Search results: public health strategies

The UK Government has “quietly disbanded” its independent advisory group on obesity.  Apparently, it didn’t like the advice it was getting.

The firing is quite understandable.  The group was appointed by the previous government as a result of recommendations in what is known as the Foresight report: Tackling Obesities: Future Choices.   This report advised mapping out strategies for obesity interventions that went way beyond education about personal food choices.

The expert group followed this advice and recommended public health programs to change the food environment and counter food industry marketing.

The new government, however, prefers a “nudge” strategy.  Derived from behavioral economics, “nudge” involves no compulsion (e.g., taxes on junk foods).  Instead, people are free to follow advice to eat better but don’t have to.

Thus, the government’s Call to Action on Obesity in England focuses on individual responsibility and says nothing about the influence of food and drink marketing on food choices.

Two members of the expert committee, Goeffrey Rayner and Tim Lang, have publicly criticized “nudge” as “a smokescreen for inaction.”

No wonder the group was fired.

But as Professor Lang explains:

The closure of the expert advisory group is bad news all round: bad politics, bad policy, and bad science. It shuts the door on an important attempt by the state to recognise the systemic nature of what drives obesity…It’s plain as a pikestaff that obesity requires systems change, not a tweak here and there, yet that is what is being offered.

Doing something about obesity requires eating less and eating better, both very bad for business.   For this UK government, business interests trump those of public health.

Order from your local independent bookstore or University of California Press or Barnes and Noble or Amazon.com.

Reviews, interviews, and commentary on Why Calories Count

2014

July 26   Review in Science Magazine

2013

September  Review in Health Affairs 2012;31 (9):2150-2151.

September 7 Radio interview with Dr. Don

August 15  Review in Frankfurter Allgemeine Zeitung by Thomas Weber (in German)

August 1  Review in the American Journal of Clinical Nutrition by Barbara Rolls

July 26  Interview with Tami O’Neill for EcoCentric blog

July 13  Interview with Donna Feldman on MyNetDiaryBlog

July 19   Interview about Why Calories Count with Nina Kahori Fallenbaum for Hyphen magazine: “Rice is Nice.”

June 6  KQED’s Forum (radio) Host: Spencer Michels

May 25 Video interview with Linda Watson on HuffPo.

May 21  Radio New Zealand

May 15 Radio interview with Susan Moran

May 14 TV Interview with Linda Watson on Cook for Good

May 9  Jenny Hutt radio

May 9  Candy Sagon on the AARP blog

May 4  Fort Worth Star-Telegram

May 2  Oprah.com

April 26 Review in Eat.Drink.Better

April 26  Susan Albers in the Huffington Post

April 24 Review on StarChildScience

April 20 Review in the Wall Street Journal

April 19  Interview with LifeScript

April 18 Review on The Black Sheep Dances.

April 17  The Page 99 Test and Campaign for the American Reader’s Page 99 of Why Calories Count.

April 16  A review in Serious Eats by Leah Douglas.

March 29: Times Higher Education (U.K.)

People should read this book. They should read it if they are obsessive weight-watchers or serial dieters, or just concerned about what their children eat. They should read it if they work in public health, the food industry, catering or education. And they should certainly read it if, like my colleague who reacted with horror to the title and the idea, they work to counter the “myth of obesity” and are supporters of the “health at any size” movement.

March 29: a blog from Finland (in Finnish)

March 28: Healthy Eating blog

March 26: Lisa Young’s portion teller blog

March 25: Miriam Morgan’s review in the San Francisco Chronicle

March 22: Eleanor West’s interview on Civil Eats.

March 21: Mark Bittman in the New York Times

March 20: Jane Brody in the New York Times

March 15: Nature magazine

Obesity has gone global — as has misinformation about nutrition and food. Nutrition scientists Marion Nestle and Malden Nesheim unscramble the confusion with a serving of science. They reveal how calories — those potent but ill-understood measures of heat energy — are really counted, why we need them, how we use them, how many we actually need and why it all sometimes goes so wrong. From ‘secret’ calories to food politics, malnourishment and calorie restriction for health, this is a feast for the mind.

February 1: The Scientist

Nutritional science guru Marion Nestle’s new book, Why Calories Count, seeks to crack open the inscrutable nature of the calorie. Think of the book, cowritten with Cornell University nutritionist and biochemist Malden Nesheim, as a diner’s elemental guide to eating. Nestle and Nesheim deconstruct the calorie—the bane of many a belly in the developed and developing worlds—to its barest components as a humble unit of work or heat before reassembling it and discussing its implications for disease, obesity, politics, and modern marketing.

From the strict chemical definition of a calorie to the 25-year quest by the Center for Science in the Public Interest to require nutritional labels, including calories, on alcoholic beverages, Why Calories Count weaves scientific and social tales into a rich portrait of the American diet and the laws that have shaped it.

By thoroughly burrowing into the meaning and impacts of calories, the authors intend to bestow a more relaxed yet active state of mind upon the reader. “Get organized. Eat less. Move more. Get political,” they suggest. Sounds like the most succinct diet book ever written.

Excerpts from other reviews

From Kirkus Reviews: A strong, rigorous overview of the calorie, its regulation and the politics behind food labeling and marketing.

From Library Journal (see the Barnes and Noble website): Neither a diet nor a weight-loss book, this scholarly, seriously researched work assists readers in evaluating diet claims, formulating strategies to lose, gain, or maintain weight, and learning how to make healthy food choices….and—what will probably be of most interest to the general reader—the role of big business in creating calorie-laden food and why it’s less politically controversial to recommend exercising than cutting back on calories.  

Summary

Calories—too few or too many—are the source of health problems affecting billions of people in today’s globalized world. Although calories are essential to human health and survival, they cannot be seen, smelled, or tasted. They are also hard to understand.

This book explains in clear and accessible language what calories are and how they work, both biologically and politically.   It takes readers through issues fundamental to understanding diet and food, weight gain, loss, and obesity, and sorts through the misinformation put forth by food manufacturers and diet program promoters.

Nestle and Nesheim explain the political stakes and show how federal and corporate policies have come together to create an “eat more” environment and give readers the information needed to interpret food labels, evaluate diet claims, and understand evidence as presented in popular media.

Their concluding advice: Get organized. Eat less. Eat better. Move more. Get political.

Blurbs for Why Calories Count:

“We need to understand what ‘empty calories’ are, so that we can feed our children food that is truly nourishing. On this topic, there is no better teacher than Marion Nestle, who writes with meticulousness, clarity and grace.”  —Alice Waters, author of The Art of Simple Food

“If you want to understand what’s wrong with our eating habits, you must understand the central role that calories play.  Nestle and Nesheim are two of the America’s finest nutritionists–and this book explains, clearly and succinctly, why calories count.  It is essential reading not only for people interested in food policy, but for everyone who wants to eat well and be well.” —Eric Schlosser, author of Fast Food Nation

“This superbly well-researched and scientifically sound book makes it clear how today’s food environment often overrides physiological regulatory controls of body weight. Why Calories Count is essential reading for anyone who wants to understand why so much about food choice lies in the hands of food marketers whose goal is to sell more products, not necessarily in the interests of public health.”  —Dr. David Kessler, author of The End of Overeating

“Thank god authorities like Nestle and Nesheim have teamed up to give us an epic view of a calorie: what it is, where it came from, what it means, how and why we count them. Thank god they’ve managed to decode nutritional science into a commonsense language we can all understand.  And thank god they’ve put calories in their place in a wider cultural and political context to help us think meaningfully about the food our lives depend upon.  I’m grateful.”  —Betty Fussell, author of Raising Steaks

“Calories. We all talk about them—many are even obsessed with them—but what do we really know about them? Not much. Marion Nestle and Malden Nesheim’s latest book changes all that, pulling back the curtain on calories and helping us understand them in a whole new light. You’ll never look at a 100-calorie pack of corporate cookies the same way again.” —Anna Lappé, author of Diet for a Hot Planet

 

It used to be that the “soda wars” referred to Coke vs. Pepsi.  No more.  Today’s soda wars are fought on the health front, as more and more evidence links sugary drinks to obesity and other health problems.

The current issue of the New Yorker has an article by John Seabrook (in which I am briefly quoted) about Pepsi’s attempt to “health up” its snacks and drinks.

Seabrook’s article, “Snacks for a fat planet,” describes the extraordinary amount of money and effort Pepsi is spending to try to tweak its products to make them seem healthier.  His article doesn’t exactly give Pepsi a pass (as some of my readers have complained), but it does not really come to grips with how sugary drinks and snacks affect health or how Pepsi is marketing its products in developing countries.

That, no doubt, is why Pepsi has sent out a press release to reports that enclosed the complete article and suggested that reporters might be “interested in the company’s focus on its innovative approach to:”

• Reduce salt, fat and sugar across the portfolio – the New Yorker feature explains PepsiCo’s effort to re-shape natural salt so that it has more surface area, and, in turn, is perceived as “saltier” on the tongue – meaning they can maintain all the salty flavor in Lay’s but reduce overall sodium content
• Scale more drinks and snacks made with whole grains, fruit, vegetables and dairy to new markets – e.g. bringing vegetable-based gazpacho (perhaps with an edible whole grain spoon) to the U.S.
• Test new ingredients brought back from “treks” around the world – e.g. using a state-of-the-art robot in PepsiCo’s new Hawthorne, NY research lab to test botanicals and other natural ingredients from near and far – e.g. even secluded villages in the far East – to determine their impact on taste and viability for use in PepsiCo snacks and drinks (Do they intensify sweetness? Can they be a substitute for sugar? Do they have a particular healthful function?)

Score this one as a win for Pepsi.

Along with such pledges, Pepsi is aggressively marketing sodas to teenagers.  The San Francisco Chronicle reports on Pepsi’s new “social marketing” vending machines.

At a trade show in Chicago this week, PepsiCo rolled out a prototype interactive soda machine that lets you send a drink as a gift to a friend or a random stranger.

“Our vision is to use innovative technology to empower consumers and create new ways for them to engage with our brands, their social networks and each other at the point of purchase,” Mikel Durham, PepsiCo Foodservice’s chief innovation officer, said in a press release.

“Social Vending extends our consumers’ social networks beyond the confines of their own devices and transforms a static, transaction-oriented experience into something fun and exciting they’ll want to return to, again and again.”

But these kinds of marketing pushes are not confined to Pepsi.   Advertising Age reports that Joe Tripodi, Coke’s chief marketing officer of Coca-Cola explains the company’s growth strategy: focus on teenagers:

The company sees huge opportunities to grow colas, and the business as a whole, around the world in the next decade. Teen recruitment will be particularly important, as the company follows demographic trends.

“There was a time [a decade ago] when we walked away from teen recruitment and probably lost a generation of drinkers,” Mr. Tripodi said. “Parts of the world lost confidence in cola as the engine of growth. We’ve gotten that back in a big way. …When you look at the massive opportunity in so many huge countries in the world, that’s what energizes us and why we believe cola is still at its very early stages.”

And then there are partnership strategies. The latest is Sonic drive-ins’ campaign for Limeades for Learning. The campaign encourages eaters to vote for school projects like those that support physical activity.  Sonic promises to fund the projects with the most votes. The Limeades, by the way, are 620 calories (for a medium) or 950 calories (for a large).

Finally, for now, the Boston Globe reports that most Massachusetts voters support a sales tax on sodas if the money is used for some useful purpose.  But:

The American Beverage Association has been aggressively fighting taxes on soda, as cities and states across the country look for new tools to counter an obesity epidemic and raise revenue amid squeezed budgets. It has spent millions fighting initiatives that impose product-specific excise taxes on sugar-sweetened beverages and has been successful in nearly every attempt.

Expect more such public relations efforts superimposed on fundamental marketing techniques aimed at kids and fighting back on taxes and other attempts to limit soda intake.

 

 

 

How does this comport with the spanking new advertising guidelines to children or any of the previous pledges? Is sending a soda to a friend an activity or marketing? Or both?

 

http://www.sfgate.com/cgi-bin/blogs/techchron/detail?entry_id=87904

 

 

 

I am a member of the editorial board of the Journal of Public Health Policy, which publishes research and commentary on matters that affect international public health.  Dr. Anthony Robbins, one of its editors, and I are calling on authors to submit articles that consider ways to change behavior—not, as is all too common, of individuals but of the food industry.

The journal has published many papers on obesity policies aimed at improving the diet and exercise behavior of individuals.  These may be necessary, but they are not sufficient.  It is now time to deal with the behavior of the food industry.  Food industry profits are

generated by capturing increasingly larger shares of the market and by selling the population more food – and calories –than it needs. In this marketing environment, obesity is collateral damage.

The food industry’s ultimately anti-social behavior – whether conscious or inadvertent – is spreading globally. In higher income countries, it is ubiquitous, whereas in places where people have less disposable income, it is but the camel’s nose under the tent.

Thus, effective strategies to reduce obesity may vary depending on penetration by the industry – and less developed nations may still have more opportunities to avoid obesity, by getting ahead of the curve.

How are countries to do this?

Efforts to control obesity will have to enlist the public to focus on behavior, with a shift from a sole focus on citizens to a new one on the behavior of food corporations…We cannot eliminate the food industry to reverse the obesity epidemic, but we can constrain its anti-social behavior…We encourage authors to reach beyond the kind studies of policies on eating and activity that we receive so frequently.

We have come to believe that research studies concentrating on personal behavior and responsibility as causes of the obesity epidemic do little but offer cover to an industry seeking to downplay its own responsibility.

Instead, we urge authors to submit articles that consider how to understand and change the behavior of the food industry.

As a starting point for thinking about how to approach this topic, we ask: does the industry need to overfeed the population to remain profitable?

Have ideas?  Write them up and submit them to JPHP.  There is no deadline.  The journal will consider submissions whenever they arrive, but sooner is better than later.

My first San Francisco Chronicle “Food Matters” column for the new year deals with some predictions:

Q: Whatever you used as a crystal ball last year turned out to be a pretty good predictor of the most prominent food issues of 2010. How about trying again: What food matters will we be hearing about in 2011?

A: It doesn’t take a crystal ball to figure out what’s coming up with food issues. I’m happy to make predictions, especially since most seem fairly safe.

Dietary guidelines will be released this month. By law, they were due last year and are already late. What will they say? The 2010 guidelines advisory committee recommended eating more fruits, vegetables and whole grains, but introduced a new euphemism – SOFAs, or Solid Fats and Added Sugars – for the “eat less” advice. SOFAs really mean “cut down on fatty meat and dairy products” and “avoid sugary sodas.”

Will government agencies have the nerve to say so? Let’s hope.

The U.S. Department of Agriculture will issue a new food guide. The 2005 pyramid’s rainbow stripes proved impossible to teach and useless to anyone without a computer. I’ve heard a rumor that I will love the new design. I’m skeptical. I liked the original 1992 pyramid. It showed that bottom-of-the-pyramid foods were healthiest, making it unpopular with companies selling top-of-the-pyramid products. But it is healthier to eat some foods than others (see: dietary guidelines).

Will the USDA improve on the 1992 design? We will soon find out.

The fights over food safety will continue. At the last possible moment, Congress passed the food safety bill by a large majority. Now the fights really begin.

Funding will be most contentious, with the actual regulations not far behind. The Congressional Budget Office absurdly considered the bill’s provisions to be “budget neutral.” They are anything but.

The bill’s provisions require the Food and Drug Administration to hire more inspectors just at a time when Republican lawmakers have sworn to cut domestic spending. The FDA also must translate the bill’s requirements and exemptions for small farmers into regulations.

Rule-making is a lengthy process subject to public comment and, therefore, political maneuvering. Watch the lobbying efforts ratchet up as food producers, large and small, attempt to head off safety rules they think they won’t like.

Expect more lawsuits over the scientific basis of health claims. The Federal Trade Commission just settled a $21 million claim against Dannon for advertising that yogurt protects against the flu. The agency also has gone after scientifically unsubstantiated claims that omega-3s in kiddie supplements promote brain development and that pomegranate juice protects against prostate problems. POM Wonderful has already countersued the FTC on grounds that the First Amendment protects commercial speech. I’ll be watching this case carefully.

The FDA will issue new front-of-package label regulations. The FDA has promised to propose an at-a-glance symbol to indicate the overall nutritional value of food products. Food companies like the Guideline Daily Amount spots they are using in the upper corners of food packages because the symbols are factual but nonjudgmental. The FDA, however, is considering red, yellow and green traffic-light symbols that do convey judgments. Food companies say they will not voluntarily use a symbol that tells people to eat less of their products.

Will the FDA have the courage to make traffic lights mandatory? It will need courage. The new British government dealt with the traffic-light idea by summarily dismantling the food agency that suggested it.

Corporations will seek new ways to co-opt critics. Under the guise of corporate social responsibility, food companies have been making large donations to organizations that might otherwise criticize their products. The most recent example is the decision by Save the Children, formerly a staunch advocate of soda taxes, to drop that cause coincidentally at a time when its executives were negotiating funding from Coca-Cola.

Such strategies remind me of how the Philip Morris cigarette company distributed grants to leading arts groups. Expect food companies to use generosity to neutralize critics and buy silence.

School meals will make front-page news. Congress passed the Healthy, Hunger-Free Kids Act last month. Now the USDA must implement it by setting nutrition standards, adding fresh fruits and vegetables (some locally grown) and expanding eligibility.

President Obama has promised to restore the $4.5 billion “borrowed” from the SNAP (food stamp) program to fund this act. The scrambling over the regulations and financing should make excellent spectator sport.

Farm bill advocates will be mobilizing. You might think it too early to be worrying about the 2012 Farm Bill, but I’ve already gotten position papers analyzing commodity and food-assistance issues from groups gearing up to lobby Congress to bring agricultural policy in line with nutrition and public health policy.

I have a personal interest in such papers. I will be teaching a course on the Farm Bill at New York University next fall. Please get busy and write more of them!

Happy new year, and let’s see how my guesses play out.

It is always interesting to watch the food industry deal with criticism.  One common strategy is to discredit critics through personal attacks. Most companies are too embarrassed to do this publicly.  Instead, they pay public relations firms—in this case, the Center for Consumer Freedom—to do this for them.

What is this group?  See Center for Consumer Freedom Exposed and follow the links to see lists of the food industry donors it keeps secret.

If you have been reading this blog for a while, you know that I am an occasional target of this group, as can be seen from  the piece it posted yesterday:

Marion Nestle, Food Fascist

Sound harsh? After our latest check-in with everyone’s favorite anti-pleasure nutritionist, we think it’s completely appropriate. Marion Nestle published an article on her blog today quoting a law professor named Timothy Lytton, who insists that trampling on anyone’s First Amendment rights is a no-no. That prompted Nestle and fellow obesity warrior Dr. David Ludwig to fire off an astonishing letter.

The post goes on to quote extensively from my comments earlier this week.  It also points out:

At the end of the day, there’s no high-minded Constitutional principle in play here. This is about Marion Nestle attacking businesses she doesn’t like. This is the same professor who delivered a speech at an event sponsored by the “Socialist Conference” of the American Public Health Association. Nestle also addressed the “Socialist Scholars Conference” in 2003.

These kinds of strategies speak for themselves.

The corporations that hire the Center to do things like this should be ashamed of themselves.

The World Health Organization (WHO) has a new, tough report out: “Set of recommendations on the marketing of foods and non-alcoholic beverages to children.”

It’s policy aim: to reduce the impact on children of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.

Here are some of its recommendations (edited):

• Given that the effectiveness of marketing is a function of exposure and power, the overall policy objective should be to reduce both the exposure of children to, and power of, marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• To achieve the policy aim and objective, Member States should consider different approaches, i.e. stepwise or comprehensive, to  reduce marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt, to children.
• Settings where children gather should be free from all forms of marketing of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• Governments should be the key stakeholders in the development of policy and provide leadership, through a multistakeholder platform, for implementation, monitoring and evaluation. In setting the national policy framework, governments may choose to allocate defined roles to other stakeholders, while protecting the public interest and avoiding conflict of interest.
• Considering resources, benefits and burdens of all stakeholders involved, Member States should consider the most effective approach to reduce marketing to children of foods high in saturated fats, trans-fatty acids, free sugars, or salt.
• Member States should cooperate to put in place the means necessary to reduce the impact of crossborder marketing (in-flowing and out-flowing) of foods high in saturated fats, trans-fatty acids, free sugars, or salt to children.

The Rudd Center at Yale has just released Fast Food F.A.C.T.S., a thoroughly comprehensive report on the marketing of fast food to children and adolescents.

The report lavishly illustrates and extensively documents the ways in which fast food companies market to kids, the strategies they use, and the effects of these efforts on kids’ diets.

Readers: add it to your library!  FDA and FTC: get busy!

Addition: Advertising Age reports on the fast food industry’s response to the Rudd Center report.  All the industry can come up with, says Advertising Age, is a “canned response.”  Looks like the Rudd Center got it right.

Scientific debates about the role of sodium in high blood pressure go on and on.  Committees of scientists reviewing the research invariably conclude that people would be healthier if they ate less salt (salt is sodium chloride).  The 2010 Dietary Guidelines Advisory Committee is only the most recent group to urge population-wide reductions in sodium intake.

The Institute of Medicine has just issued a new report on reducing sodium.  Its Report in Brief gives a quick summary

As its primary strategy for sodium reduction, the committee recommends that the FDA set mandatory national standards for the sodium content in foods…beginning the process of reducing excess sodium in processed foods and menu items to a safer level. It is important that the reduction in sodium content of foods be carried out gradually…Evidence shows that a decrease in sodium can be accomplished successfully without affecting consumer enjoyment of food products if it is done in a stepwise process that systematically and gradually lowers sodium levels across the food supply.

But wait!  Hypertension rates have been increasing for years without any change in sodium excretion, says a report in FoodNavigator.com.  The report refers to new study in this month’s American Journal of Clinical Nutrition reviewing trends in sodium excretion from 1957 to 2003.

Sodium excretion, a precise reflection of intake, say Adam Bernstein and Walter Willett of the Harvard School of Public Health, has not changed in the last half century, despite rising rates of high blood pressure.   Instead, they suggest that rising rates of obesity might be the cause.

The accompanying editorial, by David McCarron and his colleagues, takes the argument even further as can be seen just from its title: “Science trumps politics: urinary sodium data challenge US dietary sodium guideline.^”

The editorial says that this new study provides:

plausible, scientific evidence of a “normal” range of dietary sodium intake in humans that is consistent with our understanding of the established physiology of sodium regulation in humans. This scientific evidence, not political expediency, should be the foundation of future government policies….Guidance for sodium intake should target specific populations for whom a lower sodium intake is possibly beneficial. Such an approach would avoid broad proscriptive guidelines for the general population for whom the safety and efficacy are not yet defined.

Is this review likely to change the Dietary Guidelines due out later this year?  The Advisory Committee was convinced that the preponderance of evidence favors the importance of sodium as a causative agent in high blood pressure.

Because so much is at stake for the processed food industry, this argument is not likely to be resolved quickly.  Stay tuned.