by Marion Nestle

Search results: food policy action

Mar 31 2015

Dietitians to remove their “endorsement” from Kraft Singles

Congratulations to Sonja Connor, president of the Academy of Nutrition and Dietetics, for this decision about the Kids Eat Right partnership with Kraft (this letter was sent to me by several AND members).  Congratulations also to all of the AND members who let their disappointment with this partnership be known.

I want to update all of you on a few immediate actions we are taking on the Kids Eat Right pilot initiative with Kraft. As our Academy members, you deserve the most immediate as well as accurate information that we are able to provide.

The Academy and Kraft are in discussions to terminate the contract for our pilot program. This will take a short period of time to complete. We will continue to keep you posted as we move to finalize the termination.

Elements of the program are already in motion and cannot be changed. On April 1, Kraft Singles will begin appearing on retail shelves with the Kids Eat Right logo on the packaging. We are working with Kraft to limit the time it remains on the shelves.

The Academy deeply regrets the circumstances that have led to the pending termination of this initiative. As we have shared previously, we launched this initiative to raise consumer awareness about the importance of having vitamin D and calcium as essential nutrients in children’s diets.

This pilot initiative was never intended to be an official Academy endorsement of a particular product, which is strictly prohibited by our policy and is expressly included in all contracts.

The Board and Academy leadership are taking immediate steps to avoid a similar situation in the future. We will engage with the Academy House of Delegates and with all Academy members on future initiatives to promote healthful foods and nutrition in the most professional, ethical and transparent manner possible.

Thank you for your continued support of the Academy and your patience as we resolve this situation.

And congratulations to Andy Bellatti, founder of Dietitians for Professional Integrity, a group working to uncouple the Academy from its cozy ties to food companies (these were documented by Michele Simon a couple of years ago).  His quote in the New York Times:

Hopefully, this is the beginning of much-needed and much-overdue dialogue on the academy’s corporate sponsorships…Dietitians need to continue advocating for an organization that represents us with integrity and that we can be proud of, rather than continually have to apologize for.

Mar 18 2015

Dietitians in turmoil over conflicts of interest: it’s about time

My e-mail inbox is filled with items about the Academy of Nutrition and Dietetics (AND, formerly the American Dietetic Association).  Its “seal of approval” on Kraft cheese singles (as discussed in an earlier post) was embarrassing—so embarrassing that it was discussed by Jon Stewart: “The Academy is an Academy in the same way this [Kraft Singles] is cheese” (the clip starts at 4:37).

The Onion also had some fun with this.

But now there is even more about how food companies buy the opinions of dietitians.

Candice Choi writes about how Coca-Cola pays dietitians to promote its drinks as healthy snacks (for an example of one of the paid posts, click here).  She explains that the dietitians

wrote online posts for American Heart Month, with each including a mini-can of Coke or soda as a snack idea. The pieces — which appeared on nutrition blogs and other sites including those of major newspapers — offer a window into the many ways food companies work behind the scenes to cast their products in a positive light, often with the help of third parties who are seen as trusted authorities.

Ms. Choi quotes a Coca-Cola spokesman:

“We have a network of dietitians we work with,” said Sheidler, who declined to say how much the company pays experts. “Every big brand works with bloggers or has paid talent.”

Other companies including Kellogg and General Mills have used strategies like providing continuing education classes for dietitians, funding studies that burnish the nutritional images of their products and offering newsletters for health experts. PepsiCo Inc. has also worked with dietitians who suggest its Frito-Lay and Tostito chips in local TV segments on healthy eating.

These are individual actions.  But at last the dietetic membership is objecting to the Academy’s partnership with Kraft.

  1. They have started a Change.org petition to #RepealTheSeal.
  2. The President of the New York State AND chapter (NYSAND), Molly Morgan, sent out a note in support of the petition.

Thank you to the many of you that have expressed your concern and disappointment about the Academy of Nutrition and Dietetics partnership with Kraft. This issue has been reviewed carefully by the NYSAND Board of Directors and the entire board is in support of actively taking steps to share our members concerns. Below are the action steps that NYSAND is taking:

–       Last week (March 11, 2015) the NYSAND Sponsorship Task Force recommendations were received and yesterday (March 16, 2015) at the March NYSAND Board of Directors meeting the Sponsorship Task Force recommendations were reviewed. Please stay tuned for more updates and note that a motion will be forth coming this week for the board to take the next step in addressing sponsorship for NYSAND.

–       Today (March 17, 2015) a letter was sent to the Academy president and emailed to several Academy leaders expressing the views that our members have shared and that as an Affiliate we are not comfortable responding with the talking points provided by the Academy on this issue.

–       Dietitians have started a petition, “Repeal the Seal”; NYSAND will be sharing this on our Affiliate Facebook and Twitter pages and encourages all members who share the concern to sign the petition as well. CLICK HERE to sign the petition.

3.  The AND national CEO, Patricia M. Babjak, sent out this letter to members, also on March 17:

Let me begin by apologizing for the concerns caused by the education initiative with Kraft. The Academy and the Foundation are listening. As a member-driven organization, the Academy’s staff and leadership hear your concerns and welcome your input.

Unfortunately, recent news articles misstated a collaboration as a Kids Eat Right “endorsement” of Kraft Singles, and that it represents a “seal of approval” from Kids Eat Right, the Foundation, or the Academy. It is not an endorsement. It is not a seal of approval. We understand this distinction is of little consequence to many Academy members who are concerned with the perception. We are working on a solution.

In addition, we are working to establish a joint, member-driven Member Advisory Panel. This Panel will work closely with both Boards to:

  • Establish dialogue with members
  • Gather input and give feedback on member issues
  • Make specific recommendations

Recognizing sponsorship as a significant issue of concern among members, the House of Delegates leadership team, who also serve on the Board of Directors, scheduled a dialogue on sponsorship for the upcoming virtual House of Delegates meeting, May 3. We encourage all members to reach out to your delegates and share your thoughts on the benefits of, concerns about and suggestions for the sponsorship program. The Academy and Foundation Boards are looking forward to your input.

Applause to members who are speaking out.

As I said in an interview with TakePart:

The food companies have learned from tobacco and drugs and other industries like that how to play this game…Let’s confuse the science, let’s cast doubt on the science, let’s shoot the messenger, let’s sow confusion.

But since everyone has to eat, the food industry has been given a pass on its pay-to-play practices….

The capital N news…is that dietitians are fighting back at last.

I hope they join Dietitians for Professional Integrity and insist that the leadership respond to their concerns.

AdditionA dietitian sends this communication from the Executive Board of the California Dietetic Association to members about the Kraft situation:

We would like to direct your attention to what the California Dietetic Association (CDA) has done to address our own issues surrounding sponsorship. We heard your concerns regarding CDA Annual Conference sponsorship and we have listened. We voted and McDonalds was not invited as a sponsor in 2015. This decision has impacted our finances; however, we believe it was important to respond to our member feedback. In addition, an ad hoc committee approved by the CDA executive board, reevaluated the sponsorship guidelines. The new sponsorship policy will be posted soon on www.dietitian.org.

Mar 10 2015

World Health Organization: Eat less sugar

The World Health Organization (WHO) has finally officially released its recommendations for sugar intake.  I say “officially,” because I posted an earlier version these guidelines late in January.

The new—and official—WHO guideline, “Sugar intake for adult and children,” makes these recommendations for adults and children:

  • For general health, Reduce daily intake of free sugars to less than 10% of total energy intake.
  • For additional health benefits: Reduce daily intake to below 5% or roughly 25 grams (6 teaspoons) per day.

This recommendation is based on a scientific review as well as comments by groups such as Center for Science in the Public Interest.

The British advocacy group, Action on Sugar, is disappointed in the recommendations, thinks they don’t go far enough, and suspects that heavy food industry lobbying was at work.

There is absolutely NO nutritional requirement for free sugars in our diets, therefore AoS is disappointed that the 5% recommendation is conditional. The WHO used the GRADE[Grading of Recommendations Assessment, Development and Evaluation] system for evaluating the evidence which is useful for drug trials, but is not appropriate for the links between diet and health. This has allowed the food industry to sow the seeds of doubt amongst the WHO, who have failed to come up with the strong recommendation that is so vitally needed, especially for children.

On the other hand, the food industry says the recommendations are misleading and based on weak evidence.

The US Sugar Association [said]…Such a claim is serious, and requires high-quality data, particularly given the potential for consumer confusion and the likelihood that the economic impact to developing countries will be severe. There was a need for extensive debate, especially before the 5% value was included in official recommendations, said the European Committee of Sugar Manufacturers (CEFS). “Especially because the data this value is based on was deemed to be of very low quality by both WHO and the dental health review authors,” it said…. The sugar industry said that sugar in isolation could not be blamed for obesity and asked people to focus on what the WHO defined as the primary cause of obesity: an imbalance between calories and activity.

The WHO recommendations are similar to those issued for decades by national health agencies.  The last time WHO tried to issue the 10% of calories advice in 2003, it got clobbered by lobbyists.

This time, lobbyists didn’t succeed.  This is progress.

Tomorrow: more on sugar lobbying.

 

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Feb 20 2015

The 2015 Dietary Guidelines Advisory Committee releases its courageous report

The 2015 Dietary Guidelines Advisory Committee (DGAC) issued its more than 500-page report yesterday.

Before I say anything about it, please note that this report informs, but does not constitute, the Dietary Guidelines. The agencies—USDA and HHS—write the actual Guidelines and are not expected to do so until the end of this year.

Here are what I see as the highlights (these are direct quotes)

  • A healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.
  • A diet higher in plant-based foods…and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet.
  • It will take concerted, bold actions…to achieve and maintain the healthy diet patterns, and the levels of physical activity needed to promote the health of the U.S. population. These actions will require a paradigm shift to an environment in which population health is a national priority and where individuals and organizations, private business, and communities work together to achieve a population-wide “culture of health” in which healthy lifestyle choices are easy, accessible, affordable, and normative.

Some facts and statements from the report (not direct quotes).

  • Half the energy intake in U.S. diets comes from a combination of burgers and sandwiches (~14%), desserts and sweet snacks (8.5%), sugary beverages (6.5%), mixed dished made with rice, pasta, and other grains (5.5%, savory snacks (~5%), pizza (4.3%), and meat, poultry and seafood mixed dishes (~4%).
  • Nearly half of total sugar intake comes from beverages other than milk and 100% fruit juice

The report comments on issues under current debate.

  • Saturated fat: “replacing SFA with unsaturated fats…significantly reduces total and LDL cholesterol…Strong and consistent evidence…shows that replacing SFA [saturated fatty acids] with PUFA [polyunsaturated fatty acids] reduces the risk of CVD [cardiovascular] events and coronary mortality…For every 1 percent of energy intake from SFA replaced with PUFA, incidence of CHD [coronary heart disease] is reduced by 2 to 3 percent. However, reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD risk.”
  • Sugars: “Strong and consistent evidence shows that intake of added sugars from food and/or sugar sweetened beverages are associated with excess body weight in children and adults…Strong evidence shows that higher consumption of added sugars, especially sugar-sweetened beverages, increases the risk of type 2 diabetes among adults and this relationship is not fully explained by body weight.[Theae findings are] compatible with a recommendation to keep added sugars intake below 10 percent of total energy intake.”
  • Food labels: “Consumers would benefit from a standardized, easily understood front-of-package (FOP) label on all food and beverage products to give clear guidance about a food’s healthfulness.” [This refers to the recommendations of the Institute of Medicine that I’ve written about previously; they disappeared without a trace.]
  • Soda taxes: “Economic and pricing approaches, using incentives and disincentives should be explored to promote the purchase of healthier foods and beverages. For example, higher sugar-sweetened beverage taxes may encourage consumers to reduce sugar-sweetened beverage consumption.”
  • SNAP: “Policy changes within the federal Supplemental Nutrition Assistance Program (SNAP), similar to policies in place for the WIC program, should be considered to encourage purchase of healthier options, including foods and beverages low in added sugars. Pilot studies using incentives and restrictions should be tested and evaluated.”

The DGAC recommends (these are direct quotes but not necessarily complete):

  • Establish local, state, and Federal policies to make healthy foods accessible and affordable and to limit access to high-calorie, nutrient-poor foods and sugar-sweetened beverages in public buildings and facilities.
  • Set nutrition standards for foods and beverages offered in public places.
  • Improve retail food environments and make healthy foods accessible and affordable in underserved neighborhoods and communities.
  • Implement the comprehensive school meal guidelines (National School Lunch Program) from the USDA that increase intakes of vegetables (without added salt), fruits (without added sugars), and whole grains.
  • Limit marketing unhealthy foods to children.
  • Make drinking water freely available to students throughout the day.
  • Ensure competitive foods meet the national nutrition standards (e.g., Dietary Guidelines for Americans).
  • Eliminate sugar-sweetened beverages [from schools].
  • Nutrition Facts label should include added sugars (in grams and teaspoons).

And for all federal nutrition programs, the DGAC recommends:

  • Align program standards with the Dietary Guidelines for Americans so as to achieve the 2015 DGAC recommendations and promote a “culture of health.”

Congratulations to this committee for its courageous recommendations.

Why courageous?  See my previous comments on the objections to such advice.

The next step: public comment:

The public is encouraged to view the independent advisory group’s report and provide written comments at www.DietaryGuidelines.gov for a period of 45 days after publication in the Federal Register. The public will also have an opportunity to offer oral comments at a public meeting in Bethesda, Maryland, on March 24, 2015. Those interested in providing oral comments at the March 24, 2015, public meeting can register at www.DietaryGuidelines.gov. Capacity is limited, so participants will be accepted on a first-come, first-served basis.

Here’s your chance to support this committee’s excellent ideas and demonstrate public approval for diets that promote the health of people and the planet.

Note: the reactions to the report are pouring in and I will deal with them next week.  Enjoy the weekend!

Nov 20 2014

What Dan Glickman is doing these days: bipartisanship

Dan Glickman, former USDA Secretary (1995-2001) has been turning up in my mailbox newsletters a lot lately.  Here’s a small collection.

On making the connection between agriculture and health

The food, agriculture, health, hunger and nutrition sectors need to create new ways of working together that harness their shared commitment to improving health through food and nutrition. And we need government and industry to work together in a way that transcends typical political and business interests….The food industry can do more to reinforce healthy diets through marketing, incentives and other strategies, including product formulation, placement, packaging, and portion sizes. And government needs to amplify its existing efforts to ensure consistent and affirming nutrition and health messages for consumers.

On the need for bipartisan approaches

While a healthy, civil debate among those with differing viewpoints is an essential component of our democracy, the current partisan tone in government is impeding progress. Through the Democracy Project and events like Bridge-Builder Breakfasts, political summits and timely policy discussions, BPC [Bipartisan Policy Center ] is fostering an ongoing conversation about how to overcome political divides and help make our government work better.

He is a co-chair of AGree–Transforming Food and Agriculture

AGree seeks to drive positive change in the food and agriculture system by connecting and challenging leaders from diverse communities to catalyze action and elevate food and agriculture as a national priority.  [Here is what AGree agrees on]

And here he is on the implications of the midterm elections’ for the “rural-urban divide:” 

Notwithstanding the very strong farm and agricultural economy the past few years, the Democratic Party and its leadership are having a great deal of trouble connecting with farmers and rural citizens and small-town America…a sustained effort at the highest political level by Democrats to connect with rural issues and concerns is necessary if they want to broaden their popularity and build bigger and more successful electoral coalitions and succeed in this country’s many rural congressional districts.

…It is no secret that casualties in Iraq and Afghanistan were borne by a disproportionate number of young men and women from these areas. The economic recession has also hit rural America very hard and many towns have not seen much impact on their lives from the rebounding American economy.

The White House and Democratic Party gurus need to recognize that they are failing to connect with rural America….The future of American leadership on nutrition, farming and hunger is in jeopardy without positive action to rebuild and maintain these bipartisan coalitions.

In his post USDA years, Glickman has become a strong spokesman for bipartisanship and bipartisan decisions about how to link agricultural policy to health policy.

Wouldn’t it be nice if he succeeds?

Sep 26 2014

Weekend reading: Brian Wansink’s Slim by Design

Brian Wansink.  Slim by Design: Mindless Eating Solutions for Everyday Life.  William Morrow, 2014.

In his new book, Wansink, the author of Mindless Eating (Amazon’s #1 Best Seller in Eating Disorders, Self-Help) and guru of Cornell’s Food and Brand Lab, promotes the idea that small changes in the food environment will encourage healthier eating.

Wansink, of course, is the behavioral economist who conducts clever and revealing experiments proving this point: the bottomless soup bowl (people eat and eat and eat), the Super Bowl study (students eat more from larger containers), the organic aura hypothesis (people perceive foods with health claims as having fewer calories), the stale popcorn study (if it’s there, people will eat it).

His studies are fun and I especially like his work because it shows how much environmental factors influence food choice.  If so, we need policies to change the environment to make the healthy choice the easy choice.

Wansink, however, usually interprets his work as suggesting what you—as an individual—can do to counter the environmental forces: pay attention, use smaller plates, snack-proof your house.

He does that in this book too, but also has suggestions for actions that restaurants, supermarkets, and food makers can take to sell healthier foods and still make money.   If you are a fast-food restaurant, for example, you can:

Make it motivating

  • Start a Healthy Habits loyalty card—five punches and the sixth healthy item is free.
  • Give 5 percent off the healthier combo version: diet versus regular, baked versus fried.

He says:

Give away a sixth meal?  Give a 5 percent discount?  On a $5 meal that’s a 25-cent loss.  Think of it instead as a $4.75 gain, because diners could have easily otherwise gone somewhere else.  And it’s a $9.50 gain if they brought a friend.

Could this start a movement?

In an e-mail, Wansink writes:

My goal is for this book to ignite a Slim by Design Movement that transforms restaurants, grocery stores, workplaces, schools into healthier places that guide us to make smarter, healthier choices. The book tells people exactly what they can ask their favorite restaurant or grocery store to do, and the web site allows them to complete abbreviated scorecards and post them to Facebook and Twitter to show people there are simple, scalable, solutions that can make all of us Slim by Design.

Policy change, anyone?

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Sep 23 2014

No, the U of California does NOT forbid faculty to express opinions about the soda tax

Last Friday, I received a phone call from Todd Kerr, the publisher of The Berkeley Times, a community newspaper in Berkeley, CA.  He was preparing a story on the Berkeley soda tax and could not find University of California (UC) faculty who were willing to speak with him.

They were, they told him, under a gag order from the president’s office not to talk to reporters about the soda tax.

I can understand his frustration.  I spoke or e-mailed about 10 people with knowledge of this issue and only two would allow me to quote them for attribution.

For starters, the idea of a gag order seems contrary to current practice.

But the rumor is serious and deserves investigation.

I sent out queries to try to find out if the rumor could have any basis in fact.

Mr. Kerr kicked off the process by giving me the names of the three faculty members he said had refused to speak with him about the soda tax.

I was able to track them down.  Here is what they told me (not for direct quotation or attribution):

  • Source #1: Mr. Kerr had asked scientific questions outside the respondent’s area of expertise.
  • Source #2: Mr. Kerr stated that his paper does not take a stance on issues, so HE can’t write for or against the tax.  This respondent’s understanding is that Berkeley faculty members can state opinions on any voting matter as long as they do not claim to speak for the university.
  • Source #3: University counsel advised this respondent that faculty can say what they want as private citizens, but not as UC employees.  This source’s understanding is that state employees are not permitted to work to alter the conduct or outcome of matters on which the public is voting.  And, if the food industry were to sue a faculty member for something said in the course of an election campaign, the university would not provide legal resources or defense.

Source #3’s comments especially demanded further inquiry.  I did some more consultation of UC faculty, legal staff, and professional staff.

UC policy on political speech is governed by state law

As one source explained, there is no gag order on faculty.  There are, however, state statutes that limit the University’s ability to take positions on ballot measures that are before the voters (be sure to look at the Webinar slide show).  These state in a Q and A:

May a University employee endorse a ballot measure in his/her private capacity and identify himself/herself by University title?

Yes. A University official may allow use of his/her name and title for identification purposes in the same manner as others who sign an endorsement. An express disclaimer of University endorsement is required only where the context might reasonably cause confusion as to whether the endorsement is made in an official or unofficial capacity.

My queries eventually landed in the Office of the President of the UC System.  Steve Montiel, Media Relations Director, one of only two people in all of this who was willing to be quoted by name, said:

All University of California employees, including faculty, have the right to express their personal opinions about any matter of civic importance, including ballot measures. Consistent with state law, however, longstanding University policy prohibits university resources from being used to oppose or support a ballot measure. Only the UC Board of Regents can take a public position on a ballot measure, and it has done so in the past.

I also consulted Michele Simon (the second quotable) about state policy.  She notes that this is standard policy for institutions receiving state funding.  UC is a state school and, therefore, is not allowed to use state funds to take political positions.

She reminded me that at Stanford, a private institution, Henry Miller of the conservative Hoover Institute violated Stanford’s no-position policy on ballot measures when he did a TV ad opposing Proposition 37, the GMO labeling initiative, using his Stanford affiliation.

When we learned of the ‘No on 37 ‘ commercial, we immediately asked to have it changed so it would be in compliance with Stanford policies,” said Debra Zumwalt, the university’s vice president and general counsel. “While everyone at Stanford is entitled to espouse whatever political view he or she may choose, we do not allow people affiliated with Stanford to take a political position in a way that could imply that it is Stanford’s position.”

In my own experience, UC’s policy also sounds like standard practice.  When the Sugar Association threatened me with a lawsuit (see documents under Controversies at the bottom of the Media pages), that’s pretty much what NYU lawyers told me.  If I said something libelous, I would be responsible for the legal consequences.  Luckily, the Sugar Association never sued.

So—how did this rumor get started?  

Here’s what I learned.

A group of faculty advocating for the soda tax asked to meet with university legal counsel for advice about how to protect themselves and the university against potential lawsuits filed by, for example, the American Beverage Association (ABA), which has been especially aggressive in fighting the tax.  The ABA’s actions reminded them of the cigarette industry’s fight with the UC system over the tobacco control archives now housed at UCSF.

Some of the legal advice to faculty—if you speak at a soda tax rally, represent yourself as an individual,not a representative of the university, and do so on your own, not the university’s time—can be interpreted as restrictive even if it is not meant as such.

UC’s policy on academic freedom

Please note that UC, since the time of the Free Speech Movement, has developed a clear policy on academic freedom:

…academic freedom depends upon the quality of scholarship, which is to be assessed by the content of scholarship, not by the motivations that led to its production. The [policy]…does not distinguish between “interested” and “disinterested” scholarship; it differentiates instead between competent and incompetent scholarship. Although competent scholarship requires an open mind, this does not mean that faculty are unprofessional if they reach definite conclusions. It means rather that faculty must always stand ready to revise their conclusions in the light of new evidence or further discussion. Although competent scholarship requires the exercise of reason, this does not mean that faculty are unprofessional if they are committed to a definite point of view. It means rather that faculty must form their point of view by applying professional standards of inquiry rather than by succumbing to external and illegitimate incentives such as monetary gain or political coercion. Competent scholarship can and frequently does communicate salient viewpoints about important and controversial questions [my emphasis].

My translation: if faculty opinions about the soda tax are based on research—and plenty of research is available to back up the rationale for and potential efficacy of such a tax (see Rudd Center and Bridging the Gap)—faculty not only have the right but also have the responsibility to express opinions about them.

UC faculty: get out there and support the tax!

And wish the FSM a happy 50th anniversary.

 

Jul 22 2014

Rest in Peace Mickey Stunkard

The Times’ obituary for Dr. Albert J. (“Mickey”) Stunkard, who died last week at the age of 92, describes his work on the genetics of obesity and quotes Dr. Walter Willett’s comment that genetics accounts for only a small part of the “legions of the obese.”

Stunkard was writing about the lifestyle and environmental determinants of weight gain, long before most of us had a clue.

I learned this in 2000 when Michael Jacobson and I were writing a paper on public health policy approaches to obesity prevention.[i]   We were arguing that policies aimed at preventing weight gain focused almost entirely on personal behavior but needed to focus on fixing the environment of food choice.

A peer reviewer scolded us for missing Stunkard’s work.

At last, we discovered Stunkard’s groundbreaking work.  In the published paper, we wrote:

The most notable exception [to the focus on personal responsibility] was the report of a 1977 conference organized by the National Institutes of Health (NIH) to review research and develop recommendations for obesity prevention and management.

In one paper, A.J. Stunkard thoroughly reviewed social and environmental influences on obesity.[ii]  As a result, the conference report included an extraordinarily broad list of proposals for federal, community, and private actions to foster dietary improvements and more active lifestyles.

These ranged from coordinated health education and model school programs to changes in regulations for grades of meat, advertising, taxes, and insurance premiums. Some of the proposals cut right to the core of the matter: “Propose that any national health insurance program…recognize obesity as a disease and include within its benefits coverage for the treatment of it.” “Make nutrition counseling reimbursable under Medicare.” And “Fund demonstration projects at the worksite.”[iii]

He was far ahead of his time and will be greatly missed.

References

[i] Nestle M, Jacobson MF.  Halting the obesity epidemic: A public health policy approach.  Public Health Reports 2000;115:12-24.

[ii] Stunkard AJ. Obesity and the social environment: current status, future

prospects. In: Bray GA, editor. Obesity in America. Washington:

Department of Health, Education, and Welfare (US); 1979. NIH Pub.

No.: 79-359.

[iii] Stunkard A. The social environment and the control of obesity. In:

Stunkard AJ, editor. Obesity. Philadelphia: WB Saunders; 1980. p. 438-