Search results: the corporation not me

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.

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.

Not everyone liked Sam Kass’s speech as much as I did (see previous post) and I’ve been asked to expand on the idea that we need to pressure the White House to do more.  Here’s how I see the situation.

We live in an era when corporations run government.  You don’t believe this?  Take a look at the appalling events in Wisconsin.  Consider the implications of last year’s Supreme Court decision in Citizens United, allowing corporations virtually unlimited funding of congressional election campaigns.

Election campaign funding is the root source of corruption in American government.   If corporations were not allowed to fund election campaigns, we might be able to elect legislators who are more interested in public health than corporate health.

The First Lady’s Let’s Move campaign aims to reduce childhood obesity.  This, in itself, is fundamentally anti-corporate.  Why?  Because fixing obesity means eating less and eating better, and both are very, very bad for business.  And they are especially bad for the corporations that make highly profitable junk foods—snacks, sodas, and the like—and for retailers who display these products on supermarket shelves.

From the perspective of the White House, the food business is not going away.  If the Obama administration is not going to be perceived as anti-business, it has to work with corporations.  But what can food corporations really do to help kids eat more healthfully?

I worried about this question when I returned from the World Economic Forum in Davos a few years ago.  There, I met high-level executives of food corporations and realized that I needed a clear, unambiguous agenda for them.  But because I think people would be healthier if they ate mostly unprocessed foods, and I’m not much impressed by small nutritional tweakings of junk foods, I had a hard time thinking of positive things they could do.

The only agenda items I could think of were negatives: stop marketing junk food, stop marketing to kids,  stop marketing junk food as health food, stop attacking critics, etc.  Negatives won’t sell.

I think Mrs. Obama’s choice of childhood obesity as her First Lady’s Cause was a courageous decision.   In the current corporate context, the accomplishments listed by Mr. Kass add up to something meaningful.  The First Lady is doing what she can.  And let’s face it: nobody else in that position ever has.  Never have issues of food and nutrition been made so legitimate.  For that alone, she deserves thanks.

If the Obamas think they have to work with business, they have to work with Walmart—it’s the 800-pound food gorilla.  In theory, if Walmart tweaks food products, reduces the price of healthier food options, sources lower cost fruits and vegetables, and moves stores into inner cities, the net result will be healthier choices for Walmart customers.  In practice, we have to wait and see.

The White House must think these potential gains are worth the cost of the nose-holding they have to do about Walmart’s labor and business practices.  Nose-holding is the price of getting things done at that level.

I am in the privileged position of not having to make those kinds of compromises (thank you, NYU).

It is not an accident that Mr. Kass’s riff began with “parents told us.”  The First Lady cannot budge without substantial popular support and pressure.  If we think she is in a position to do any good at all for the movement to reverse childhood obesity and improve the food system, we have to let her know what we’d like her to try to do—loudly and repeatedly.

So maybe the First Lady’s—and Sam Kass’s—next speech will begin: “Everyone who cares about how our food is produced and consumed told us….”

Maybe I’m overly optimistic (it’s my nature), but I still see Mrs. Obama’s efforts as an opportunity.  We ought to be using it to push for what we think is right.

If you were a UK Health Secretary faced with soaring rates of obesity, alcohol misuse, and diet-related diseases, what would you do? Were you to take an evidence-based approach, you might consider minimum pricing per unit of alcohol and restrictions on its availability. You might look at toughening the regulation of how the least healthy foods are marketed to children.

You could even demand that manufacturers reformulate their least healthy products to meet minimum nutritional standards. Or you could, if your name was Andrew Lansley, dismiss all of the above and instead invite representatives of McDonald’s, PepsiCo, and the drinks giant Diageo among others, to submit their policy suggestions on how best to deal with the UK’s public-health crises for a forthcoming governmental white paper.

After the initial surprise, it can still take a while for the bizarre reality to sink in—that the companies who have profited the most from the epidemics of obesity and alcohol misuse should now be responsible for setting the agenda on public health simply beggars belief.

…The creeping influence of corporate power on public policy is not news to anyone in the UK, but the breathtaking speed and scale by which the UK coalition Government is embracing the agenda of business at the expense of the health of the electorate is an unwelcome novelty. By putting the interests of big business at the heart of public-health policy, Lansley is ensuring that the UK’s big society will not be shedding the pounds any time soon.

The Lancet is a British medical journal with unusual and highly commendable editorial interests in international public health.  I’m happy to see it take on questions about the role of corporations in obesity.  The British Food Standards Agency was doing a good job of trying to institute policy approaches to obesity prevention, but these are not popular with corporations.  Recall: eating less is very bad for business.

And this kind of resistance to policy approaches is not just a British or European problem.  Our corporations also prefer what they do to be voluntary. So this is a cautionary tale.

 Bill Marler, the food safety lawyer in Seattle, is asking for responses to the question, “if you had a magic wand, how would you fix the food safety system?” 

I’ve been mulling over his question in light of the recent enactment of the food safety bill, as yet unfunded.  Magic wand in hand, here’s what I’d do:

Create a single food safety agency: the new law is designed to fix the FDA.  It does nothing to fix the USDA’s food safety functions.  These remain divided between the two agencies, with USDA responsible for the safety of meat and poultry, and FDA responsible for everything else.  This division pretends that animal wastes have nothing to do with the safety of fruits and vegetables which, alas, they do. 

Require safety control systems for all foods.  Everyone who produces food should do it safely using proven methods for identifying where hazards can occur, taking steps to prevent those hazards, monitoring to make sure the steps were taken, and—when appropriate— testing to make sure the system is working. 

Apply safety controls from farm to table.  The new law does this for FDA-regulated foods.  But USDA safety regulations begin at the slaughterhouse after animals have already been contaminated in feedlots or in transport.  Everyone involved in food production, even farmers large and small, should be actively engaged in food safety efforts.

Fund food safety through congressional health committees.  For irrational reasons of history, the FDA gets its funding through agricultural committees, not health—even though FDA is an agency of the Public Health Service within the Department of Health and Human Services.   As a consequence, the FDA is at the mercy of appropriations committees whose mandate is to protect agricultural interests.  This anomaly explains why 80% of food safety funding goes to USDA, and only20% to FDA.  The new chair of the House agricultural appropriations committee has made it clear that he does not believe FDA needs any more funding.   Health appropriations committees might view FDA’s role in food safety in a more favorable light.

Fund food safety adequately.  To protect the domestic food supply—and to ensure the safety of imported foods—more money is needed to pay for inspection, testing, and research. 

Give the food agency cabinet-level status.  Everyone eats.  Food safety affects everyone.  Food has critically important economic and food security dimensions, domestically and internationally.   

Require election campaigns to be publicly funded, with no loopholes. This is the only way we will be able to remove corruption from our political system and elect officials who care more about public health than corporate health.

Require Wall Street to rate corporations on long-term sustainability.  Wall Street pressures on corporations to report growth every quarter are at the root of corner-cutting on food safety.  Food corporations should be valued for excellent food safety records and for maintaining high ethical standards in every aspect of their business.

Even a magic wand may not be enough to do this.  It will take more than a magic wand to do this, I fear.  Hey, I can dream.

My first San Francisco Chronicle “Food Matters” column for the new year deals with some predictions:

Q: Whatever you used as a crystal ball last year turned out to be a pretty good predictor of the most prominent food issues of 2010. How about trying again: What food matters will we be hearing about in 2011?

A: It doesn’t take a crystal ball to figure out what’s coming up with food issues. I’m happy to make predictions, especially since most seem fairly safe.

Dietary guidelines will be released this month. By law, they were due last year and are already late. What will they say? The 2010 guidelines advisory committee recommended eating more fruits, vegetables and whole grains, but introduced a new euphemism – SOFAs, or Solid Fats and Added Sugars – for the “eat less” advice. SOFAs really mean “cut down on fatty meat and dairy products” and “avoid sugary sodas.”

Will government agencies have the nerve to say so? Let’s hope.

The U.S. Department of Agriculture will issue a new food guide. The 2005 pyramid’s rainbow stripes proved impossible to teach and useless to anyone without a computer. I’ve heard a rumor that I will love the new design. I’m skeptical. I liked the original 1992 pyramid. It showed that bottom-of-the-pyramid foods were healthiest, making it unpopular with companies selling top-of-the-pyramid products. But it is healthier to eat some foods than others (see: dietary guidelines).

Will the USDA improve on the 1992 design? We will soon find out.

The fights over food safety will continue. At the last possible moment, Congress passed the food safety bill by a large majority. Now the fights really begin.

Funding will be most contentious, with the actual regulations not far behind. The Congressional Budget Office absurdly considered the bill’s provisions to be “budget neutral.” They are anything but.

The bill’s provisions require the Food and Drug Administration to hire more inspectors just at a time when Republican lawmakers have sworn to cut domestic spending. The FDA also must translate the bill’s requirements and exemptions for small farmers into regulations.

Rule-making is a lengthy process subject to public comment and, therefore, political maneuvering. Watch the lobbying efforts ratchet up as food producers, large and small, attempt to head off safety rules they think they won’t like.

Expect more lawsuits over the scientific basis of health claims. The Federal Trade Commission just settled a $21 million claim against Dannon for advertising that yogurt protects against the flu. The agency also has gone after scientifically unsubstantiated claims that omega-3s in kiddie supplements promote brain development and that pomegranate juice protects against prostate problems. POM Wonderful has already countersued the FTC on grounds that the First Amendment protects commercial speech. I’ll be watching this case carefully.

The FDA will issue new front-of-package label regulations. The FDA has promised to propose an at-a-glance symbol to indicate the overall nutritional value of food products. Food companies like the Guideline Daily Amount spots they are using in the upper corners of food packages because the symbols are factual but nonjudgmental. The FDA, however, is considering red, yellow and green traffic-light symbols that do convey judgments. Food companies say they will not voluntarily use a symbol that tells people to eat less of their products.

Will the FDA have the courage to make traffic lights mandatory? It will need courage. The new British government dealt with the traffic-light idea by summarily dismantling the food agency that suggested it.

Corporations will seek new ways to co-opt critics. Under the guise of corporate social responsibility, food companies have been making large donations to organizations that might otherwise criticize their products. The most recent example is the decision by Save the Children, formerly a staunch advocate of soda taxes, to drop that cause coincidentally at a time when its executives were negotiating funding from Coca-Cola.

Such strategies remind me of how the Philip Morris cigarette company distributed grants to leading arts groups. Expect food companies to use generosity to neutralize critics and buy silence.

School meals will make front-page news. Congress passed the Healthy, Hunger-Free Kids Act last month. Now the USDA must implement it by setting nutrition standards, adding fresh fruits and vegetables (some locally grown) and expanding eligibility.

President Obama has promised to restore the $4.5 billion “borrowed” from the SNAP (food stamp) program to fund this act. The scrambling over the regulations and financing should make excellent spectator sport.

Farm bill advocates will be mobilizing. You might think it too early to be worrying about the 2012 Farm Bill, but I’ve already gotten position papers analyzing commodity and food-assistance issues from groups gearing up to lobby Congress to bring agricultural policy in line with nutrition and public health policy.

I have a personal interest in such papers. I will be teaching a course on the Farm Bill at New York University next fall. Please get busy and write more of them!

Happy new year, and let’s see how my guesses play out.

Every now and then, I enjoy answering questions posed by Eating Liberally’s Kerry Trueman.  Here’s one for today.

Let’s Ask Marion: How Did Junk Food and Obesity Become a Red State/Blue State Debate?

(With a click of her mouse, Kerry Trueman, aka kat, corners Dr. Marion Nestle, NYU professor of nutrition and author of Feed Your Pet Right, Pet Food Politics, What to Eat, Food Politics, and Safe Food):

kat: The “agri-culture war” that’s long been simmering is coming to a boil now, as recently noted in The Washington Post, The Daily Dish, and elsewhere in the blogosphere.

The Palin/Beck/Limbaugh axis of egos is vigorously defending junk food, lamenting the passage of the food safety bill, and decrying all efforts to address our obesity epidemic, even as David Frum, a rare voice of reason (sometimes) on the right, tells CNN that obesity poses a greater threat to our national security than, say, openly gay soldiers.

You yourself are under fire yet again (sigh) from those uber-astroturfers at the Center For Consumer Freedom for having the audacity to question whether our cherished principle of free speech entitles Big Food to emblazon the labels of its edible food-like substances with Big Lies (i.e. dubious, unproven health claims).

Why do you think that the issues of junk food and obesity have become so incredibly politicized?

Dr. Nestle: Politicized? Of course they are politicized. Junk food and obesity are key indicators of political divisions in our society. For starters, junk food is cheap and obesity is more common among low-income populations. So right away we are into divisive issues of income inequality and class and, therefore, who pays for what and which sectors of society get government handouts.

The minute we start talking about small farms, organic production, local food, and sustainable agriculture, we are really talking about changing our food system to accommodate a broader range of players and to become more democratic. Just think of who wins and who loses if $20 billion in annual agricultural subsidies go to small, organic vegetable producers who are part of their communities rather than to large agricultural producers who do not live anywhere near their corn and soybeans.

The issue at stake is who gets to decide how food is grown and what people eat. For as long as I can remember, big agriculture and big food were in control, in close partnership with congressional agricultural committees and the USDA. Today, the food movement–democracy in action, if you will–is challenging their authority and power. No wonder defenders of the status quo don’t like the challenge. It is only to be expected that they are fighting back.

I see the intensity of the debate (and, alas, the personal attacks) as a clear sign that the movement is making headway. The system is clearly changing. It has to change if we are to address obesity, climate change, and the other unsustainable aspects of our present ways of doing food business.

Anyone who is working to reduce income inequity and to make healthier food available to every American has to expect to encounter the methods corporations always use to fight critics: personal attacks, claims of junk science, invocation of personal responsibility, cooptation, and plenty of behind-the-scenes lobbying.

Telling truth to power has never been popular. But I’m convinced it’s worth doing.