by Marion Nestle

Search results: sugar policy

Jul 27 2022

Taxing sugar-sweetened beverages: a how-to guide to legislation

We have Healthy Food America and the University of Washington, the UCONN Rudd Center for Food Policy & Health, and the Public Health Law Center at Mitchell Hamline School of Law to thank for this guide to tax legislation that will promote health and racial equity.

The report:

  • Reviews tax laws proposed and achieved in the US
  • Summarizes the experience of advocates and policymakers
  • Examines approaches used in alcohol, tobacco, and cannabis taxes
  • Recommends how to draft legislation to promote equity

The full report: Investing Sweetened Beverage Tax Revenues to Advance Equity: Recommendations for Drafting Legislation

The brief report is here.

An infographic provides a quick overview.

Other supporting materials are available on the Healthy Food America website.

Want to give this a try?  Here’s how.

May 16 2022

Industry-sponsored study of the week: Sugars!

Here’s a good one for my collection:

The Study: TRENDS IN ADDED SUGARS INTAKE AND SOURCES AMONG U.S. CHILDREN, ADOLESCENTS AND TEENS USING NHANES 2001-2018.  Laurie Ricciuto,Victor L. Fulgoni III, P. Courtney Gaine, Maria O. Scott, Loretta DiFrancesco. The Journal of Nutrition, Volume 152, Issue 2, February 2022, Pages 568–578, https://doi.org/10.1093/jn/nxab395 

  • Background: Over the past 2 decades, there has been an increased emphasis on added sugars intake in the Dietary Guidelines for Americans (DGA), which has been accompanied by policies and interventions aimed at reducing intake, particularly among children, adolescents, and teens.
    Objectives: The present study provides a comprehensive time-trends analysis of added sugars intakes and contributing sources in the diets of US children, adolescents, and teens …focusing on variations according to sociodemographic factors.
  • Methods: Data from 9 consecutive 2-year cycles of the NHANES were combined…Trends were also examined on subsamples stratified by sex, race and ethnicity…income (household poverty income ratio), food assistance, physical activity level, and body weight status.
  • Results: From 2001–2018, added sugars intakes decreased significantly…mainly due to significant declines in added sugars from sweetened beverages.
  • Conclusions: Declines in added sugars intakes were observed among children, adolescents, and teens…Despite these declines, intakes remain above the DGA recommendation; thus, continued monitoring is warranted.
  • Support: The funding for this research was provided by The Sugar Association, Inc. The views expressed in the manuscript are those of the authors and do not necessarily reflect the position or policy of The Sugar Association, Inc. The Sugar Association, Inc. had no restrictions regarding publication.
  • Author Disclosures: LR and LD as independent consultants provide nutrition and regulatory consulting to various food manufacturers, commodity groups and health organizations. VLF III as Vice President of Nutrition Impact, LLC conducts NHANES analyses for numerous members of the food, beverage and dietary supplement industry. PCG and MOS are employed by The Sugar Association, Inc.
Comment: The Sugar Association would dearly love to demonstrate that sugar intake has nothing to do with weight gain or its consequences.  Its logic: sugar intake is declining while body weights continue to rise.  But here’s the key: “Despite these declines, intakes remain above the DGA recommendations.”  Yes they are, and we would all do better eating less sugar.
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Mar 18 2022

Weekend reading: Taxing Sugar-Sweetened Beverages

Here’s a report from the World Health Organization on the effects of taxing sugar-sweetened beverages.

The study:

Consumption of SSBs is associated with increased risk of overweight and obesity (5), cardiovascular events (6), hypertension (7) and diabetes (8). There is now substantial evidence that SSB taxes can both discourage consumption and encourage reformulation (9,10). SSB taxes have also been found to have positive impacts on population weight and to potentially have greater health benefits among lower socioeconomic populations (11,12)….This study takes a policy analysis lens to studying SSB tax adoption and implementation in the WHO European Region. The focus was on the politicoeconomic and stakeholder dynamics in cross-sectoral policy-making, as well as considering adaptation in policy design.

https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2022/sugar-sweetened-beverage-taxes-in-the-who-european-region-success-through-lessons-learned-and-challenges-faced-2022

https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/publications/2022/sugar-sweetened-beverage-taxes-in-the-who-european-region-success-through-lessons-learned-and-challenges-faced-2022

  • Be adapted to a country’s legislative, fiscal, economic and health context.
  • Be designed and implemented through collaboration between finance and health policy-makers.
  • Take revenues into consideration.
  • Expect opposition from industry.

On this last point, the report says:

SSB taxes were strongly opposed by actors in the food and beverage industry in all the study countries, before and after  implementation. Industry made strong public statements regarding the negative economic impact that the tax would have on industry, particularly in relation to employment. In Finland, France, Hungary, Ireland and Portugal, they also argued that the tax would be regressive and, therefore, have a negative impact on consumers. In Belgium, Finland, France and Hungary (notably, these were earlier taxes), industry actors raised concerns that the tax singled out beverages and/or the beverage industry for differential taxation. Industry actors also presented a range of arguments regarding the taxes being ineffective and poorly designed.

Soda tax advocates need strategies to counter this opposition.  Plenty are available.  See the toolkit at Healthy Food America, for example.

Oct 12 2021

The Sugar Association vs. Artificial Sweeteners

As I mentioned yesterday, the American Beverage Association represents the interests of soft drink companies that use sugars and artificial sweeteners in their products.  Its goal: to make you think both are just fine for your health.

Today, let’s take a look at a related, but different trade association, this one The Sugar Association.  Its goal: to make you not worry about sugars and to think that they are better for you than artificial sweeteners.

Here, for example, is a press release from this Association from this past summer: New Research Shows Large Majority of Consumers Understand Real Sugar Comes from Plants & That it Can Be Part of a Healthy Diet; Data reveals significant shift in perceptions of sugar and artificial sweeteners.

And here is its infographic showing data on public suspicions of artificial sweeteners.

Now, we have a new campaign from The Sugar Association: The Campaign for Sweetener Transparency.

More than 10,000 consumers across the United States have joined the fight for sweeping reform of the government’s labeling regulations covering the use of alternative sweeteners in packaged food by signing an online petition urging the U.S. Food & Drug Administration (FDA) to require food companies to place clear, complete and accurate information on food labels…it’s virtually impossible for shoppers to know what alternative sweeteners are in which packaged foods because the FDA only requires food companies to list the chemical names of sugar substitutes on food ingredient labels. So, consumers only see names like Xylitol, Hydrogenated Starch Hydrolysates, Saccharin, Acesulfame Potassium, Neotame, Isomalt and Lactitol on ingredients lists without even knowing what they are and why they are used.

The Sugar Association wants artificial sweeteners clearly labeled so customers will switch to products that have sugars instead.

  • Products containing artificial sweeteners fall in the category of ultra-processed—foods that should be avoided or eaten in small amounts.
  • Products containing added sugars also should be avoided or eaten in small amounts.

That’s why this campaign is about market share, not health.

For a basic guide to what to do about sugars, see this resource guide from Hunter’s Food Policy Center.

Oct 15 2020

Good news #4: Successes in reducing sugary drinks

Berkeley, California, ever at the cutting edge of public health nutrition policy, is banning junk food from checkout counters and aisles.

The new policy will require retailers larger than 2,500 square feet to stock healthy food at the register and in areas where customers wait in line, instead of items like chips, soda and candy. It forbids food items with 5 grams of added sugars and 200 milligrams of sodium, chewing gum and mints with added sugars, and beverages with added sugars or artificial sweeteners. In Berkeley, the policy will affect stores like Safeway, Monterey Market, Whole Foods and Berkeley Bowl.

As a result of efforts like these—public health campaigns, soda taxes, and other initiatives—heavy consumption of sugary drinks (more than 500 calories/day) is declining.

According to a recent study, the percentage of children who drink more than 500 calories worth of soft drinks a day declined from 11% to 3%  from 2003 to 2016, and the percentage of adult heavy consumers declined from 13% to 9%.

This trend is in the right direction.

Jun 26 2020

Weekend reading: marketing of sugary drinks to minorities

The COVID-19 pandemic has pointed out how the higher risk of complications and death among members of minority groups.  The reasons are fairly well established.  Members of minority groups are more likely to:

  • Be overweight
  • Have diet-related risk factors: hypertension, type-2 diabetes, multiple metabolic problens
  • Live in high-pollution areas
  • Have asthma
  • Suffer from the daily stress of discrimination
  • Lack sick leave benefits
  • Have poor health care

The .latest report from Rudd Center on Food and Obesity Policy, Sugary Drinks FACTS 2020, highlights how sellers of sugary drinks target their products to minority populations.  The press release says that the report found:

  • In 2018, companies spent $84 million to advertise regular soda, sports drinks, and energy drinks on Spanish-language TV, an increase of 8% versus 2013 and 80% versus 2010.
  • Sports drink brands disproportionately advertised on Spanish-language TV, dedicating 21% of their TV advertising budgets to Spanish-language TV, compared to 10% on average for all sugary drinks.
  • Compared to White children and teens, Black children saw 2.1 times as many sugary drink ads and Black teens saw 2.3 times as many. Black youth exposure was particularly high for sports drinks, regular soda, and energy drinks.

Click here for the full report. 

The report’s main finding:

CNN has an excellent account of this, in which I am quoted.

Experts say soda companies have also taken a page out of the tobacco industry’s marketing playbook, by providing funding for many Black communities and endeavors “in ways that don’t look like advertising, like funding playgrounds in minority neighborhoods, minority community groups, and sponsorship of Black and Hispanic sports figures,” said Marion Nestle, who also authored “Eat, Drink, Vote: An Illustrated Guide to Food Politics.”  “These work,” Nestle said. “Minority kids identify soda brands with sports figures, and minority community groups find it hard to oppose soda company marketing when the companies have been so generous.”
The account refers to the CEO of Pepsi’s statement on the company’s efforts to address race.  I am quoted again:
“The great irony of Ramon Laguarta’s promises to counter PepsiCo’s conscious or unconscious racist practices in the company, its business, and communities is that none of them addresses targeted marketing,” said Nestle.
“The best thing Pepsi could do to improve the health of its customers would be to stop advertising and marketing to children and teenagers, especially those of color,” Nestle added.
Addition, June 29
US Right to Know also has an excellent article on this topic.
Jul 24 2019

At last: attention to sugar’s role in dental health

I included a chapter on sugar and dental disease in my 2015 book, Soda Politics: Taking on Big Soda (and Winning), because billions of people have decayed teeth and other dental problems that could have been kept intact by dental hygiene, fluoride treatment, or—consuming less sugar or sugary drinks.

But:

  • Dental disease has a long history of being overlooked as a public health problem.
  • Sugar has a long history of being ignored as a cause of dental disease.

This may now be changing.

The Lancet has a new series on oral health:

Radical action on oral health will benefit from harnessing a clear global health mandate. Because oral diseases share the main risk factors of other non-communicable diseases (NCDs)—sugar consumption, tobacco use, and harmful alcohol use—oral health should have a stronger place on the global NCDs agenda.

  • Oral diseases: a global public health challenge: Marco A Peres, Lorna M D Macpherson, Robert J Weyant, Blánaid Daly, Renato Venturelli, Manu R Mathur, Stefan Listl, Roger Keller Celeste, Carol C Guarnizo-Herreño, Cristin Kearns, Habib Benzian, Paul Allison, Richard G Watt.  The Lancet, Vol. 394No. 10194.  

Among this article’s key messages:

  • Oral conditions share common risk factors with other non-communicable diseases, which include free sugar consumption, tobacco use, and harmful alcohol consumption, as well as the wider social and commercial determinants of health
  • Of particular concern is the effect of free sugar consumption on the prevalence of caries and overweight or obesity, and associated conditions such as diabetes
  • Recognition is increasing of the influence, power, and effect of the global sugar industry as a threat to public health, which requires tighter regulation and legislation by governments
  • Ending the neglect of global oral health: time for radical action: Richard G Watt, Blánaid Daly, Paul Allison, Lorna M D Macpherson, Renato Venturelli, Stefan Listl, Robert J Weyant, Manu R Mathur, Carol C Guarnizo-Herreño, Roger Keller Celeste, Marco A Peres, Cristin Kearns, Habib Benzian.  The LancetVol. 394No. 10194

In this Series paper, we focus on the need to reduce sugar consumption and describe how this can be achieved through the adoption of a range of upstream policies designed to combat the corporate strategies used by the global sugar industry to promote sugar consumption and profits. At present, the sugar industry is influencing dental research, oral health policy, and professional organisations through its well developed corporate strategies. The development of clearer and more transparent conflict of interest policies and procedures to limit and clarify the influence of the sugar industry on research, policy, and practice is needed. Combating the commercial determinants of oral diseases and other NCDs should be a major policy priority.

A check of dental research organisation websites shows that corporate members of ORCA include Cloetta, a Nordic confectionery company; Unilever, a global consumer goods company that sells ice cream and sugary beverages; and Mars Wrigley Confectionery, a leading manufacturer of chewing gum, chocolate, mints, and fruity confections (through its Wrigley Oral Healthcare Program). Corporate members of the International Association for Dental Research (IADR) include Unilever and Mondelēz International, one of the world’s largest snack companies, whose products include cookies, chocolate, and confectionery. These financial ties are slightly less shocking given the oral health-care products these companies sell: xylitol chewing gum and pastilles (Cloetta), sugar-free gum with xylitol (Mondelēz, Mars Wrigley), and toothbrushes and fluoridated toothpaste (Unilever). Nonetheless, as the dental research community comes to terms with its neglect of sugars intake, these relationships with industry are ripe for scrutiny.  [I’ve written previously about Kearns’ discovery of links between sugar trade associations and dental professional organizations].

Two key strategic aims for a global oral health movement will be to ensure that oral health treatment and prevention services are central to UHC [universal health coverage] and to support global efforts to limit the damage caused by the sugar industry…There is fragmented global action for reducing the damage of the sugar industry and some progress has been made in a number of cities and countries, especially with the introduction of taxes on sugary drinks.  However, there is no united global movement against sugar, as there is against the tobacco industry.

  • Perspective:  Richard Watt: time to tackle oral diseases: Rachael Davies.  The Lancet, Vol. 394No. 10194.  “The mouth really is a marker of people’s social position and future disease risk…and oral diseases are a canary in the coal mine for inequality.”
  • Perspective: Polished smiles and porcelain teeth.  Richard Barnett.  The Lancet, Vol. 394No. 10194. 
This is a history of George Washington’s teeth and the later development of the dental profession, ending with this thought: “in the early 21st century, the great global divide in dentistry remains—as it was in Washington’s day—between the rich and the poor.”

It’s great that The Lancet has finally taken this on.

Here’s The Guardian’s Account.  There should be a lot more press coverage.  Dental conditions affect billions of people throughout the world.

Jul 15 2019

Industry-funded studies: The Sugar Association’s view

You may think, as I do, that everyone would be better off eating less sugar, but that’s not how The Sugar Association sees it.  This trade association for sugar producers funds research to demonstrate that eating sugar is a good thing and not harmful.

Here’s what The Sugar Association says:

The Sugar Association is committed to transparent engagement with researchers, external partners and consumers to address knowledge gaps and support independent, peer-reviewed science. Recent literature suggests this framework, rooted in transparency and communication and reflected in our Operating Principles, leads to increased public confidence in industry-funded research,* a goal the organization is working to achieve.

The asterisk refers to Achieving a transparent, actionable framework for public-private partnerships for food and nutrition research, a consensus report written by, among others, representatives of the International Life Sciences Institute, a well known front group for the food industry, and other organizations with ties to food companies.

The Sugar Association lists some of its recent publications [you can’t make this stuff up]:

Nutrition Today Supplement: Sweet Taste Perception and Feeding Toddlers. March/April 2017 – Volume 52 [The Sugar Association funded the conference that resulted in this supplement, which it also funded].