses throughout the world, notably in Asia, Africa and Latin America, deal solely or largely in fresh and minimally processed foods. These businesses and the foods they produce need to be encouraged, defended and supported.

By contrast, ultra-processed foods are mostly enabled, produced and sold by a small number of transnational corporations, some of whose turnovers exceed the revenues of many countries and make annual profits of US$ billions.3 These corporations use their power to formulate, mass manufacture, distribute and aggressively market their products worldwide.4

These corporations shape scientific findings by funding in-house and university-based research, so as to defend and promote ultra-processed foods.5 They also exercise political power by intensive lobbying, donations and sponsorships, and until now have dissuaded most governments from adequately regulating their products and practices.6

Time-series food sales data indicate the explosive growth in manufacturing and consumption of ultra-processed foods worldwide.7 National dietary surveys show that ultra-processed foods already make up 50% or more of total dietary energy intake8 in high-income countries, with even higher consumption among children and adolescents.9 In middle-income countries, they now represent between 15% and 30% of total energy intake8 but sales of ultra-processed foods are increasing fastest in these countries.10

The pandemic of obesity and related diseases and its link with ultra-processing

According to WHO, worldwide prevalence of obesity has nearly tripled since the mid-1970s, and now over 650 million adults are obese, and 1.9 billion adults and over 370 million children and adolescents are overweight or obese (https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight). No country has yet reversed these increases. Closely driven by the increase in obesity is a doubling of worldwide type 2 diabetes prevalence since 1980, now affecting about 420 million people (https://www.who.int/news-room/fact-sheets/detail/diabetes). Obesity, type 2 diabetes and related non-communicable diseases, including cardiovascular diseases and some common cancers, have become pandemics. Pre-COVID-19, health systems in most countries did not have the capacity to effectively treat diet-influenced diseases. Now, many health systems are at or beyond breaking point struggling with COVID-19, the severity of which is significantly higher in people with obesity and related diseases.

Evidence of the general healthfulness of dietary patterns based on fresh and minimally processed foods and culinary preparations, and their protection against all forms of malnutrition, ‘is noteworthy for its breadth, depth, diversity of methods, and consistency of findings’.11

But only in the last decade, with the advent of the NOVA food classification system that distinguishes ultra-processed foods from minimally processed or processed foods,1 has the link between changes in types of food processing and the pandemic of obesity and related diseases been revealed. Evidence here includes:

  • Three meta-analyses of findings from epidemiological studies, including large, long-duration, carefully conducted cohort studies, show dose-response associations between consumption of ultra-processed foods and obesity, abdominal obesity, type 2 diabetes, dyslipidaemias, metabolic syndrome, depression, cardio and cerebrovascular diseases and all-cause mortality.12–14

  • Analysis of national dietary or food purchase surveys in middle-income or high-income countries shows that the higher the dietary share of ultra-processed foods, the higher the obesogenic dietary nutrient profiles. These are characterised by higher energy density, free sugars, unhealthy fats and sodium, and lower protein and dietary fibre.8

  • Epidemiological and experimental studies indicate that ultra-processed foods may increase risks for obesity and related diseases in other ways beyond their nutritional composition. These include structural and physical properties that blunt satiety signalling, organoleptic characteristics associated with higher energy intake rate, neo-formed substances and migrated packaging materials that are endocrine disruptors, additives that promote pro-inflammatory microbiome, and reduced thermic effect that decreases total energy expenditures.12–14

  • A randomised controlled cross-over trial shows that consuming a high ultra-processed diet causes a highly significant increase in ad libitum calorie intake and consequent weight gain. Over a 2-week period, 20 young adults following a diet with 83% of energy from ultra-processed foods consumed approximately 500 more kcal per day than when they followed a diet with no ultra-processed foods. Participants gained 0.9 kg at the end of the 2 weeks with the ultra-processed diet and lost 0.9 kg at the end of the non ultra-processed diet, mostly of body fat.15

  • A longitudinal ecological study of 80 countries from 2002 to 2016 shows a direct association between changes in annual per capita volume sales of ultra-processed foods and corresponding changes in population adult body mass index.16

Taken together, the totality of evidence summarised here shows beyond reasonable doubt that increased consumption of ultra-processed foods is a major contributor to the pandemic of obesity and related diseases. There is also mounting evidence of the harmful effects of the ultra-processed food industry on the planet, through its global demand for cheap ingredients that destroy forests and savannah, its displacement of sustainable farming, and its resource-intensive manufacturing and packaging.17

Policy responses

To begin with, the UN Food Systems Summit should urge international and national health and food and nutrition authorities to review their dietary guidelines to emphasise preference for fresh or minimally processed foods and avoidance of ultra-processed foods, in line with guidelines developed, for example, by the WHO/Pan American Health Organization,18 and issued in several Latino-American countries, and now also in France, Belgium, and Israel.

At the same time, national governments should be urged to use fiscal measures, marketing regulations, bold mandatory front-of-pack labelling schemes and food procurement policies, all designed to promote the production, accessibility and consumption of a rich variety of fresh or minimally processed foods, and to discourage the production, distribution and consumption of ultra-processed foods, as now done in several countries.19

Current food and nutrition policies are mostly intended to encourage food manufacturers to reformulate their products by reducing the use of salt, sugar or unhealthy fats. There is a role for strong regulations that effectively limit the levels of these components, but reformulation alone will not turn ultra-processed products into healthy foods,20 as in effect recently acknowledged in one internal document from one leading ultra-processed food corporation – “some of our categories and products will never be ‘healthy’ no matter how much we renovate” (https://www.ft.com/content/4c98d410-38b1-4be8-95b2-d029e054f492). Policies should instead stimulate the entire manufacturing industry to maintain, develop or improve processing methods that prolong the duration of whole foods, enhance their sensory properties and make their culinary preparation easier and more diverse. Ultra-processed foods should be replaced by processed foods with limited levels or absence of added salt, sugar or unhealthy fats or, preferably, by minimally processed foods.20

Conclusions

Food systems are failing. This is most clearly shown by what are now the pandemics of obesity and type 2 diabetes, of which ultra-processed food is a main contributor. The UN Food Systems Summit should urge member states to implement multiple policy interventions to reduce ultra-processed food production, distribution and consumption, while simultaneously making fresh or minimally processed foods more available, accessible and affordable.

Data availability statement

All data relevant to the study are included in the article.

Ethics statements

Acknowledgments

This paper expands a one-page submission made by the authors to the UN Food Systems Summit within Solution Cluster 2.2.1 (food environment).

References

 

Footnotes

  • Twitter @CMonteiro_USP

  • Contributors All authors contributed to the ideas presented in the manuscript. CAM wrote the manuscript. All authors contributed to redrafting and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.