by Marion Nestle

Search results: tobacco

Aug 22 2016

Catching up on soda politics

My book, Soda Politics, came out not quite a year ago but so much has happened since then that it’s been hard to keep up with everything that’s happening in campaigns to discourage consumption of sugar-sweetened beverages.

Fortunately, Healthy Food America’s Casey Hinds puts out a daily roundup of sugar and soda news (you can sign up for it and HFA’s other materials here).

A few recent items of particular interest:

USA Today’s editorial, “soda taxes fall flat

More effective ways already are being used to change people’s diets. The best use of government authority is to empower people with the information they need to make healthier choices.

The editorial comes with a poll, still up.  You can vote on it here.  At this moment only 183 votes have come in, 51% strongly in favor of the editorial opinion.

Jim Krieger of Healthy Food America did a counterpoint

The time has come to tax sugary drinks like we tax tobacco. The analogy is powerful: As with tobacco, rock-solid evidence shows habitual use harms health. Sugary drinks are a prime culprit in rampant health problems — diabetes, obesity, and heart, dental and liver disease – that cut lives short and drive up health care costs.  Tobacco taxes have reduced smoking, while raising money to make lives better. Taxing sugary drinks would do the same

This too has a poll on which you can still vote.  Only 92 votes have come in, and only 38% strongly agree.

Americans don’t like taxes.  Even so, either this issue doesn’t generate much interest or it’s just August and too hot to think about such things.

 

The beverage industry spent $10.6 million to oppose Philadelphia’s soda tax initiative

The soft drink industry does not like taxes and seems willing to put fortunes into opposing them.

The Philadelphia City Council passed the tax anyway.  I keep thinking of all the good things nearly $11 million could do for public health.

Melbourne’s The Alfred Hospital reduces sugary drink consumption

The hospital did an experiment to see if they could shift the mix of drinks purchased from sugary to less sugary.  They did this by increasing the price of sugary drinks and hiding them under counters.  Sales of sugar-sweetened beverages sales fell by 36,500 drinks in a year.

I don’t get it.  Why not just stop selling them altogether?

That’s it for this August Monday.  Stay cool.  More to come.

Addition, August 23

A reader from New Zealand writes to say that “all of its hospitals no longer sell sugary sodas and some are also beginning to remove juice and artificially sweetened beverages due to their acidic nature and detrimental impact on oral health.”

May 5 2016

More on corporate funding of nutrition research: exchange of letters

In January this year, JAMA Internal Medicine published my Viewpoint on corporate funding of nutrition research: science or marketing.

Richard Kahn, former chief scientist and medical officer of the American Diabetes Association, wrote a letter in reply (see below for more about him**).  The journal published his letter, along with my response, in its current issue.  Here’s what I said.

In Reply Dr Kahn requests evidence that nutrition research funded by food companies is of lesser quality than studies funded by independent agencies or performed by investigators with nonfinancial conflicts of interest. Concerns about such issues are relatively recent; few published studies address them directly. Instead, concerns about industry sponsorship of nutrition research derive from comparisons with the results of studies of funding by tobacco, chemical, drug, or medical device companies. This research typically finds industry-sponsored studies to report results more favorable to the products of the sponsor than studies not funded by industry. It identifies subtle rather than substantive differences in the quality of this research; industry-funded studies are more likely to underreport unfavorable results and interpret neutral results more positively.1 When results are negative, they are less likely to be published.2

Between March 2015 and March 2016, I identified 166 industry-funded nutrition research studies and posted and discussed them on my blog.3 Of these, 154 reported results favorable to the interest of the sponsor; only 12 reported contrary results. The few studies systematically examining the influence of industry funding on nutrition research tend to confirm results obtained from other industries. For example, a systematic review comparing industry-funded and nonindustry-funded trials of probiotics in infant formula reported no association of funding source with research quality. Industry-funded studies, however, seemed more likely to report favorable conclusions unsupported by the data.4

Dr Kahn states that sponsored studies often specify that the funder had no role in the study. Only recently have some journals required such statements, and I am unaware of research on the extent of this practice or authors’ adherence to it. Among the 166 industry-funded studies that I reviewed, few disclosed involvement of a sponsor.

Dr Kahn asks whether industry funding is any more biasing than career self-interest or intellectual passion. Unlike industry funding, self-interest and passions are intrinsic to every scientist who conducts research, are a matter of public record, cannot be eliminated, and have not been shown to consistently bias research results in the same ways as industry funding.5 Fortunately, nutrition societies and research institutions are developing policies to manage financial relationships with industry.6 Such policies hold promise for preventing financial conflicts of research in nutrition research.

1. Lundh  A, Sismondo  S, Lexchin  J, Busuioc  OA, Bero  L.  Industry sponsorship and research outcome. Cochrane Database Syst Rev. 2012;12:MR000033. PubMed

2. Rising  K, Bacchetti  P, Bero  L.  Reporting bias in drug trials submitted to the Food and Drug Administration: review of publication and presentation. PLoS Med. 2008;5(11):e217. PubMed   |  Link to Article

3. Nestle  M. Food Politics Blog. https://foodpolitics.com/. Accessed March 2, 2016.

4. Mugambi  MN, Musekiwa  A, Lombard  M, Young  T, Blaauw  R.  Association between funding source, methodological quality and research outcomes in randomized controlled trials of synbiotics, probiotics and prebiotics added to infant formula: a systematic review. BMC Med Res Methodol. 2013;13:137. PubMed   |  Link to Article
5. Bero  L.  What is in a name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol. 2014;67(11):1239-1241. PubMed   |  Link to Article 
6. Charles Perkins Centre. Engagement with Industry Guidelines 2015. University of Sydney, 2015. https://intranet.sydney.edu.au/perkins/research-support/engaging-with-industry.html. Accessed March 2, 2016.
**Richard Kahn is infamous in my circles for supporting the positions of the sugar and soda industries while with the American Diabetes Association and now.  I wrote about what he said in an interview with Corporate Crime Reporter in my book What to Eat (pages 355-356).  Recently, The Russells (of CrossFit) had a lot more to say about Kahn’s ongoing opposition to public health measures.
Apr 15 2016

Food politics: Mexico then and now

I’m in Mexico City doing talks for El Poder del Consumidor, the advocacy group in part responsible for Mexico’s soda tax.  I had some time to be a tourist yesterday afternoon and got to see the Diego Rivera murals at the Palacio Nacional.

These are enormous, and stunning.  They deal with the history of Mexico in conflict and in peace.  Look closely, and you see Rivera’s deep respect for Mexico’s traditional food culture.

Along the corridor flanking the main mural, for example, is a painting above a plaque listing what the world owes Mexico—corn, obviously—but also beans, tobacco (oops), chocolate, hemp, and tomatoes.

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Other panels also deal with corn—in this one, production.

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Another shows how corn is used.

 

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The corner panel at the end of the corridor is devoted to chocolate.

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Along the way, quieter panels display the harvest of fruits and vegetables.

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Leave the Palacio, cross the Zócolo, and you come to the Coca-Cola bar and toy store.IMG_20160414_1500139

A brief look at Mexico’s food culture, then and now.

Aug 19 2015

Coca-Cola’s sponsorship of favorable research: the saga continues

When the New York Times published an article describing Coca-Cola’s financial sponsorship of university researchers who de-emphasize the role of sugary drinks in raising the risk of obesity and type 2 diabetes, it kicked up a storm.

USA Today’s editorial board said:

It isn’t that companies pay scientists to put out false research. It’s that companies fund the work of scientists who happen to be doing research that spurs consumers to look away from science that hurts corporate interests.

Soft drinks are far less dangerous than cigarettes, but GEBN’s website, tweets and videos come right out of Big Tobacco’s playbook, brought into the digital era. Its leaders have done research in the past under about $3 million in grants given to their universities.

USA Today also printed a response by a Coca-Cola spokesman:

A recent New York Times article created confusion about our support of research and non-profit organizations, stating we want people to think that only exercise matters and not diet — but nothing could be further from the truth. We have always operated under the fact that a healthy, balanced diet and regular exercise are key ingredients for a healthy lifestyle.

That said, we need to do a better job of being even more transparent about the research we fund, the non-profit organizations we support and the way we publicly share this information. And we will.

Yesterday, Senator Richard Blumenthal sent letters to the University of Colorado, West Virginia University, and the University of South Carolina urging them to  clarify the nature of the University’s relationship with projects funded by Coca-Cola and to review the academic integrity of such grant agreements.

I believe your university must determine whether this research is in effect promoting a predisposed and biased agenda, rather than reflecting the impartiality and objectively (sic) expected from a public academic institution.

Years of litigation with tobacco companies were necessary to fully expose the tragic public health consequences when companies lie about the hazards of the products they sell.  I am deeply concerned that we may force future generations to relive this history if corporate-sponsored studies devoid of scientific integrity are permitted once again to deceptively downplay and conceal the dangers of a product consumed on a mass scale.

Do not underestimate Senator Blumenthal’s ability to deal with food companies.  He, you may recall, was responsible for withdrawal in 2009 of the ill-conceived Smart Choices program during his stint as Connecticut’s attorney general.

I’m still waiting for the Global Calorie Balance Network to issue its promised statement.  Stay tuned.

Aug 13 2015

The Guardian: Coca-Cola says its drinks don’t cause obesity. Science says otherwise

I wrote this piece for The Guardian in response to the New York Times article earlier this week about Coca-Cola’s funding of scientists who think obesity is more about exercise than drinking sodas:

These days, you almost have to feel sorry for soda companies. Sales of sugar-sweetened and diet drinks have been falling for a decade in the United States, and a new Gallup Poll says 60% of Americans are trying to avoid drinking soda. In attempts to reverse these trends and deflect concerns about the health effects of sugary drinks, the soda industry invokes elements of the tobacco industry’s classic playbook: cast doubt on the science, discredit critics, invoke nanny statism and attribute obesity to personal irresponsibility.

Casting doubt on the science is especially important to soda makers. Overwhelming evidence links habitual consumption of sugary drinks to poor health. So many studies have identified sodas as key contributors to chronic health conditions – most notably obesity, type-2 diabetes and coronary artery disease – that the first thing anyone trying to stay healthy should do is to stop drinking them.

Soda companies know this. For at least the last 10 years, Coca-Cola’s annual reports to the US Securities and Exchange Commission have listed obesity and its health consequences as the single greatest threat to the company profits. The industry counters this threat with intensive marketing, lobbying and millions of dollars poured into fighting campaigns to tax or cap the size of sugary drinks.

But it is also pours millions into convincing researchers and health professionals to view sodas as benign.

Just last month, the Mayo Clinic Proceedings published a study arguing that the results of national dietary surveys, such as those that link sugary drinks to type-2 diabetes, are so flawed that they constitute a major misuse of public funds. The authors report honoraria, speaking and consulting fees from Coca-Cola.

This week’s revelation of Coca-Cola’s funding of the Global Energy Balance Network is only the latest example of this strategy in action. The Network promotes the idea that to prevent obesity you don’t need to bother about eating less or drinking less soda. You just have to be more active. Never mind that most people can’t lose weight without also reducing their intake.

A reporter who looked into this group discovered that Coca-Cola had funded the research of the scientists behind it, and generously. The network’s website was registered to Coca-Cola. None of this, however, had been made explicit.

Most nutrition professional journals now require researchers to declare who funds their studies, making it possible to compare study outcomes with funding sources. Studies sponsored by Coca-Cola almost invariably report no association of sugary drinks with diabetes, they question the validity of studies that do find such associations or, as in the case of Global Energy Balance Network investigators, they find activity to be the most important determinant of body weight.

Analyses of studies funded by Coca-Cola or its trade association demonstrate that they have an 83% probability of producing results suggesting no harm from soda consumption. In contrast, the same percentage of studies funded by government agencies or independent foundations find clear linkages between sugary beverages and such conditions. Coincidence? I don’t think so.

Since March, I’ve been posting industry-funded studies with results that favor the sponsor’s interests every time I find five of them. They are easy to find. Despite pleas to readers to send me industry-funded studies that do not favor the sponsor, I hardly ever get them. Whenever I come across a study that shows no harm from sodas, I immediately look to see who paid for it.

Soda companies spend generously to convince researchers and health professionals not to worry about sodas’ health effects. But why do researchers take the money? It is too simplistic to say that they are “bought.” Industry-funded investigators say they believe the funding has no effect on the design, conduct or interpretation of their research. But research involves choices of questions, assumptions and methods. It is not difficult to carry out a study that appears to meet high scientific standards yet fails to include critical controls that might lead to alternative conclusions.

Researchers funded by Coca-Cola need to take special care to control for unconscious biases but can only do this if they recognize the possibility. Many do not. Neither do many peer reviewers or editors of scientific journals. Although food-company financial support should not necessarily bias results, it appears to do so in practice.

Industry-funded scientists resent questioning of the influence of sponsorship on the quality of their science. They charge that investigators who find adverse effects of sodas on health are equally biased by career goals, righteous zeal or anti-corporate morality. Yes, independent scientists may have biases of their own, but their overarching research goal is to improve public health. In contrast, the goal of soda companies is to use research as a marketing tool.

Disclosure is essential. If a study is funded by Coca-Cola, caveat emptor.

Aug 12 2015

Coca-Cola’s promotion of activity: a follow up

I’ve had a busy week dealing with the aftermath of Anahad O’Connor’s New York Times story about how Coca-Cola pays scientists who argue that obesity is more about activity than what you eat—drinking sodas, for example (I’m quoted).   It’s gotten 1180 comments.

Here’s Dan Wasserman’s from the Boston Globe:

In all fairness, let’s see what Coca-Cola’s Chief Technical Officer, Dr. Ed Hays, says in response (straight out of the tobacco industry’s playbook):

I was dismayed to read the recent New York Times’ inaccurate portrayal of our company and our support of the Global Energy Balance Network (GEBN). The story claimed Coke is funding scientific research to convince people that diets don’t matter – only exercise. In fact, that is the complete opposite of our approach to business and well-being and nothing could be further from the truth.

Yes, we fund scientific research through GEBN and we are proud to support the work that scientists such as Dr. Jim Hill and Dr. Steve Blair do – because their type of research is critical to finding solutions to the global obesity crisis.

At Coke, we believe that a balanced diet and regular exercise are two key ingredients for a healthy lifestyle and that is reflected in both our long-term and short-term business actions.

The article even got the attention of Congress.  Here’s the statement from Rosa de Lauro (Dem-CT), sponsor of The SWEET Act to tax sugars:

This research is reminiscent of the research conducted by the tobacco companies to mislead the public about the health risks of smoking.  The American public will not be fooled. There is a wealth of sound scientific research that demonstrates the link between sugar-sweetened beverage consumption and a host of health conditions, including diabetes, heart disease, and obesity.  This new group and their research are a sham,” DeLauro said.  “People want to be healthy and they want their kids to be healthy and realize that drinks full of empty calories are not good for them. That is why more and more Americans are opting to drink less soda every year.

I wrote a piece for The Guardian, which I will post tomorrow.

I don’t keep track of my interviews or media appearances unless people send me links (I post them under Media), but Rachel Harrison at NYU kept score yesterday.  As I said, a busy couple of days.

Additions, August 14

Fox News, August 11

  • Shepard Smith says “the story “reminds you of exactly what the tobacco industry did back in day, and more recently, it also reminds you of what the climate deniers — the climate change deniers — are doing as well.”
  • Rush Limbaugh said the Times‘ Coca-Cola story “undermine[s] the whole notion of a scientific consensus,” because it “can be bought and paid for.”

New York Times editorial, August 14

the evidence continues to mount that sugar-sweetened drinks are a major contributor to obesity, heart disease and diabetes, and that exercise makes only a modest contribution to weight loss compared to ingesting fewer calories.

Jul 28 2015

Trans-Pacific Partnership’s food issues: rice, sugar, Malaysian palm-oil, trans fats

The Trans-Pacific Partnership (TPP) negotiations are taking place this week in Maui, as usual, in deep secret.

Doug Palmer of Pro Politico describes the major food issues: dairy, origin names, pork, rice, and sugar.  The issues come down to market share.  Every country wants to protect its own products but have free access to markets in other countries.

Although not a food, tobacco best explains why the TPP makes people nervous.  US tobacco companies want the TPP to open new markets.  But one of the TPP provisions is said to allow corporations sue governments that pass rules that might hurt the corporation’s business.  Philip Morris sued Australia over its “plain packaging” law and is now suing Great Britain.

The US position is supposedly that a country’s measures  to protect the health of humans, animals, or plants should not be in violation of the TPP, and that challenges to tobacco-control measures should be cleared with TPP partners.   Malaysia, for example, has proposed to exempt tobacco-control measures from challenges under TPP.

Malaysia?

The State Department has just taken Malaysia off its list of the worst countries for human trafficking (see the July 2015 Trafficking in Persons Report).

What a coincidence.  This allows Malaysia to participate in TPP negotiations.

But what bad timing.  The Wall Street Journal has just published a harrowing story about the de facto slavery of palm-oil workers on Malaysian plantations (the New York Times just did one on “sea slaves” forced to fish for pet food or animal feed).

As Rainforest Action Network said of the Malaysia story in a press release:

July 27, 2015 (SAN FRANCISCO) – The Obama administration has removed Malaysia from the list of worst offenders for human trafficking and forced labor today, one day after The Wall Street Journal published an extensive report on human trafficking and forced labor on Malaysian palm oil plantations that directly supply major U.S. companies. Malaysia is one of 12 nations in the contentious Trans-Pacific Partnership trade deal, and inclusion of a country with the lowest ranking in the State Department’s Trafficking in Persons Report would be problematic for the administration.

And then, there’s the trans-fat connection:  The US demand for replacement of partially hydrogenated vegetable oils has pushed Malaysia and other palm-oil countries to produce more palm oil, faster.

The Wall Street Journal explains:

Palm oil has been repeatedly named on the U.S. Department of Labor’s list of industries that involve forced and child labor, most recently in 2014. Activists have blamed palm-oil plantations in Indonesia and Malaysia for large-scale deforestation and human-rights abuses. Oil palm growers respond that the palm tree, a high-yield crop, is a useful tool for socioeconomic development.

palm oil

The TPP is hard to understand, not least because negotiations are secret.  In giving the President the go-ahead to sign the agreement, Congress made two stipulations:

  • Congress must be notified 90 days in advance of signing.
  • The terms of the agreement must be disclosed to the public 60 days prior to signing.

At least that.  TPP deserves very close scrutiny.

Jul 1 2015

Small farms in Cuba: a brief report on my visit

As noted in an earlier post, I was offline from from June 13-20 on a visit to Cuba with a Food First group visiting small organic farms, rural and urban.

This was my third trip to Cuba.  I came with other groups in 1990 and 1992 at the beginning of what Cubans refer to as the “Special Period,” the economic disaster caused by the collapse of the Soviet Union, the end of its support for the 1959 Castro revolution, and the U.S. embargo on trade with Cuba.

The embargo also required countries that trade with the U.S. to stop trading with Cuba.  For tourists like me, the lingering effects of the embargo are the travel restrictions, the failure of U.S. cell phones to work, and the scarce and slow Internet access.  Hence: Offline.

But change is imminent.  I heard many Cubans mention December 17, the day of President Obama’s 2014 announcement of resumption of relations with Cuba, as if it ought to be celebrated as a national holiday.

Our group traveled by charter flight from Miami.  My first surprise: We were not alone: The Miami airport devotes two entire concourses exclusively to Cuban charter flights.  As many as 20 flights every day are packed with people who have families in Cuba, business people, and tourists of one kind or another.

2015-06-13 06.05.39Our group was interested in Cuban agriculture and food systems.  This post deals with rural agricultural production.  In subsequent posts, I’ll talk about urban farming and what the Cuban food scene looks like.

The USDA provides useful background information and statistics on Cuban agriculture.

The 2015 report has this interesting tidbit: US agricultural exports to Cuba rose from $139.2 million in 1956-58 to $365.3 million in 2012-14.

This, however, does not break the embargo; it is classified as sales, not trade.  The Cubans buy agricultural products from us, mostly frozen chicken for people, and soybeans and soybean meal for animal feed.

We did not see much agriculture on this trip.  There is plenty of land, but gas, transportation, and tractors are extremely limited.  The highway between Havana and Pinar del Rio is well maintained but we saw few cars on it.  Horse-drawn carts, yes; cars and trucks, no.  And lots of land not in production.

2015-06-17 10.13.09

The reasons for this go beyond the embargo.  We heard repeatedly that Cubans don’t like doing agricultural labor: the population is highly educated, is 80% urban, the climate is hot and humid, and Cuban culture does not value that kind of work.

Much of Cuban food is imported.  How much?  Estimates range from 35% to 85% depending on whether whoever is doing the estimating is for or against the Cuban revolution.

An official of the agriculture ministry told us that Cuba is self-sufficient or nearly so in eggs, mangos, sugar, and tobacco.  I took this photo of mangos grown on the remarkable farm in Pinar del Rio established as a model for sustainability by Fernando Funes-Monzote.

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At present, food is grown in Cuba on large farms owned by the state or held by family-owned cooperatives of one kind or another, or on smaller farms that are owned by private individuals or families.  Only 70% or so of arable land is in production.  The state still has a million hectares to distribute, but has a hard time getting anyone to farm it.

Most production is organic, but not by choice.  The embargo makes agricultural inputs unavailable or prohibitively expensive. See, for example, Modern Farmer’s photo-essay on Cuban farming.  Rice and potatoes, however, are not organically grown, and neither is most tobacco.   We heard from farmers in the exceptionally beautiful Viñales region that tobacco is beginning to be grown organically.

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They are proud of their tobacco.  It is used for high-quality cigars and is a major cash crop.

The agricultural situation in Cuba, like much else about the country, is full of contradictions.

Tomorrow: urban farming.