Search results: sugar policy

My latest publication is a commentary on the reversal of the Danish fat tax in New Scientist, November 26:

Fighting the flab means fighting makers of fatty foods

A YEAR ago in these pages, I congratulated the Danish government on its revolutionary experiment. It had just implemented a world-first fiscal and public health measure – a tax on food products containing more than 2.3 per cent saturated fat.

This experiment has now been dropped. Under intense pressure from the food industry in an already weak economy, the Danish government has repealed the fat tax and abandoned an impending tax on sugars.

Nobody likes taxes, and the fat tax was especially unpopular among Danish consumers, who resented having to pay more for butter, dairy products and meats – foods naturally high in fat.

But the real reason for the repeal was to appease business interests. The ministry of taxation’s rationale was that the levy on fatty foods raised the costs of doing business, put Danish jobs at risk and drove customers to buy food in Sweden and Germany.

In June this year, a coalition of Danish food businesses organised a national repeal-the-tax campaign. The coalition said that fat and sugar taxes would cause the loss of 1300 jobs, generate high administrative costs and increase cross-border shopping – precisely the arguments cited by the government for its U-turn.

We can now ask the obvious questions. Did the tax achieve its aims? Was it good public policy? What should governments be doing to reduce dietary risk factors for obesity?

The purpose of food taxes is to reduce sales of the products concerned. In bringing in its fat tax, the Danish government also wanted to raise revenue, reduce costs associated with obesity-related diseases, and increase health and longevity. A year is hardly time to assess the impact on health, but the tax did bring in $216 million. Danes will now face higher income taxes to make up for the loss of the fat tax.

Business groups insist that the tax had no effect on the amount of fat that Danes ate, although they chose cheaper foods. In contrast, economists at the University of Copenhagen say Danish fat consumption fell by 10 to 20 per cent in the first three months after the tax went into effect. But it is not possible to know whether it fell, and cross-border shopping rose, because of the tax or because of the slump that hit the Danish economy.

A recent analysis in the BMJ suggests that 20 per cent is the minimum tax rate on food to produce a measurable improvement in public health. The price of Danish foods hit by the tax increased by up to 9 per cent, enough to cause a political firestorm but not to make much of a difference to health.

Is a saturated-fat tax good public policy? A tax on sugary drinks would be a better idea. To see why, recall that obesity is the result of an excess intake of calories over what we burn. Surplus calories, whether from carbohydrate, protein or fat, are stored as body fat. All food fats are a mix of unsaturated and saturated fatty acids; all provide the same number of calories per unit weight.

Saturated fats raise the risk of coronary heart disease, although not by much. Trans fats, banned in Denmark since 2003, are a greater risk factor. Because the different saturated fatty acids vary in their risk, imposing a single tax on them as if they are indistinguishable is difficult to support scientifically.

For these reasons, anti-obesity tax measures in other countries have tended to avoid targeting broad nutrient groups. Instead, they focus on processed foods, fast food or sugary drinks – all major sources of calories. Taxing them seems like a more promising strategy.

What else should governments be doing? That they have a role in addressing the health problems caused by obesity is beyond debate, not least because they bear much of the cost of dealing with such problems. In the US, economists estimate the cost of obesity-related healthcare and lost productivity at between $147 billion and $190 billion a year. The need to act is urgent. But how?

One lesson from Denmark is that small countries with open borders cannot raise the prices of food or anything else unless neighbouring countries also do so. But the greater lesson is that any attempt to encourage people to eat less will encounter fierce food-industry opposition. Eating less is bad for business.

In the US, state and city efforts to tax sugary drinks have met with overwhelming opposition from soft-drink companies. They have successfully spent tens of millions of dollars lobbying legislators and convincing the public that such measures deprive voters of their “right to choose” or, as in Denmark, can damage the economy.

What’s more, the poor cannot be expected to support measures that increase food costs, even though obesity-related problems are much more common among low-income groups.

If governments really want to reduce the costs of obesity-related chronic diseases, they will have to address the problem at its source: the production and marketing of unhealthy food products.

A review by the American Heart Association cites increasing evidence for the benefits of anti-obesity interventions: food taxes, subsidising healthy foods, media campaigns to promote exercise and good diet, restrictions on portion sizes, and restrictions on the marketing of unhealthy foods and their sale in schools.

Governments must decide whether they want to bear the political consequences of putting health before business interests. The Danish government cast a clear vote for business.

At some point, governments will need to find ways to make food firms responsible for the health problems their products cause. When they do, we are likely to see immediate improvements in food quality and health. Let’s hope this happens soon.

Marion Nestle is the author of Food Politics and What to Eat and is the Paulette Goddard professor of nutrition, food studies, and public health at New York University

My NYU Food Policy class meets tonight and we’ll be talking about the farm bill and Dan Imhoff’s most helpful book Food Fight: The Citizens’ Guide to the Next Food and Farm Bill.

To review what’s up with the 2012 farm bill:

Congress updates farm bills every five years or so.  It passed the last one in 2008, with an expiration date at midnight on September 30, 2012.  This was the first time Congress ever set an expiration date to land in the midst of a presidential election.  This was asking for trouble.  Congress is paralyzed in election years.

That date has now come and gone.

But in June 2011, the Senate passed its version of the bill: The Agriculture Reform, Food and Jobs Act of 2012.

The House, however, was unable to come to agreement on its version: The Federal Agriculture Reform and Risk Management Act of 2012.

Why?  Election-year politics and disagreements about whether and by how much the SNAP (food stamps) budget should be cut.  More than 80% of farm bill spending goes to SNAP benefits—a whopping $72 billion last year–making it a prime target for budget cutting.

This situation puts us in farm bill limbo.

The significance of limbo is best explained by the National Sustainable Agriculture Coalition (NSAC).

• Without a new farm bill, commodity (corn, soybean, etc) support programs revert to permanent law contained in the farm bills passed in 1938 and 1949.  Why?  Because unlike subsequent bills, these did not have expiration dates.
• The old laws reintroduce much higher support prices (through certain loans instead of payments), require much smaller crop production, and lead to much higher consumer prices.  They do not include  support for soybeans, other oilseeds, peanuts, or sugar, making them woefully out of date.
• Limbo has no effect on SNAP or crop insurance.  Congress covered SNAP with a resolution for continued funding through March 2013.  The Federal Crop Insurance Act effectively authorizes crop insurance permanently.
• Dairy programs are in turmoil.  Milk payments to farmers ended in September.  The dairy price support program ends on January 1.   Under the 1949 law, government-supported prices would be about four times higher than current law and about twice as high as current market prices.
• The Agricultural Appropriations Act extended some—but not all—conservation programs through 2014.
• The permanent law does not support the hard-won programs that encourage fruit and vegetable production: organic, farmers’ market, beginning farmer, socially disadvantaged farmer, or specialty crop programs.  These now have no funding.

This leaves Congress with three options between now and January:

• Finish the current process and pass a bill (unlikely since it only has a few weeks to do this)
• Vote to extend provisions through the 2013 crop year, or
• Start from scratch all over again in a much tighter budget environment—the infamous “fiscal cliff.”

As NSAC explains:

The farm bill is the nation’s major food and agricultural policy vehicle and is about much more than the big ticket items: food stamps, crop insurance, and commodity support.  The farm bill is also about conservation and environmental protection, rural economic and community development, food system reform and agricultural research.

With no new farm bill or extension, the programs that address rural and urban job creation, natural resource conservation, renewable energy, and improved production and access to healthy food are in big trouble.

This is a big mess, and a serious result of dysfunctional government.  It will be interesting spectator sport to see how Congress handles it.

Will Congress find a way to bring agricultural policy in line with health policy?

Or will Congress simply do whatever is most expedient, given the budgetary mess it has also created.

It’s too bad so much is at stake.

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

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

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

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

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

Policy or lifestyle?

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

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

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

Corporate spending

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

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

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

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

Lobbyists

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

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

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

Soda tax

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

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

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

I can hardly believe it but is the FDA really proposing to test consumer understanding of food industry evasions of the “Jelly Bean Rule?”

The FDA established this “rule” (a principle, actually) in 1994 to prevent food companies from adding vitamins to junk foods in order to allow them to be marketed as healthy.

The FDA said that just because a food is low in fat, cholesterol, and sodium—like a jelly bean—the manufacturer cannot make a health claim for it unless it contains at least 10% of the Daily Value of vitamin A, vitamin C, calcium, protein, fiber, or iron.

But, the FDA also said, companies could not fortify foods with these nutrients for the sole purpose of making health claims.

This is explained in the FDA’s policy on food fortification, given in 21 CFR 104.20(a).

The addition of nutrients to specific foods can be an effective way of maintaining and improving the overall nutritional quality of the food supply.

However, random fortification of foods could result in over- or underfortification in consumer diets and create nutrient imbalances in the food supply.

It could also result in deceptive or misleading claims for certain foods.

The Food and Drug Administration does not encourage indiscriminate addition of nutrients to foods, nor does it consider it appropriate to fortify fresh produce; meat, poultry, or fish products; sugars; or snack foods such as candies and carbonated beverages.

Now the FDA announces that it wants to study consumer responses to health claims on fortified snack products:

The FDA has an interest in the American public achieving and maintaining diets with optimal levels of nutritional quality, wherein healthy diets are composed of foods from a variety of nutrient sources.

The FDA does not encourage the addition of nutrients to certain food products (including sugars or snack foods such as [cookies] candies, and carbonated beverages).

FDA is interested in studying whether fortification of these foods could cause consumers to believe that substituting fortified snack foods for more nutritious foods would ensure a nutritionally sound diet.

The makers of fortified junk foods and drinks must be trembling in their boots.  Health claims sell food products.  Health claims are practically the only things that sell food products these days.

And companies will have plenty of time to lobby.

Like all FDA processes, this one is required to move at glacial speed.  It must give 60 days to allow people to comment on the proposal and get their lobbying acts together.

Then, the FDA will have to review the comments and, presumably, include them when it submits its request to do the study to the White House Office of Management and Budget.

No point in holding breath for this one.  The OMB has been sitting on FDA proposals for months.

My prediction: if the FDA ever gets to do the study, it will show that consumers interpret health claims as government guarantees that the products are healthy and, probably, have fewer calories than they actually do.

The makers of such products would prefer that the FDA not have this information confirmed.  Watch the lobbying begin!

If you want to comment, do so by October 15.  Here’s how:

• File electronic comments here for Docket No. FDA–2012–N–0871.
• Submit written comments to Division of Dockets Management (HFA–305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Use Docket No. FDA–2012–N–0871.

Here’s my once a month on the first Sunday Food Matters column for the San Francisco Chronicle, out today:

Nutrition and public policy expert Marion Nestle answers readers’ questions in this column written exclusively for The Chronicle. E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.

Q: I’m confused about calories. If I cut calories to lose weight, does it matter what foods I eat? Or are all calories the same?

A: As the co-author of “Why Calories Count: From Science to Politics,” I hear this question all the time.

The short answer: Calories matter for weight. The choice of foods that provide the calories matters a lot for health and may make it easier for you to diet successfully.

To lose weight, reducing calorie intake below expenditure works every time.

To prove this point, a professor at Kansas State University lost 27 pounds in 10 weeks on the Twinkies diet – one Twinkies every three hours with occasional snacks of chips, sugary cereals and cookies. Even so, he cut his usual calorie intake by 800 a day. Anyone would lose weight doing that.

Only four dietary components provide calories: fat (9 per gram), carbohydrate and protein (4 per gram each) – and alcohol (7 per gram).

Does the particular mix of these components make any difference to weight loss? Yes, say proponents of diets low in carbohydrate, especially rapidly absorbable sugars and refined starches.

Low-carbohydrate diets are necessarily high in fat, and somewhat higher in protein. Do people lose weight on them because of the effects of carbohydrates on insulin levels or because low-carbohydrate diets help reduce calories?

This question does not have an easy answer, but not for lack of trying. Weight-loss studies are hard to do. Estimating calorie intake is notoriously inaccurate, and measuring calories is difficult and expensive.

The first measurement study I know of took place in 1964. Investigators from the Oakland Institute for Medical Research studied weight loss in five obese patients in a hospital metabolic ward. They calculated the number of calories needed to induce rapid weight loss in each patient, and fed each of them a liquid formula diet containing that number every day. Every few weeks, they changed the formula to vary the proportions of protein (ranging from 14 percent to 36 percent of calories), fat (12 percent to 83 percent), and carbohydrate (3 percent to 64 percent).

Regardless of the proportions, all patients lost weight at a constant rate. The investigators titled their study “Calories Do Count.”

This study was conducted under rigidly controlled conditions of hospitalization and involved actual measurements – not estimations – of calorie intake and body weight.

But what about weight-loss studies involving people who are not incarcerated? Since the early 2000s, numerous clinical trials have shown low-carbohydrate diets to produce greater weight loss than low-fat diets. Some also have observed improvements in blood pressure, blood glucose levels and blood lipids.

But it is so inaccurate to estimate calorie intake in such studies that most didn’t bother to try. This means they can’t say whether the weight loss was due to composition of the diet or to calorie reduction.

It’s possible that low-carbohydrate, high-fat diets make people less hungry, but the evidence for this is mixed. Most studies of extreme diets of any type report high dropout rates or failure to stick to the diet for more than six months or so. And even though initial weight loss is rapid on low-carbohydrate diets because of water loss, these diets are low in fiber and some vitamins.

One problem with losing weight is that it takes fewer calories to maintain smaller bodies. Dieting also reduces energy expenditure.

One recent study of that problem involved taking detailed measurements for several years, and illustrates the difficulties of obtaining definitive answers to questions about diet composition and energy balance.

The researchers wanted to know whether diet composition affected energy expenditure in very obese people who had just dieted off up to 15 percent of their weight. They found that a low-carbohydrate diet did not slow down energy expenditure nearly as much as a low-fat diet, meaning that low-carbohydrate diets might make it easier for people to maintain weight loss.

On this basis, the investigators said, “The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective.”

Perhaps, but study subjects were fed prepared calorie-controlled diets for only four weeks, and lost and maintained weight under highly controlled conditions. Does diet composition matter for weight maintenance in the real world? Longer-term studies by other investigators show that diet composition makes little difference in the ability to maintain weight loss.

Most reviews of the subject conclude that any diet will lead to weight loss if it cuts calories sufficiently.

Obviously, some diets are better for health than others.

Face it. The greatest challenge in dieting is to figure out how to eat less – and to eat healthfully on a regular basis – in the midst of today’s “eat more” food environment. And that’s a much more important research problem than whether low-carbohydrate or low-fat diets work better for weight loss.

Marion Nestle is an author and a professor in the nutrition, food studies and public health department at New York University. She blogs at foodpolitics.com. E-mail: food@sfchronicle.com

It’s the (relatively) quiet season and I’m getting caught up on reports coming in.   Here are two.

1.  The Bipartisan Policy Center, a group founded by former cabinet secretaries, has come up with a plan to improve the health of Americans: Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future.   The Executive Summary is online, but the website is difficult to navigate and you have to log into Facebook to read the entire report.

The report calls on the public and private sectors to collaborate in creating healthy families, schools, workplaces and communities. Some of the recommendations are aimed at the food environment, rather than individuals, which is good.  And they are addressed to families, schools, workplaces, communities, and farm policy.  But like most such reports this one does not explain how any of its recommendations might be achieved.

2.  The Rudd Center at Yale has produced Cereal Facts, a study showing that cereal companies:

Increased media spending on child-targeted cereals by 34% from 2008 to 2011, mainly on the least nutritious products.

• More than doubled spending in Spanish-language media.
• Improved overall nutritional quality of 13 of 14 brands advertised to children by 10 percent on average.
• Sponsor TV ads that typically promote products containing one spoonful of sugar for every three spoonfuls of cereal.

Two more findings of interest:

• In 2011, the average 6- to 11-year-old saw more than 700 TV ads for cereals.
• Although General Mills and Kellogg do make nutritious products that are marketed to parents, they do not advertise those products to children.

Watch the video!

I’ve just learned that I’m missing a Focus on Obesity conference in Washington DC today, organized by The Root as part of its Black, Fit & Healthy initiative.

Black Americans have the highest rates of obesity, and a conference devoted to promoting healthy diets in this population seems like a good idea.  This one has an impressive list of speakers.  Sam Kass, Michele Obama’s chef and food policy adviser, is giving the keynote, and many of the speakers are associated with government or private groups devoted to improving the diets, physical activity, and overall health of Black Americans.

The sponsors got my attention.  Two are the Office of Minority Health in the Department of Health and Human Services, and HBO, which produced the Weight of the Nation obesity documentary I discussed a few weeks ago.

But the third is the American Beverage Association (ABA), the trade association for Coke, Pepsi, and other sugary drinks linked to poor diets and overweight among children and adults.

This is the group that so opposes Mayor Bloomberg’s proposed bad on soft drinks larger than 16 ounces.

Not only that, but as documented by the Rudd Center at Yale, ABA members devote special efforts to marketing their products to Black Americans.  Advertising Age notes that the soft drink industry makes no apologies for targeting minorities and considers it “smart marketing.”

The Rudd study’s findings:

The irony: soft drink companies are sponsoring a conference to solve a health problem that their products helped cause in the first place.

Want to take bets on whether any of the speakers suggests cutting down on sodas or “don’t drink your calories”?

Rumors, as yet unverified, are flying:

• The American Beverage Association dreamed this conference up as a public relations move to position sodas as a solution to minority obesity, not its cause.
• Several of the speakers are former employees of, or have ties to, Coca-Cola.
• The Washington Post will be running a special section on the conference next week, flanked with American Beverage Association advertisements

If this last one is true, please save me a copy.

In the meantime, think about who is likely to derive the greatest benefit from this co-sponsorship alliance: the Office of Minority Health, Black Americans, or corporate members of the American Beverage Association.

I am in Brazil at meetings of World Nutrition Rio 2012 but was deluged yesterday by links to a lengthy Reuters’ Special Report: How Washington went soft on childhood obesity.

In an e-mail, Reuters explains that its report is about how food and beverage companies dominate policymaking in Washington, doubled lobbying expenditures during the past three years, and defeated government proposals aimed at changing the nation’s diet.

• The White House, despite First Lady Michelle Obama’s child obesity campaign, kept silent as Congress killed a plan by four federal agencies to recommend reductions to sugar, salt and fat in food marketed to children.
• Corporate lobbying last year led Congress to declare pizza a vegetable to protect it from a nutritional overhaul in the school lunch program.
• The Center for Science in the Public Interest, widely regarded as the lead lobbying force for healthier food, spent about $70,000 lobbying– roughly what companies opposing stricter food guidelines spent every 13 hours.
• The food and beverage industry has a near-perfect record in political battle even while health authorities link unhealthy food to the child obesity epidemic.
• During the past two years, each of the 24 states and five cities that considered “soda taxes” has seen the efforts dropped or defeated.

Reuters Investigates also has a video about how the food industry fought back when the White House sought healthier school lunches and Congress directed federal agencies to set nutrition standards.

Readers of this blog may recall my post last December fretting about the White House pullback, and the vigorous denial the next day by White House senior food policy advisor Sam Kass.

I attributed White House caution to the upcoming election.  Reuters does too, apparently, and so does the New York Times. 

If the First Lady is to make real progress on Let’s Move, she needs all the support she can get.  This might be a good time to send a note to the White House strongly encouraging more vigorous action on methods to address childhood obesity.