My post yesterday about Michele Simon’s report on food company sponsorship of the Academy of Nutrition and Dietetics (AND) elicited a wealth of thoughtful comments.  These are well worth careful consideration.

Many express disappointment that I would suggest that corporate sponsorship might influence their thinking or practice, that other nutrition professionals have equal or better education, that I singled out AND when other nutrition and health organizations also accept food industry funds, or that I am unsympathetic to their plight (they are required to be AND members whether or not they agree with its policies).

Let me clarify:

On the effects of corporate sponsorship: I don’t know a single individual who thinks that taking money from food companies influences personal opinion or practice, but research on the effects of drug—and food—company sponsorship demonstrates otherwise.    At the very least, sponsorship gives the appearance of conflict of interest.  Individuals and organizations who accept sponsorship from soda companies, for example, can hardly be expected to advise the public to drink less soda.

On education: my point here is not that dietetic education is inadequate but that other nutritionists without such training may be equally qualified to advise the public about diet and health.

On other organizations:  That other nutrition and health organizations accept funds from food companies has long been a point of discussion on this blog (click on Partnerships).  I am especially concerned  about the practices of the American Society of Nutrition, to which I belong.  Its embarrassing role in the Smart Choices fiasco was an example of why nutrition professional organizations should avoid getting involved in such alliances.

On sympathy: I have plenty.  Food company sponsorships create painful dilemmas for nutrition professionals and each of us must figure out our own way to deal with them.  I have written about my own struggles with this issue in Food Politics and elsewhere.

I especially appreciate the comments from those of you engaged in your own struggles with this issue within AND.  You have your work cut out for you.  Here, for example, is the response of your president, Dr. Ethan Bergman, to Simon’s report. He writes [and see addition below]:

There is one indisputable fact in the report about the Academy’s sponsorship program: We have one. And for the record, I support the Academy’s sponsorship program, as does the Board of Directors and our members.

Let me make it clear that the Academy does not tailor our messages or programs in any way due to influence by corporate sponsors and this report does not provide evidence to the contrary.

…As members of a science-based organization, I encourage you to not take all information you see at face value, always consider the source (in this case, an advocate who has previously shown her predisposition to find fault with the Academy) and seek out the facts.

My interpretation: ignore the message because the messenger is not one of us.

As nutrition professionals, we ignore such messages at our peril.  If we want the public to trust what we say, our views cannot be perceived as compromised by financial ties to food companies.

What you can do.  If, as some of you noted, you oppose corporate sponsorship and would like to do something about it, here are a few suggestions:

• Let your voice be heard: write letters, post blogs, send tweets.
• Make it clear to colleagues and clients that you oppose current policies on corporate sponsorship.
• Provide evidence that your organization can do just fine without the money.
• Join committees and groups within your organization; say what you think.
• Organize petition campaigns.
• Run for office; run a slate for office.

If you want the policy to change, work for it.

But don’t be discouraged if nothing much happens right away.  Change takes time.  Keep at it.

Thanks to all of you for taking this issue so seriously.  Let’s keep working together to find ways to keep food company money out of our professional lives.

Addition, January 25: a reader, Craig, points out that Coca-Cola gave Dr. Bergman the opportunity to carry the torch at last summer’s Olympic games.  A news story about this event quotes Dr. Bergman on the Academy’s partnership:

I think the philosophy that Coca Cola has through its Live Positively campaign, and our philosophy at the academy, is about trying to improve the nation’s health through better nutrition and fitness so this fits in well with our cause.

 

Michele Simon, president of Eat, Drink, Politics, an industry watchdog consulting group, has just published an exposé of the close financial relationships between food and beverage companies and the Academy of Nutrition and Dietetics (AND, formerly the American Dietetic Association).

Her hard-hitting report, And Now a Word from Our Sponsors: Are America’s Nutrition Professionals in the Pocket of Big Food? provides ample evidence that partnerships and alliances with Big Food make it impossible for AND members to convey clear and accurate messages about nutrition and health.

When she talks about nutrition professionals, she doesn’t mean me.  I have a PhD (in molecular biology, although long lapsed) and a master’s in Public Health Nutrition.  She means AND members.  AND represents more than 70,000 individuals who mostly hold credentials as Registered Dietitians (RDs).

To qualify, they had to complete a bachelor’s degree that included a specified set of courses and a 6-month clinical internship.  I once tried to get credentialed as an RD after I completed a qualifying internship but I had never had a practical course in food service management.  That lack was a deal breaker.

Never mind.  Here’s what Simon’s report is about:

And here are a small selection of her observations and conclusions:

• AND collected $1.85 million in sponsorship funds in 2011, a relatively small percentage of its $34 million income.
• Companies such as Coca-Cola, Kraft, Nestlé, and PepsiCo offer approved continuing education courses to AND members.
• Two of the messages conveyed by one of Coca-Cola’s courses: sugar is not harmful to children, and federal nutrition standards for school meals are too restrictive.
• More than 20% of speakers at AND’s annual meeting have financial ties to Big Food companies, although most were not disclosed.
• A survey found 80% of members to believe that sponsorship implies an AND endorsement of the sponsor’s products.
• A majority of AND members believe that three current sponsors are unacceptable: Coca-Cola, Mars, and PepsiCo.

If you want to see how sponsorship plays out in practice, take a look at her photographs of the exhibit hall at the 2012 AND annual meeting.  She also provides photos taken elsewhere at the meeting.  And here’s the New York Times’ take on it.

As a trade association for Registered Dietitians, AND—as I discussed in Food Politics—has as its primary goal to position RDs as the leading source of nutrition information for patients, clients, and the public.

As you might imagine, I’ve always had a bit of trouble with that goal.

For one thing, nutritionists with master’s and doctoral degrees are likely to know more than RDs about nutrition science and to think more critically about it.

For another, that self-interested goal creates an image problem.  RDs might be accepted as more credible sources if their primary goal was to improve the nutritional health of the American people.

Their advice also would be more credible if AND were not so heavily linked to food and beverage corporations, especially those whose products contribute to poor health.

Let’s hope this new report gets AND members talking about how to change some current AND policies.

I am an avid follower of NutraIngredients-USA.com, a daily newsletter for the food industry.  Today, it collects its recent articles on energy drinks in one place.

• Monster Beverage Corporation: Alarmist DAWN report is highly misleading
• Legislators seek info from energy drink manufacturers
• Shot in the arm: The secret to success in shots… without going head to head with 5-Hour Energy…
• Majority of caffeine-containing supplements have inaccurate labels, claims study
• New Canadian caffeine limits part of growing pressure on energy drink sector
• Monster hit with another suit over advertising, caffeine content
• Senators tilt at Red Bull as FDA hints at energy action
• Durbin seeks meeting with FDA following 5-Hour adverse events news
• 5-Hour Energy: Adverse event reports do not prove that our shots caused 13 deaths
• New lawsuit targets Monster and its ‘dangerous and potentially lethal’ ingredient: EGCG
• Third time’s the charm: Durbin, Blumenthal call on FDA to investigate energy drinks
• Lawyer urges FDA to ban energy drink sales to minors after US teen death
• California company looking to create ‘synergy’ beverages category

The makers of energy drinks have managed to get away with positioning these products as healthier alternatives to regular soft drinks.

They also have gotten away with being able to add vitamins and minerals to them that the FDA would not permit in regular Coke or Pepsi.

Unfortunately for them, some manufacturers upped the caffeine to the point where it might be making people sick.  Illnesses among energy drink users have focused attention on these products.

Are energy drinks the new frontier for food advocacy?  I think so, and I’m guessing NutraIngredients-USA does too.

As part of an interactive case study and point-counterpoint on regulation of sugar-sweetened beverages, the New England Journal of Medicine (NEJM) conducted a poll of its U.S. and international readers.  The poll elicited responses from 1290 readers from 75 countries.

Overall, 68% of respondents favored government regulation.

High as this percentage is, the average is much lower than percentages from most countries as a result of one outlier—the United States.

Only 58% of U.S. voters in the poll favored regulation.  Everywhere else in the world, the percent in favor averaged 84%.

These results reminded me of change-in-sales figures from a few years ago:

Americans have reduced soft drink consumption, causing soda companies to focus their marketing efforts overseas.  Trends like these explain Coca-Cola’s new obesity ad campaign and Pepsi’s $50 million deal with Beyoncé. 

In America these days, 58% is an impressive majority.  NEJM readers are likely to be physicians, scientists, and health and health policy professionals. I suspect we will be hearing more about this idea.  Stay tuned for this one too.

The Federal Trade Commission (FTC) just ruled that POM Wonderful’s claims for the health benefits of its pomegranate juices and products are indeed deceptive.

The FTC also said POM cannot claim that its products do anything special for heart disease, prostate cancer, and erectile dysfunction—unless it produces convincing evidence for these claims through two randomized, controlled clinical trials.

The dispute over POM’s health claims has gone on for more than two years.  The FTC says POM has not proved that drinking its juice will cheat death.

POM says it has spent $35 million on peer-reviewed research proving that the antioxidants in pomegranate products promote health.

Of course they do.  Antioxidants in all fruits and vegetables promote health.

Maybe POM should resort to the defense used by Coca-Cola against charges that Vitamin Water makes deceptive health claims.

As Stephen Colbert reports, Coca-Cola’s argues: “No consumer could reasonably be misled into thinking Vitaminwater was a healthy beverage.”

Once again: health claims are about marketing, not health.

Expect POM to take the FTC to court over this ruling.  Stay tuned.

In case you missed all the publicity about Coca-Cola’s new ad campaign positioning the company as a force for public health, take a look at its new two-minute TV ad.

The video—how much do these things cost?—argues that the company is producing lower-calorie products in smaller sizes and promoting community activity, that all calories count, and that it’s up to you to fit Coke into your healthy active lifestyle.

The ad is an astonishing act of chutzpah, explainable only as an act of desperation to do something about the company’s declining sales in the U.S. and elsewhere.

If Coke really wanted to help prevent obesity, it would STOP:

• Targeting its “drink more Coke” marketing to kids.
• Targeting marketing to low-income minorities.
• Lobbying and spending a fortune to defeat soda taxes and caps on soda sizes.
• Fighting attempts to remove vending machines from schools.
• Pricing drinks so the largest sizes are the best value.
• “Bribing” health professions organizations to shut up about research linking sugar-sweetened beverages to poor diets and weight gain.
• Pushing Coke sales in developing countries where rates of obesity and related conditions are skyrocketing.

Instead, it’s doing all these things, but not talking about them in videos.

The company is supposed to be releasing a second video tonight, explaining how to work off the “140 happy calories” in a soda by dog-walking, dancing, or laughing. If only.

I can’t wait.

Addition, January 18:  Someone who calls himself John Pemberton has gone to the trouble of presenting the 2-minute commercial with a somewhat different narrative—the real story about Coca-Cola and obesity.  If that link doesn’t work, try this one.

I’m also catching up on reading.

This just in:

Wenonah Hauter.  Foodopoly: The Battle Over the Future of Food and Farming in America.  The New Press, 2012.

Hauter heads up Food and Water Watch, a tough-minded advocacy group in Washington DC working to preserve and ensure a safe, accessible, and sustainable food supply.  Foodpoly is her manifesto.  She has a lot to say about the problems with food policy, food chains, the organic-industrial complex, the food safety system, factory farms, and corporate control of the food supply.  She urges: “eat and act your politics.”  I’m using it as required reading in my food advocacy course this spring at NYU.

And here are a couple of others I’ve been saving up:

Bee Wilson, Consider the Fork: A History of How We Cook and Eat, Basic Books, 2012.

I blurbed this one:

Consider the Fork is a terrific delve into the history and modern use of kitchen tools so familiar that we take them for granted and never give them a thought.  Bee Wilson places kitchen gadgets in their rich cultural context.  I, for one, will never think about spoons, measuring cupts, eggbeaters, or chopsticks in the same way again.

W.A. Bogart, Permit But Discourage: Regulating Excessive Consumption, Oxford University Press, 2011.

I blurbed this one too:

Permit But Discourage is an engagingly written examination of a hugely important question: How can laws best be used to protect individuals and societies against out-of-control consumption of such things as alcohol, junk foods, sodas, and other unhealthy indulgences, without doing more harm than good?  The book clearly and compellingly argues for a mix of laws that permit consumption but discourage excesses, and for finding that mix through trial and error.  This fascinating book is as must read for anyone who cares about promoting health as well as human rights in a market-driven economy.

I’m catching up with events that occurred while I was out of the country.  One was the release by FDA of two of its long-awaited proposals for food safety rules.

These go into the Federal Register on January 16. But they were announced on January 4, perhaps to commemorate the two-year anniversary of President Obama’s signing the Food Safety Modernization Act authorizing these rules.

The two massive sets of proposed rules, 680 and 547 pages, respectively, are:

• Current Good Manufacturing Practice and Hazard Analysis and Risk-Based Preventive Controls for Human Food

• Standards for Growing, Harvesting, Packing, and Holding of Produce for Human Consumption

Still to come: proposed rules for

• Food importers
• Preventive controls for animal feed
• Accreditation of third-party auditors

Notice that all of these are proposals.  Terrific as it is to have them released, no breath-holding is in order.

Once the proposals appear in the Federal Register, interested parties will have 120 days to comment.  It will probably take a year for the FDA to write final rules.   For the produce standards at least, larger farms get 2 years before implementation kicks in.  Smaller farms get 3 or 4 more years to figure out how to comply.

Some farms, such as those bringing in less than $500,000 per year, are exempt.  Chalk that up to successful lobbying by small farmers.

The FDA estimates that the new rules will cost large farms about $30,000 a year, and small farms $13,000.   It says that following the rules will prevent 1.75 million cases of foodborne illness a year and save more than $1 billion in costs.

The rules for produce focus on prevention of contamination through:

• Agricultural water
• Biological soil amendments
• Poor worker hygiene
• Domesticated and wild animals
• Equipment, tools and buildings.

All food producers will need to develop, submit, and follow a written food safety plan that includes:

•  A hazard analysis
• Preventive controls
• Monitoring procedures
• Corrective action procedures
• Verification procedures
• A recall plan

That’s the basic outline.  The devil is in the details and in this case there are plenty of them (I have much sympathy for whoever has to write these things).  The proposals devote hundreds of pages to definitions.  Here, for example, is FDA’s summary of its definition of farm and farm activities.  Hint: RAC = Raw Agricultural Commodity.

• The basic purpose of farms is to produce RACs and RACs are the essential products of farms.
• Activities that involve RACs and that farms traditionally do for the purposes of growing their own RACs, removing them from the growing areas, and preparing them for use as a food RAC, and for packing, holding and transporting them, should all be within the definition of “farm” in §§ 1.227 and 1.328.
• Activities should be classified based in part on whether the food operated on is a RAC or a processed food, and on whether the activity transforms a RAC into a processed food.
• Activities farms may perform on others’ RACs should appropriately be classified as   manufacturing/processing, packing, or holding in the same manner as these activities are classified off-farm when the RACs are to be distributed into commerce.
• Manufacturing/processing, packing, or holding food– whether RACs or processed foods, from any source–for consumption on the farm should remain within the farm definition.

I include this example to illustrate what food producers are up against.  It explains why practically every group commenting on the proposals said the same things: “we are glad they are out but must reserve comment until we—and our lawyers—have a chance to go over the rules in detail.”

My guess is that we will be hearing plenty more about these reactions when they do.

In the meantime, the elephant in the room issue is funding.  The FDA’s budget is already overstressed.  How can it possibly add monitoring and enforcement responsibilities without additional staff and funding?  How can it get new resources from this Congress?

Recall: the FDA gets its funding from congressional agriculture appropriations committees, not health committees.

The FDA addresses the funding issue in a website Q and A:

G.5.  Does FDA have sufficient funding to implement the new rule?  The funding we have available through the annual budget cycle and fees impacts the number of FTEs we have and will be a factor in the way that FDA handles its significant and far-ranging activities, including the way that this legislation is implemented… Without additional funding, FDA will be challenged in implementing the legislation fully without compromising other key functions. We look forward to working with Congress and our partners to ensure that FDA is funded sufficiently to achieve our food safety and food defense goals.

Indeed.

To submit a comment:

• Go to http://www.regulations.gov.
• Refer to Docket No. FDA-2011-N-0920.
• Do it by May 16.