Search results: Coca Cola

In the current issue of the online Journal of the World Public Health Nutrition Association (of which I am a charter member), Carlos Monteiro, a professor at the University of São Paulo writes “The big issue is ultra-processing.”  Because his Commentary is so lengthy, I am taking the liberty of extracting pieces from it, not always in the order presented.

The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing.

Monteiro makes it clear that all foods and drinks are processed to some extent.  Fresh apples are washed and, sometimes, waxed.  Drinking water is filtered.  Instead, he distinguishes three types of processing, depending on their nature, extent, and purpose:

• Type 1: Unprocessed or minimally processed foods that do not change the nutritional properties of the food.
• Type 2: Processed culinary or food industry ingredients such as oils, fats, sugar and sweeteners, flours, starches, and salt.  These are depleted of nutrients and provide little beyond calories (except for salt, which has no calories).
• Type 3: Ultra-processed products that combine Type 2 ingredients (and, rarely, traces of Type 1).

The purpose of Type 3 ultra-processing is to create:

durable, accessible, convenient, attractive, ready-to-eat or ready-to-heat products. Such ultra-processed products are formulated to reduce microbial deterioration (‘long shelf life’), to be transportable for long distances, to be extremely palatable (‘high organoleptic quality’) and often to be habit-forming. Typically they are designed to be consumed anywhere – in fast-food establishments, at home in place of domestically prepared and cooked food, and while watching television, at a desk or elsewhere at work, in the street, and while driving.

Monteiro argues: “the rapid rise in consumption of ultra-processed food and drink products, especially since the 1980s, is the main dietary cause of the concurrent rapid rise in obesity and related diseases throughout the world.”

As evidence, he notes that ultra-processed products as a group are:

• Much more energy-dense than unprocessed and minimally processed foods and processed culinary ingredients taken together.
• [Contain] oils, solid fats, sugars, salt, flours, starches [that] make them excessive in total fat, saturated or trans-fats, sugar and sodium, and short of micronutrients and other bioactive compounds, and of dietary fiber.
• Relatively or even absolutely cheaper to manufacture, and sometimes – not always – relatively cheaper to buy.
• Often manufactured in increasingly supersized packages and portions at discounted prices with no loss to the manufacturer.
• Available in ‘convenience’ stores and other outlets often open late or even 24/7, and vended in machines placed in streets, gas stations, hospitals, schools and many other locations.
• The main business of transnational and big national catering chains, whose outlets are also often open until late at night, and whose products are designed to be consumed also in the street, while working or driving, or watching television.
• Promoted by lightly regulated or practically unregulated advertising that identifies fast and convenience food, soft drinks and other ultra-processed products as a necessary and integral part of the good life, and even, when the products are ‘fortified’ with micronutrients, as essential to the growth, health and well-being of children.

Overall, he says:

Their high energy density, hyper-palatability, their marketing in large and super-sizes, and aggressive and sophisticated advertising, all undermine the normal processes of appetite control, cause over-consumption, and therefore cause obesity, and diseases associated with obesity.

His groups the main points of his argument in three theses:

• Diets mainly made up from combinations of processed ingredients and unprocessed and minimally processed foods, are superior to diets including substantial amounts of ultra-processed products.
• Almost all types of ultra-processed product, including those advertised as ‘light’, ‘premium’, supplemented, ‘fortified’, or healthy in other ways, are intrinsically unhealthy.
• Significant improvement and maintenance of public health always requires the use of law. The swamping of food systems by ultra-processed products can be controlled and prevented only by statutory regulation.

Lest there be any confusion about the significance of this proposal for public health nutrition, an accompanying editorial (unsigned but assumed to be by Geoffrey Cannon) poses a serious challenge: “Nutrition science: time to start again.”

This editorial is about the significance of food processing, and in particular of ‘ultra-processed’ food and drink products. It is also about the nature, purpose, scope and value of nutrition science, which as conventionally taught and practiced, is now widely perceived to have run into the buffers or, to change metaphor, to have painted itself into a corner.

The editorial argues that nutritionists’ focus on nutrients, rather than foods, has led to the assumption that if foods contain the same nutrients, they are the same—even though it is never possible to replicate the nutritional content of foods because too much about their chemical composition is still unknown.

This notion is an exquisite combination of stupidity and arrogance, or else of intelligence and cunning. For a start, similar results can only be of those chemical constituents that are at the time known, and actually measured.

These are important ideas, well worth consideration and debate.  I am struck by their relevance to the latest survey of soft drink availability in American elementary schools.  Despite the efforts of the Clinton Foundation and the voluntary actions of Coca-Cola and Pepsi-Cola, the availability of soft drinks to young school children increased from 49.% to 61% just in the year from 2006-07 to 2008-09.  Soft drinks, in Monteiro’s terms, are ultra-processed.  Doing something about them requires statutory regulation.

Consideration of the effects of ultra-processing might help us look at what we feed our kids in a more constructive way.  This is important work.

Addition: I should have mentioned that Monteiro’s approach is consistent with that of the people (including me) who worked with the Strategic Alliance in Oakland, CA to write Setting the Record Straight: Nutritionists and Health Professionals ” Define Healthful Food.

The Alliance is California’s network of food and activity advocates, we’ve developed a definition of healthy food that asserts that truly healthful food comes from a food system where food is produced, processed, transported, and marketed in ways that are environmentally sound, sustainable, and just.

If you agree with Setting the Record Straight, you can endorse it on the Strategic Alliance’s website.

I’ve been saying for ages that the sugar composition of high fructose corn syrup (HFCS) is no different from that of table sugar (sucrose).

Oops.  A new study in the journal, Obesity, actually measured the amounts and kinds of sugars in 23 kinds of HFCS-sweetened drinks.

The findings are summarized in a fact sheet:

• The sugar content varied widely from amounts stated on labels.  Some drinks had 15% less sugar than labeled, but others had as much as 30% more.
• On average, the drinks had 18% more fructose than expected.
• Several brands of sodas seemed to be made with HFCS that is 65% fructose, not 55%.
• The average amount of fructose in the drinks was 59%.

The press release points out one other finding.  You know how everyone thinks Mexican Coca-Cola is so much more delicious than American Coke because it is made with table sugar (sucrose), not HFCS?  Oops again.  The investigators could not find any sucrose in the Coke, but did find plenty of glucose and fructose.  This suggests that Mexican Coke is also made with HFCS (or it could also mean that the sucrose had been split into its constituent glucose and fructose).

To review the biochemistry: sucrose is a double sugar of glucose and fructose bonded together.  HFCS is glucose and fructose, separated.  The sucrose bond is quickly split in the intestine and its glucose and fructose are the same as those in HFCS.

The metabolic problems that result from sugar intake are mostly due to the fructose content.  Less is better for health.  More is better for the soft drink industry, however.  Fructose is sweeter than either glucose or sucrose, and sweet is what sells sodas.

At most, HFCS is supposed to be 55% fructose, as compared to the 50% in table sugar.  Most foods and drinks are supposed to be  using HFCS that is 42% fructose.  A percentage of 55 is not much different biologically than 50, which is why the assumption has been that there is no biologically meaningful difference between HFCS and table sugar.   This study, if confirmed, means that this supposition may need some rethinking.

The study names the beverages that contain 65% fructose: Coke, Pepsi, Sprite. It identifies Dr. Pepper, Gatorade, and Arizona Ice Tea as containing close to 60% fructose.

If, in fact, the percentage of fructose is higher than advertised, it’s another good reason to avoid sugar-sweetened beverages.

Addition and possible caution:  I’ve now heard separately from two experts on measuring sugars in beverages who point out serious flaws in the methods used in this study:

• The results are based on one beverage sample, analyzed once.   Analytical methods invariably produce ranges of values and require multiple samples and analyses.
• Measuring sugars in beverages is technically challenging and there are several possible methods, some of which give more accurate results than others.  Although the paper says the investigators used standard methods, it does not specify which.
• The methods used did not seem to detect the small starches or maltose that are always present in HFCS.  If the methods “read” the little starches as fructose, the percentage could easily have been 59 rather than 55.
• The drinks that contained 65% fructose were bottled drinks, and that is a concern.  The fountain drinks are mixed by the company–McDonald’s or Burger King–and could have been made too concentrated by whoever did the mixing.
• The failure to find sucrose in Mexican Coca-Cola could be two to two reasons: the Coke is old and the sucrose “inverted” (split into glucose and fructose), or the company used HFCS instead of sucrose.

The bottom line remains the same: it’s best not to eat too much sugar or any kind.

Addition, October 27: Cara Wilking, an attorney with the Public Health Advocacy Institute in Boston, notes that this study raises the possibility that HFCS violates federal prohibitions against:

• False and misleading food labeling
• Food adulteration
• False and misleading advertising

It will be interesting to follow how the lawyers deal with these issues.

The Pop-Tarts store in Times Square (see yesterday’s post) is only the loudest example of innovative food marketing to come out recently.  I’ve been collecting more subtle examples:

Using social media (and getting customers to pay for it): For 99 cents to I-tunes, you can buy an app that gives nutritional information for products at Jack-in-the-Box or at McDonald’s.   As Mark Douglas of Culinate explains: “They want $0.99 to tell you what you probably already know… Watch Out!”

Co-opting health professionals: Michele Simon (author of Appetite for Profit) writes on AlterNet about how PepsiCo hires distinguished health professionals and experts to give a company that sells snack foods and soft drinks an aura of health and wellness.

Co-opting professional organizations: Lisa Young (the Portion Teller) points me to a Webinar on August 25 run by the industry-sponsored School Nutrition Foundation and the Milk Processor Education Program on what is surely an urgent issue for sellers of chocolate (sugar-added) milk: “Keep flavored milk from dropping out of school!”

Deflecting attention from diet: Lisa sends another Webinar notice for September 14, this one for “skills & tools to enhance change in physical activity behavior.”  Its sponsor?

The Coca-Cola Company’s Beverage Institute For Health & Wellness is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) – provider number BF001.

Plain, old-fashioned lobbying: Food Safety News has a nifty report on food company lobbying expenditures (huge), mainly on the food safety bill but also on many other bills that might affect labeling or sales of food products.

I reviewed these methods in my book, Food Politics. A revised edition came out in 2007.  Not much change, alas.

Addition: Attracting school kids: Michele Simon sends this Pepsi partnership with Hy-Vee stores in Iowa.  Parents buy five Pepsi products; Pepsi buys backpacks for their kids.

Food companies interested in doing something meaningful to prevent childhood obesity are in a bind.  Preventing obesity usually means staying active; eating real, not processed, foods; and reserving soft drinks and juice drinks for special occasions.  None of this is good for the processed food business.  At best, food and beverage companies can make their products a bit less junky and back off from marketing to children.  In return, they can use the small changes they make for marketing purposes.

Perhaps as a result of Michelle Obama’s campaign (see yesterday’s post), companies are falling all over themselves – and with much fanfare – to tweak their products.

GROCERY MANUFACTURERS ASSOCIATION (GMA):  By all reports, GMA members applauded Mrs. Obama’s remarks.  GMA says its member companies are already doing what she asked.

Parke Wilde, a professor at the Tufts School of Nutrition (and food policy blogger), gave a talk at that meeting in a session dismissingly titled,  “The New Foodism.”  His comment:

I enjoyed hearing Michelle Obama’s talk, which was well written and delivered and fairly forceful in places. In my afternoon panel, I said grocery manufacturers would find some threatening themes in books and documentaries promoting local and organic and sustainable food, but that there is also much of substance and value. Then, Susan Borra [Edelman Public Relations] and Sally Squires [Powell Tate Public Relations] in the next session said that grocery manufacturers are frequent subjects of unfair criticism and have nothing to apologize for.

Take that, you new foodists!

MARS must think it knows more than the FDA about how to label food packages.  It is developing its own version of front-of-package labels. It volunteered to put calories on the front of its candies; its multi-pack candies ay 210 calories per serving on the front.  That number, however, remains on the back of the small candy store packs.  Mars’ new labeling plans use the complex scheme used in Europe.  I’m guessing this is a bold attempt to head off what it thinks the FDA might do – traffic lights.

KRAFT announces that it is voluntarily reducing the sodium in its foods by 10% by 2012.  Kraft’s Macaroni & Cheese (SpongeBob package) has 580 mg sodium per serving and there are two servings in one of those small boxes: 1160 in total.  A 10% reduction will bring it down to 1050 mg within two years.  The upper recommended limit for an adult is 2300 mg/day.

PEPSICO announced “a voluntary policy to stop sales of full-sugar soft drinks to primary and secondary schools worldwide by 2012.”  In a press statement, the Yale Rudd Center quotes Kelly Brownell saying that “tobacco companies were notorious for counteracting declining sales in the U.S. with exploitation of markets elsewhere, particularly in developing countries:”

it will be important to monitor whether the mere presence of beverage companies in schools increases demand for sugared beverages through branding, even if full-sugar beverages themselves are unavailable…This appears to be a good faith effort from a progressive company and I hope other beverage companies follow their lead…this announcement definitely represents progress [Note: see clarification at end of post].

According to PepsiCo, this new policy brings its international actions in line with what it is already doing in the U.S.  The policy itself is voluntary, uses words like “encourage,” assures schools that the company is not telling them what to do, and won’t be fully implemented until 2010.  It keeps vending machines in schools and still allows for plenty of branded sugary drinks: Gatorade, juice drinks, and sweetened milk for example.

Could any of this have anything to do with Kelly Brownell’s forceful endorsement of soda taxes?

LOBBYING: The Center for Responsive Politics says food companies spent big money on lobbying last year, and notes an enormous increase in the amount spent by the American Beverage Association (soda taxes, anyone?).  For example:

How to view all this?  I see the company promises as useful first steps.  But how about the basic philosophical question we “new foodists” love to ask: “is a better-for-you junk food a good choice?”

OK.  We have the Public Relations.  Now let’s see what these companies really will do.

Addendum: I received a note clarifying Kelly Brownell’s role in the PepsiCo press release from Rebecca Gertsmark Oren,Communications Director,The Rudd Center for Food Policy and Obesity,Yale University:

The Rudd Center did not work with PepsiCo on their initiative to stop sales of full-sugar beverages in schools worldwide, nor did we jointly issue a press release. A statement released by Kelly Brownell in response to PepsiCo’s announcement was simply intended to commend what appears to be a step in the right direction. As Kelly’s statement also mentioned, there is still plenty of work to be done. It’s also worth noting that the Rudd Center does not take funding from industry.

Just in time for the Albany conference on soda taxes (see previous post), the Beverage Association has issued a report on the great progress it is making in reducing calories from sodas sold in schools.

In fact, the Beverage Association is doing a terrific job on reducing soft drink consumption.  Sales of sodas are down by impressive percentages, but so are sales of all drinks sold in school vending machines, as illustrated by this chart from today’s Wall Street Journal.

Source: Wall Street Journal, 3-8-10

This is good news.  The next steps to improve school food?  Here are a few of my favorites:

• Get the vending machines out of schools altogether, those for snacks as well as sodas.
• Get rid of “competitive” foods, those sold in competition with school meals.
• Put some restrictions on the frequency and quantity of foods brought in for birthdays and other celebrations.
• Institute universal school meals.

If kids don’t buy drinks from vending machines, the schools don’t need them, right?

Update March 9.  Thanks to Coca-Cola for sending a copy of the press release and the final progress report summary.

I went to the reception last week for Diet Coke’s red dress event,:

Diet Coke and the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health have joined forces to raise awareness about women’s risk of heart disease — in support of NHLBI’s The Heart Truth campaign — with a multi-faceted program that will reach consumers across the nation.

To celebrate American Heart Month in February, Diet Coke’s Red Dress Program will take center stage at high-profile events, including sponsorship of The Heart Truth’s, Red Dress Collection fashion show at Fashion Week 2008. Diet Coke will also unveil new packaging and programs featuring The Heart Truth and Red Dress logos and messages on heart health.

The Center for Science in the Public Interest points out that Coca-Cola, whose products are not exactly heart healthy, is a strange partner for the NHLBI.  The agency should reconsider.  It wrote NHLBI to say so.

New York Times reporter Tara Parker-Pope asks: “Should Coke talk about heart health?”

I don’t know how long Diet Coke and NHLBI have been engaged in this partnership but it is surely more than five years.  From NHLBI’s point of view, the partnership publicizes the risk of heart disease to women.  For Coca-Cola, the benefits are obvious.

Are such partnerships a benign win-win?  History suggests otherwise.  In 1984, Kellogg cooked up a partnership with the National Cancer Institute to put health claims for fiber on the boxes of All-Bran cereals (I discuss this incident in Food Politics).  In doing so, Kellogg (and NCI) went around the FDA and undermined that agency’s control over health claims on food packages.  This let to the current mess over health claims, which the FDA is now trying to clean up.

Update March 3: The Public Health Advocacy Institute at Northeastern University has filed a petition to NHLBI to give up the partnership.

Smart Money has produced a most instructive display of the cost of 100 calories in meals at fast food restaurants.  Click on the numbers starting with #1 (for which you have to click on #2 – the numbers are off by 1 for some reason).  #1 is the most expensive: $1.47 per 100 calories for at McDonald’s Southwest Salad with Grilled Chicken.  # 13 (click on #14) is a Burger King Double Whopper with Cheese at 49 cents for 100 calories but you have to buy 1010 calories at this price.  The cheapest, #15 (click on #16) is a 32-ounce Coca-Cola at 38 cents per 100.

It would be interesting to do the same thing for nutritional value.  Could nutrients (other than calories) be proportional to cost?  That idea might be worth a closer look.

Center for Science in the Public Interest has filed a class-action lawsuit against Coca-Cola, the parent company of Glaceau Vitamin Water.   Vitamin Water, says CSPI, makes sugary drinks that promote obesity but positions these products as healthful because they contain added vitamins and herbs.  Does this make them healthier?  No, but it certainly makes them sell better.