Most of you probably don’t read the Journal of Public Health Policy, but I’m on its editorial committee.  Nevertheless, this editorial came as a surprise.*   I thought I would share it with you.  Enjoy!  (I did).

Big food

Anthony Robbins M.D., M.P.A., Co-Editor

I first encountered Marion Nestle in the late 1990s when I edited Public Health Reports, the scientific journal of the US Public Health Service. We published a provocative piece of hers about the marketing by Proctor and Gamble of Olestra, a zero calorie fat substitute. Marion taught me a great deal about how the food industry markets its products that are tasty, convenient, and relatively inexpensive. It markets intensively to children and continues to do so long after overeating and obesity have been shown to have deadly health consequences. Sound familiar? Perhaps like the tobacco industry.

In 2003, I invited Marion to Public Health Grand Rounds to describe the obesity epidemic to my public health students at Tufts Medical School. To follow Marion, I invited Richard Daynard from Northeastern Law School, who had litigated extensively against the tobacco industry. Dick carefully noted the differences between tobacco, which has no healthy use, and food. But he suggested that the anti-health behavior of the two industries might be similar: continuing to market products in a way that certainly harmed health.

When the public health faculty at Tufts and the law faculty at Northeastern joined forces to establish the Public Health Advocacy Institute, one of our first projects was Legal Approaches to the Obesity Epidemic¹, a symposium published in the Journal of Public Health Policy, in 2004. It attracted a great deal of attention and JPHP became a favorite place to publish research on obesity.

But I was not entirely pleased, because although the research was usually methodologically sound, it often missed Marion’s point and the focus of the PHAI symposium. Most submissions concentrated on individual behavior and personal responsibility. In 2010, I asked Marion, who was on the JPHP editorial board to join me in writing an Editorial: ‘Obesity as collateral damage: a call for papers on the Obesity Epidemic’.² We had ‘come to believe that research studies concentrating on personal behavior and responsibility as causes of the obesity epidemic do little but offer cover to an industry seeking to downplay its own responsibility’. We urged ‘authors to submit articles that consider how to understand and change the behavior of the food industry’.

Imagine our pleasure in learning that starting this June, PLoS Medicine will publish a series of articles exploring the food industry’s involvement in health with Marion Nestle as a guest editor. To PLoS Medicine, we say bravo!

References

1. Journal of Public Health Policy (2004) Special section: Legal approaches to the obesity epidemic. 25(3&4): 346–434.
2. Robbins, A. and Nestle, M. (2011) Obesity as collateral damage: A call for papers on the Obesity Epidemic. Journal of Public Health Policy 32(2): 143-145.

 *Journal of Public Health Policy (2012) 33, 285–286. doi:10.1057/jphp.2012.25

I’m following the soda tax initiative in Richmond, CA with rapt attention.  Richmond, as I explained last week, is a low-income city with a lot of obesity-related chronic disease and high soda consumption.

Residents will vote on its soda tax initiative in November.  In the meantime, the American Beverage Association has gone to work to spin the science, attack critics, and fund “community coalition” groups to oppose the initiative.

Richmond requires such groups to disclose their top donors on political mailings.  The soda-industry funded “Coalition” went to court to block this requirement on First Amendment grounds.

Now, according to Robert Rogers, the terrific reporter for the Contra Costa Times who has been working on this story, a federal judge in San Francisco issued a temporary restraining order doing just that.

Complete victory for our side,” said coalition spokesman Chuck Finnie. “(Judge Charles Breyer) indicated he doesn’t think (the ordinance) applies to us because we are not engaged in independent expenditures. (Breyer) indicated a city can’t require a campaign to publish political arguments under the guise of claiming it is a disclosure.

This will be back in court on September 18.

In the meantime, “Big Soda” is expected to spend more than a million dollars in Richmond to make its efforts look like a local campaign.

Here is the Statement on Ruling on Richmond Mailer Ordinance.

And here are related Contra Costa Times stories on the soda tax initiative.

• Poll: Should Richmond add a tax to sodas and other sugared drinks?
• Actor Danny Glover comes out in support of Richmond soda tax ballot measure
• Barnidge: Voters should be prepared for a lot of taxing issues
• Big money from ‘Big Soda’ sloshes around Richmond’s controversial sugar-tax measure
• Groups take sides in Richmond soda tax debate
• El Monte joins Richmond, becomes second California city to propose soda tax

Thanks to Juan Pablo Peña-Rosas of the World Health Organization for sending this photo.

It’s of Lake Geneva in front of Nestlé’s (no relation) food museum in Vevey.

The museum’s current exhibit is called COLLECTIONNEZ-MOI!  It includes thousands of such things as sardine cans, fruit wrapping papers, soft drink bottles, and—my favorite—sugar cubes obsessively accumulated by private collectors, and well worth the visit (I was there a month or so ago).

And the fork!

Sometimes the actions of food companies defy credulity.

Get this: The Community Coalition Against Beverage Taxes, a “grassroots” group funded by the American Beverage Association, has taken the city of Richmond, California to court to block it from requiring disclosure of funding sources in election campaigns.

In case you haven’t been following this situation, the Richmond city council got a soda tax initiative (“Measure N”) placed on the November ballot.

Richmond is a low-income, mixed-race city (80% non-white), with an 11% unemployment rate, and an average household income of $23,000 a year.  It population is largely obese and drinks a lot of sodas.

You would hardly think a city like this would get on the radar of Big Soda, but you would be oh so wrong.

For details, we have to thank Robert Rogers who writes for the local Contra Costa Times.

Mr. Rogers has been following the money.

Because California requires lobbyists to register, he has been able to get hard numbers on the relative spending of anti-tax forces and those who favor the tax.  The difference is impressive.

The city of Richmond must have suspected that something like this would happen because the city council passed an ordinance that requires special interest groups to disclose who funds them in campaign literature.  They must list their top five funders.

You might think this idea entirely appropriate to a democratic society, but the American Beverage Association (translation: Coca-Cola and PepsiCo) does not.

According to Rogers’ account on September 4, Big Soda has sued the city in federal court to stop it from insisting that campaigns disclose who funds them.

On what grounds, pray tell?

The First Amendment, of course.

The suit, filed in federal court in San Francisco on Aug. 30, seeks an order barring the city from imposing its campaign ordinance on the Community Coalition Against Beverage Taxes, a declaration that the groups’ First Amendment rights were violated and money to cover court costs.

The coalition is funded mostly by the American Beverage Association and has spent more than $350,000 locally in an effort to defeat a November ballot measure that could impose a penny-per-ounce tax on sales of all sugar-sweetened beverages in the city.

…Coalition spokesman Chuck Finnie said Tuesday that the law itself is unconstitutional and should not be applied to the anti-soda tax groups.

“The law in question is being enforced to prevent opponents of an unfair, misleading and misguided tax from being able to communicate effectively with Richmond voters,” Finnie said. “The sponsors of the Measure N tax don’t want voters to hear how the tax is going to raise grocery bills, hurt local businesses on which livelihoods depend, and the fact that city politicians would be free to spend all of the money raised by Measure N in any way they see fit and that not one penny must be used to fund anti-obesity efforts.”

In other words, revealing funding sources prevents “effective communication.”

The court will hear this suit on Friday.  Stay tuned.

In the meantime, here are the relevant documents, thanks to Robert Rogers.

• Document: Richmond’s campaign disclosure ordinance
• Document: Soda-tax opponent’s application for temporary restraining order
• Document: Soda-tax opponent’s lawsuit against Richmond campaign disclosure law

The latest study arguing that organics are not more nutritious than conventionally grown crops once again makes big-time news.

The last time I wrote about a study like this, I posted the British newspaper headlines.

Never mind the media hype.  Here’s what the authors conclude:

The published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods. Consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria.

Isn’t reducing exposure to pesticides and antibiotic use precisely what organic production is supposed to do?

Organics is about production methods free of certain chemical pesticides, herbicides, irradiation, GMOs, and sewage sludge in plant crops, and antibiotics and hormones in animals.

This meta-analysis confirms that organic foods have much lower levels of these things.  I’d call that doing exactly what it is supposed to.

But what about nutrients?  I can’t think of a single reason why organics should have fewer nutrients than conventional crops, and plenty of reasons why they might have a bit more if the soils are rich enough.

Plants make their own vitamins.  The vitamin levels should not be expected to differ significantly.  The mineral content might.

But even if organics do have higher levels of nutrients, so what?  Will people eating them be healthier as a result?

Just as with supplements, additional nutrients do not make healthy people healthier.

The only reason for organics to be about nutrition is marketing.  Nutrition turns out to be a better selling point than lower levels of pesticides and antibiotics.  It also makes better headlines, apparently.

But aren’t those lower levels—in production and in the body—good reasons to buy organics?

I think so.  You?

Economists tell us that we are in a recovery period.  Jobs, yes.  But money?  No.

According to the report in the New York Times, the employment statistics reflect substantial increases in low-wage jobs but losses in better paying jobs.

Lower-wage occupations, with median hourly wages of $7.69 to $13.83, accounted for 21 percent of job losses during the retraction. Since employment started expanding, they have accounted for 58 percent of all job growth.

The occupations with the fastest growth were retail sales (at a median wage of $10.97 an hour) and food preparation workers ($9.04 an hour). Each category has grown by more than 300,000 workers since June 2009.

Need a job?  Head for the kitchen.

But be careful.  According to another New York Times report, a new study finds that:

Low-wage workers are routinely denied proper overtime pay and are often paid less than the minimum wage…Of workers who receive tips, 12 percent said their employer had stolen some of the tips.

Wouldn’t unions help?  They might, but take a look at the Ithaca Journal’s analysis of union membership.  New York, it seems leads the nation in the percentage of its workers who belong to labor unions: 24.1% in 2011.

But, this percentage:

glosses over the fact that while union representation has increased in the state’s public sector, it has fallen off dramatically in the private sector.

Last year, according to the unionstats.com website, 72.2 percent of the state’s public work force was unionized…But in the private sector, the unionization rate last year was 13.5 percent.

The easy answer for the decline in the private sector, analysts say, is the state’s loss of job slots in the manufacturing sector — 908,400 in 1991 to 458,000 in 2011 — which has long been organized labor’s bread and butter.

But there are other reasons for the resistance to private sector unionization:

Part is based on employers’ imagined need to increase their profitability and part has to do with a tremendous growth in law firms and consultants that specialize in breaking private unions.

No wonder more than 46 million Americans qualify for and receive SNAP (food stamp) benefits.

The food service industry exists on low-wage jobs.  Such jobs should be entry-level, not permanent.  They are not a solution to America’s economic problems and they are not good for social stability or American democracy.

What is the solution?  Wish I knew.

Any ideas?

My monthly, first Sunday column in the San Francisco Chronicle:

Q: I still don’t get it. Why would a city government think that a food regulation would promote health when any one of them is so easy to evade?

A: Quick answer: because they work.

As I explained in my July discussion of Richmond’s proposed soda tax, regulations make it easier for people to eat healthfully without having to think about it. They make the default choice the healthy choice. Most people choose the default, no matter what it is.

Telling people cigarettes cause cancer hardly ever got anyone to stop. But regulations did. Taxing cigarettes, banning advertising, setting age limits for purchases, and restricting smoking in airplanes, workplaces, bars and restaurants made it easier for smokers to stop.

Economists say, obesity and its consequences cost our society $190 billion annually in health care and lost productivity, so health officials increasingly want to find equally effective strategies to discourage people from over-consuming sugary drinks and fast food.

Research backs up regulatory approaches. We know what makes us overeat: billions of dollars in advertising messages, food sold everywhere – in gas stations, vending machines, libraries and stores that sell clothing, books, office supplies, cosmetics and drugs – and huge portions of food at bargain prices.

Research also shows what sells food to kids: cartoons, celebrities, commercials on their favorite television programs, and toys in Happy Meals. This kind of marketing induces kids to want the products, pester their parents for them, and throw tantrums if parents say no. Marketing makes kids think they are supposed to eat advertised foods, and so undermines parental authority.

Public health officials look for ways to intervene, given their particular legislated mandates and authority. But much as they might like to, they can’t do much about marketing to children. Food and beverage companies invoke the First Amendment to protect their “right” to market junk foods to kids. They lobby Congress on this issue so effectively that they even managed to block the Federal Trade Commission‘s proposed nonbinding, voluntary nutrition standards for marketing food to kids.

Short of marketing restrictions, city officials are trying other options. They pass laws to require menu labeling for fast food, ban trans fats, prohibit toys in fast-food kids’ meals and restrict junk foods sold in schools. They propose taxes on sodas and caps on soda sizes.

Research demonstrating the value of regulatory approaches is now pouring in.

Studies of the effects of menu labeling show that not everyone pays attention, but those who do are more likely to reduce their calorie purchases. Menu labels certainly change my behavior. Do I really want a 600-calorie breakfast muffin? Not today, thanks.

New York City’s 2008 ban on use of hydrogenated oils containing trans fats means that New Yorkers get less trans fat with their fast food, even in low-income neighborhoods. Whether this reduction accounts for the recent decline in the city’s rates of heart disease remains to be demonstrated, but getting rid of trans fats certainly hasn’t hurt.

Canadian researchers report that kids are three times more likely to choose healthier meals if those meals come with a toy and the regular ones do not. When it comes to kids’ food choices, the meal with the toy is invariably the default.

A recent study in Pediatrics compared obesity rates in kids living in states with and without restrictions on the kinds of foods sold in schools. Guess what – the kids living in states where schools don’t sell junk food are not as overweight.

Circulation has just published an American Heart Association review of “evidence-based population approaches” to improving diets. It concludes that evidence supports the value of intense media campaigns, on-site educational programs in stores, subsidies for fruits and vegetables, taxes, school gardens, worksite wellness programs and restrictions on marketing to children.

The benefits of the approaches shown in these studies may appear small, but together they offer hope that current trends can be reversed.

Researchers also suggest other approaches, not yet tried. The Yale Rudd Center has just shown that color-coded food labels (“traffic lights”) encourage healthier food choices.

And Rand Corp. researchers propose initiatives like those that worked for alcoholic beverages: Limit the density of fast-food outlets, ban sales in places that are not food stores, insist that supermarkets put junk foods and sodas where they are hard to see, ban drive-through sales, restrict portion sizes and use warning labels.

These regulatory approaches are worth trying. If research continues to demonstrate their value, cities will have even more reason to use them. If the research becomes compelling enough, the federal government might need to act.

In the meantime, cities are leading the way, Richmond among them. Their initiatives are well worth trying, testing and supporting.

**Marion Nestle is the author of “Why Calories Count: From Science to Politics,” as well as “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at foodpolitics.com. E-mail: food@sfchronicle.com

I’ve written previously about the holdup on implementation of the FDA Food Safety Modernization Act by the White House Office of Management and Budget, reportedly because anything regulatory is likely to be a campaign issue in this especially contentious election year.

To get things moving, The Center for Food Safety and the Center for Environmental Health have sued the FDA to implement the rules on the grounds that the law requires federal agencies to conclude matters presented to them “within a reasonable amount of time.”

The suit complains that the FDA is failing to meet required deadlines for at least seven new food regulations and that nine more are coming due in 2013.  It asks the court to order the agency to enforce the law right now.

In several instances, the FDA has attempted to make FSMA’s deadlines only to have its work held up at the White House Office of Management and Budget. FDA reported sending its proposed Foreign Supplier Verification Program to the OMB in November and its proposed produce safety standards in December, though the OMB has yet to release either regulation. Both were required by FSMA on Jan. 4.

FSMA also required FDA to establish standards for analyzing and documenting hazards and implementing preventative measures by July 4 of this year, the suit recounts.

The plaintiffs are especially alarmed that the FDA is not enforcing policies that are “self-executing,” meaning the new preventive standards for example.

From where I sit, the preventive standards are the critical factor in stopping outbreaks of foodborne illness before they happen.

While we are waiting for politics to resolve, the CDC keeps adding new outbreak home pages.

• Multistate Outbreak of Salmonella Braenderup Infections Associated with Mangoes is the latest.
• Multistate Outbreak of Salmonella Typhimurium Infections Linked to Cantaloupe isn’t over yet.

Would implementation of preventive standards help?  Yes it would, especially if the problem is in the packing houses (packing houses can be cleaned).