by Marion Nestle

Search results: the corporation not me

Oct 24 2011

On Denmark’s “fat tax”

I have a commentary in the October 23 issue of New Scientist (UK):

Cover of 22 October 2011 issue of New Scientist magazine

World’s first fat tax: what will it achieve?

Enviably healthy Denmark is leading the way in taxing unhealthy food. Why are they doing it, and will it work

THE Danish government’s now infamous “fat tax” has caused an international uproar, applauded by public health advocates on the one hand and dismissed on the other as nanny-state social engineering gone berserk.

I see it as one country’s attempt to stave off rising obesity rates, and its associated medical conditions, when other options seem less feasible. But the policies appear confusing. Why Denmark of all places? Why particular foods? Will such taxes really change eating behaviour? And aren’t there better ways to halt or reverse rising rates of diet-related chronic disease?

Before getting to these questions, let’s look at what Denmark has done. In 2009, its government announced a major tax overhaul aimed at cushioning the shock of the global economic crisis, promoting renewable energy, protecting the environment, discouraging climate change, and improving health – all while maintaining revenues, of course.

The tax reforms make it more expensive to produce products likely to harm the environment and to consume products potentially harmful to health, specifically tobacco, ice cream, chocolate, candy, sugar-sweetened soft drinks, and foods containing saturated fats.

Some of these taxes took effect last July. The current fuss is over the introduction this month of a tax on foods containing at least 2.3 per cent saturated fat, a category that includes margarine, salad and cooking oils, animal fats, and dairy products, but not – thanks to effective lobbying from the dairy industry – fluid milk.

Copenhagen is the home of René Redzepi’s Noma, voted the world’s best restaurant for the past two years. To Americans, “Danish” means highly calorific fruit – and cheese-filled breakfast pastries. Despite such culinary riches, the Nordic nation reports enviable health statistics and a social support system beyond the wildest imagination of inhabitants of many countries. Danish citizens are entitled to free or very low-cost childcare, education and healthcare. Cycle lanes and high taxes on cars make bicycles the preferred method for getting to school or work, even by 63 per cent of members of the Danish parliament, the Folketing.

Taxes pay for this through policies that maintain a relatively narrow gap between the incomes of rich and poor. The Danish population is literate and educated. Its adult smoking rate is 19 per cent. Its obesity rate is 13.4 per cent, below the European average of 15 per cent and a level not seen in the US since the 1970s. Denmark has long used the tax system to achieve health goals. It has taxed candy for nearly 90 years, and was the first country to ban trans-fats in 2003.

Because its level of income disparity is relatively low, the effects of health taxes are less hard on the poor than in many other countries. But the Danes want their health to be better. Obesity rates may be low by US standards, but they used to be lower – 9.5 per cent in 2000. Life expectancy in Denmark is 79 years, at least two years below that in Japan or Iceland. The stated goal of the tax policies is to increase life expectancy as well as to reduce the burden and cost of illness from diet-related diseases.

Like all taxes, the “health” taxes are supposed to raise revenue: 2.75 billion Danish kroner annually ($470 million). The tax on saturated fat is expected to account for more than one-third of that. Since all food fats – no exceptions – are mixtures of saturated, unsaturated, and polyunsaturated fatty acids, the tax will have to be worked out food by food. Producers must do this, pay the tax, and pass the cost on to consumers.

Taxes on cigarettes are set high enough to discourage use, especially among young people. But the food taxes are low, 0.34 kroner on a litre of soft drinks, for example. The “fat” tax is 16 kroner per kilogram of saturated fat. In dollars, the taxes will add 12 cents to a bag of crisps and 40 cents to the price of a burger. Whether these amounts will discourage purchases remains to be seen.

Other countries are playing “me too” or waiting to see the results of Denmark’s experiment. Hungary has imposed a small tax on sweets, salty snacks, and sugary and caffeinated drinks and intends to use the revenues to offset healthcare costs. Romania and Iceland had such taxes but dropped them, whereas Finland and Ireland are considering them. Surprisingly, given his party’s anti-nanny state platform, UK prime minister David Cameron is suggesting food taxes to counter the nation’s burgeoning obesity crisis. The US has resisted calls for taxes on sugar-sweetened beverages, not least because the soft drink companies spent millions of dollars on defeating such proposals.

Leaving aside the usual criticisms, such as the impact on poorer people, I have a different reason for being troubled by tax interventions. They aim to change individual behaviour, but do little to change the behaviour of corporations that make and market unhealthful products, spending vast fortunes to make them available, desirable and socially acceptable.

Today, more and more evidence demonstrates the importance of food environment factors, such as processing, cost and marketing, in influencing food choices (The Lancet, DOI: 10.1016/S0140-6736(11)60813-1). Raising taxes is one way to change that environment by influencing the cost to the consumer. But governments seriously concerned about reducing rates of chronic disease should also consider ways to regulate production of unhealthy products, along with the ways they are marketed.

In the meantime, let us congratulate Denmark on what could be viewed as a revolutionary experiment. I can’t wait to see the results.

Marion Nestle is the author of Food Politics and What To Eat and is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University

Sep 19 2011

United Nations to consider the effects of food marketing on chronic disease

In what Bloomberg News terms an “epidemic battle,” food companies are doing everything they can to prevent the United Nations from issuing a statement that says anything about how food marketing promotes obesity and related chronic diseases.

The U.N. General Assembly meets in New York on September 19 and 20 to develop a global response to the obesity-related increase in non-communicable, chronic diseases (cancer, cardiovascular disease, respiratory disease, type 2 diabetes) now experienced by both rich and poor countries throughout the world.

As the Bloomberg account explains,

Company officials join political leaders and health groups to come up with a plan to reverse the rising tide of non- communicable diseases….On the table are proposals to fight obesity, cut tobacco and alcohol use and expand access to lifesaving drugs in an effort to tackle unhealthy diets and lifestyles that drive three of every five deaths worldwide. At stake for the makers of snacks, drinks, cigarettes and drugs is a market with combined sales of more than $2 trillion worldwide last year.

Commenting on the collaboration of food companies in this effort:

“It’s kind of like letting Dracula advise on blood bank security,” said Jorge Alday, associate director of policy with World Lung Foundation, which lobbies for tobacco control.

The lobbying, to understate the matter, is intense.  On one side are food corporations with a heavy financial stake in selling products in developing countries.  Derek Yach, for example, a senior executive of PepsiCo, argues in the British Medical Journal that it’s too simplistic to recommend nutritional changes to reduce chronic disease risk.  [Of course it is, but surely cutting down on fast food, junk food, and sodas ought to be a good first step?]

On the other side are public health advocates concerned about conflicts of interest in the World Health Organization.  So is the United Nations’ special rapporteur for  the right to food, Olivier De Schutter.  Mr. De Schutter writes that the “chance to crack down on bad diets must not be missed.”

On the basis of several investigative visits to developing countries,  De Schutter calls for “the adoption of a host of initiatives, such as taxing unhealthy products and regulating harmful food marketing practices…Voluntary guidelines are not enough. World leaders must not bow to industry pressure.”

If we are serious about tackling the rise of cancer and heart disease, we need to make ambitious, binding commitments to tackle one of the root causes – the food that we eat.

The World Health Organization’s (WHO) 2004 Global Strategy on Diet, Physical Activity and Health must be translated into concrete action: it is unacceptable that when lives are at stake, we go no further than soft, promotional measures that ultimately rely on consumer choice, without addressing the supply side of the food chain.

It is crucial for world leaders to counter food industry efforts to sell unbalanced processed products and ready-to-serve meals too rich in trans fats and saturated fats, salt and sugars. Food advertising is proven to have a strong impact on children, and must be strictly regulated in order to avoid the development of bad eating habits early in life.

A comprehensive strategy on combating bad diets should also address the farm policies which make some types of food more available than others…Currently, agricultural policies encourage the production of grains, rich in carbohydrates but relatively poor in micronutrients, at the expense of the production of fruits and vegetables.

We need to question how subsidies are targeted and improve access to markets for the most nutritious foods.…The public health consequences are dramatic, and they affect disproportionately those with the lowest incomes.

In 2004, the U.N. caved in to pressures from food companies and weakened its guidelines and recommendations.  The health situation is worse now and affects people in developing as well as industrialized countries.  Let’s hope the General Assembly puts health above politics this time.

 

Sep 13 2011

It’s OK to use food stamps to buy fast food? Better check for conflicts of interest

Readers Robyn and Will sent me a link to an ABC News story about Yum! Brands efforts to get more states to authorize the use of food stamp (SNAP) benefits in fast food restaurants.

Michigan, California, Arizona, and Florida already do this.  Yum!, the parent company of KFC, Taco Bell, and Pizza Hut, wants it to go national.

They write:

We believe that food stamps should be used to buy nutritious food for kids and families, not junk food! This nonsense has to stop!  This is a government program–it should not be a means for corporations to sell products that will eventually lead to ever-increasing health problems–obesity, heart issues, diabetes, etc. What can we do to be heard?

USA Today did a story on this last week.  It elicited more than 1,000 comments.  I’m not surprised.

The issue thoroughly divides the food advocacy community.   Public health and anti-hunger advocates sharply disagree on this issue, as they do on the question of whether sodas should be taxed.

USA Today quoted Kelly Brownell, director of Yale’s anti-obesity Rudd Center:

It’s preposterous that a company like Yum! Brands would even be considered for inclusion in a program meant for supplemental nutrition.

But then the article quoted Ed Cooney, executive director of the Congressional Hunger Center and a long-time anti-hunger advocate:

They think going hungry is better?…I’m solidly behind what Yum! is doing.

Of course he is.  Want to take a guess at who funds the Congressional Hunger Center?

Yum! is listed as a “Sower,” meaning that its annual gift is in the range of $10,000.   I’m guessing Yum! is delighted that it is getting such good value at such low cost.

USA Today was negligent in not mentioning Mr. Cooney’s financial ties to Yum! and other food brands.  Such ties matter, and readers deserve to know about them.

But Mr. Cooney’s argument worries me on grounds beyond the evident conflict of interest.

For one thing, it smacks of elitism.  “Let them eat junk food” argues that it’s OK for the poor to eat unhealthfully.  I think the poor deserve to be treated better.

For another, promoting use of SNAP benefits for fast food and sodas makes it and other food assistance programs vulnerable to attack.

Rates of obesity are higher among low-income groups, including SNAP recipients, than in the general population.

Anti-hunger and public health advocates need to work a lot harder to find common ground if they want food assistance programs to continue to help low-income Americans.

Let’s be clear about what’s at stake here.  SNAP is an entitlement program, meaning that anyone who qualifies can get benefits.

In June 2011 alone, according to USDA, 45 million Americans received an average of $133 in benefits at a total cost to taxpayers of more than $6 billion.

That’s a lot of money to spend on fast food.  Yum!’s interest in getting some of that money is understandable.

If you think low-income Americans deserve better:

  • Complain to Congress for permitting the legal loophole that allows this.
  • Insist to USDA that SNAP benefits be permitted only for real food.
  • Get your city to recruit farmers’ markets, grocery stores, and other sources of healthy food to low-income areas.
  • Let your congressional representatives know that you want a safety net for people who are out of work that enables people to eat healthfully.
  •  And tell the Congressional Hunger Center and similarly inclined anti-hunger groups that you think conflicts of interest interfere with their ability to help the clients they are supposedly trying to serve.
Jul 22 2011

Mrs. Obama’s food access initiatives: retailers say yes

Michelle Obama, who has made elimination of “food deserts” a cornerstone of her campaign to end childhood obesity, announced this week that several supermarket and drug store chains—Walmart, SuperValue, and Walgreens among them—have committed to finding ways to put healthier foods into low-income areas.

The USDA issued a press release and a fact sheet on the initiative.

This week, the Food Marketing Institute released “Access to Healthier Foods: Challenges and Opportunities for Retailers in Underserved Areas.”  The report summarizes the risks and benefits of locating grocery stores, describes how to get local governments to provide incentives, and gives some examples of success stories.

Mrs. Obama’s event was thoroughly covered by ObamaFoodorama, which notes that recent research suggests only minimal benefits from putting grocery stores into low-income areas and observes that it’s going to take a lot more than just better access to encourage people in underserved areas to eat more healthfully.

Some advocates worry that the access issue is being used as an excuse for large retail corporations to get a foothold in inner cities than it is for residents to have better food choice, and that an influx of big chains will put small grocers out of business.

Maybe, but I’m guessing that people who live in areas without decent grocery stores will be more than delighted to have them nearby, especially if the stores keep their promises to provide fresh produce.

Just for the record, the research on food deserts (or swamps as some prefer) makes it clear why this is an important issue:

Read, think, advocate!

Apr 21 2011

More on Oxfam’s anti-poverty partnership with Coca-Cola

Among the many thoughtful comments on yesterday’s post is one from the Director of Oxfam America’s Private Sector Department, Chris Jochnick, who writes that I did not “quite capture the scope and intent of this project.”

As part of our work, Oxfam has a responsibility to engage with global corporations, through both collaboration and campaigns, in order to have constructive dialog on their business practices.

….Throughout the work, Oxfam has maintained complete independence including the ability to undertake advocacy against either company if the situation warranted. The Coca-Cola Company and Oxfam America shared the costs of the collaboration roughly in the proportion of 2:1, with The Coca-Cola Company contributing two-thirds of the costs (US $400,000) and Oxfam America contributing one-third of the costs in kind including staff time.

Unrelated to the study, The Coca-Cola Company made an earlier donation of $2,500,000 to Oxfam between 2008-2010 for humanitarian work in Sudan, with an emphasis on work related to water, sanitation and hygiene.

….Our independent voice keeps Oxfam’s approach to private sector collaborations dynamic and honest.

Let me add a bit more about what I think is wrong with this picture.

The goal of Coca-Cola is to sell more Coca-Cola.  The goal of Oxfam is to address world poverty.  I’m having trouble understanding how these goals could be mutually compatible.

Coke sales in the United States are flagging.  Last year, three quarters of Coke’s revenue derived from sales outside of North America in emerging economies where rates of obesity are increasing rapidly.

Sugary beverages like Coke are increasingly associated with obesity and its health consequences, problems now rampant in developing economies.

In the past year, Coke has embarked on an aggressive campaign of contributions to potentially critical groups such as the American Academy of Family Physicians, the Children’s Hospital of Philadelphia, Save the Children, and now Oxfam.

These groups are now highly unlikely to advise their constituents to cut down on sugary sodas.  If nothing else, sponsorship buys silence.

Oxfam may have done the work of its Poverty Footprint Report without company interference.  It is what is not in the report that is so much in Coke’s interest.

For just under $3 million, Coke has purchased an endorsement from Oxfam of its “anti-poverty” practices and silence on the role of sugary drinks in obesity.  This kind of public relations is well worth the price.

What does Oxfam get in this bargain?  The money, of course, but at the cost of serious questions about the credibility of its report and its independence.  Perhaps these are tolerable, but what about loss of respect?

I score this as a win for Coca-Cola.

 

 

 

Apr 20 2011

The latest oxymoron: Oxfam helps Coca-Cola reduce poverty

I keep arguing that partnerships and alliances with food corporations put agriculture, food, nutrition, and public health advocacy groups in deep conflict of interest.

The latest example is Oxfam America’s partnership with Coca-Cola and bottler SAB Miller to evaluate the effectiveness of these corporations in reducing poverty (again, you can’t make these things up):

Despite the challenges involved, The Coca-Cola Company and SABMiller have each made ambitious and laudable commitments to labor rights, human rights, water, gender, and sustainability. However, there is little accountability to such commitments without the informed engagement of affected groups. By looking across all relevant issues (no cherry-picking) with an organization like Oxfam America and reporting out to stakeholders, these companies have opened themselves to heightened public scrutiny and hopefully increased accountability.

Hopefully, indeed.

The Oxfam Poverty Footprint Report describes the work Coca-Cola and SAB Miller are doing in Zambia and El Salvador to empower and promote sustainability.  It highlights Coca-Cola’s sustainability initiatives.

It does include some telling recommendations for follow-up.  For example:

  • Engage sugar farmers and producers to improve safety and health of sugarcane harvesters.
  • Investigate why independent truck drivers in Zambia work more than eight hours per day and discuss with drivers potential mechanisms to ensure safe driving.
  • Ensure The Coca-Cola Company’s global Advertising and Marketing to Children Policies are being effectively and consistently implemented at a regional level.

You have to read between the lines to see what this report really says.

And what about health, obesity, or the shocking increase in childhood tooth decay that is occurring in Latin America these days as a result of the influx of sugary drinks?  Not a word.

Why is Oxfam America helping Coca-Cola to market its products in Latin America and Africa?  I can only guess that Coca-Cola’s grant to Oxfam must have been substantial.

And thanks to Kelly Moltzen for sending the links.

 

Apr 18 2011

Obesity as collateral damage: changing food industry behavior

I am a member of the editorial board of the Journal of Public Health Policy, which publishes research and commentary on matters that affect international public health.  Dr. Anthony Robbins, one of its editors, and I are calling on authors to submit articles that consider ways to change behavior—not, as is all too common, of individuals but of the food industry.

The journal has published many papers on obesity policies aimed at improving the diet and exercise behavior of individuals.  These may be necessary, but they are not sufficient.  It is now time to deal with the behavior of the food industry.  Food industry profits are

generated by capturing increasingly larger shares of the market and by selling the population more food – and calories –than it needs. In this marketing environment, obesity is collateral damage.

The food industry’s ultimately anti-social behavior – whether conscious or inadvertent – is spreading globally. In higher income countries, it is ubiquitous, whereas in places where people have less disposable income, it is but the camel’s nose under the tent.

Thus, effective strategies to reduce obesity may vary depending on penetration by the industry – and less developed nations may still have more opportunities to avoid obesity, by getting ahead of the curve.

How are countries to do this?

Efforts to control obesity will have to enlist the public to focus on behavior, with a shift from a sole focus on citizens to a new one on the behavior of food corporations…We cannot eliminate the food industry to reverse the obesity epidemic, but we can constrain its anti-social behavior…We encourage authors to reach beyond the kind studies of policies on eating and activity that we receive so frequently.

We have 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.

Instead, we urge authors to submit articles that consider how to understand and change the behavior of the food industry.

As a starting point for thinking about how to approach this topic, we ask: does the industry need to overfeed the population to remain profitable?

Have ideas?  Write them up and submit them to JPHP.  There is no deadline.  The journal will consider submissions whenever they arrive, but sooner is better than later.

Apr 15 2011

Why partnerships with food companies don’t work

Michael Siegel, MD, MPH, a Professor at the Boston University School of Public Health (whom I do not know), has been mailing me copies of his recent blog posts on partnerships between food corporations and health organizations, particularly the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP) (see my previous posts), and the American Dietetic Association (ADA) (see my previous posts on this one too).

Dr. Siegel’s current post discusses two reasons why these partnerships do more for the food companies than they do for the organizations:

1. Coca-Cola and other Big Food companies are using these partnerships to enhance their corporate image, and therefore, their bottom line: sales of unhealthy products that are contributing towards the nation’s obesity epidemic.

In its 2010 annual report, Coca-Cola writes: “…researchers, health advocates and dietary guidelines are encouraging consumers to reduce consumption of sugar-sweetened beverages, including those sweetened with HFCS or other nutritive sweeteners. Increasing public concern about these issues…may reduce demand for our beverages, which could affect our profitability.”

…Pepsico, in its 2010 annual report, also makes clear the connection between the company’s public image and its bottom line: “Damage to our reputation or loss of consumer confidence in our products for any of these or other reasons could result in decreased demand for our products and could have a material adverse effect on our business, financial condition and results of operations, as well as require additional resources to rebuild our reputation.”

2. The American Dietetic Association, American Academy of Pediatrics, and American Academy of Family Physicians are supporting companies that oppose virtually every state-specific public health policy related to improvement of school nutrition, reduction of junk food and soda consumption, and environmental health and safety.

…Through its contributions to the Grocers Manufacturers Association (GMA), Coca-Cola is opposing any and all taxes on sugar-sweetened beverages (soft drinks), opposing the removal of BPA from bottles containing liquids consumed by infants, opposing legislation to simply require the disclosure of product ingredients, opposing taxes on candy, opposing bottle bills, opposing all restrictions on BPA-containing packaging, opposing standards for food processing, and opposing school nutrition standards.

…That the AAP, AAFP, and ADA have fallen for Coca-Cola’s tricks is one possibility. The other, which I find more likely, is that they have been bought off. In other words, that the receipt of large amounts of money has caused them to look the other way. It’s amazing what a little financial support will do. And of course, this is precisely the reason why companies like Coca-Cola and Pepsico include the sponsorship of public health organizations in their marketing plans.

I’m just back from the American Society of Nutrition meetings in Washington, DC, where the daily newsletter put out by the society included full-page advertisements from Coca-Cola, the beef industry, and the Corn Refiners Association (see yesterday’s post).  And then there is the astonishing example of Coca-Cola’s $10 million gift to Children’s Hospital of Philadelphia to head off a potential city soda tax.

It is completely understandable why food and beverage companies would want to buy silence from health professionals.  It is much less understandable why health organizations would risk their credibility to accept such funding.  Professor Siegel’s analyses of these issues are worth close attention.