Currently browsing posts about: Obesity

Occasionally I write short pieces on request.  A couple have just been published.

The State Department’s Bureau of International Information Programs (who knew?) runs a website, America.gov, on which it provides answers to questions “YOU Asked!”   It invited me to respond to the question, “Why are so many Americans overweight.”

And the professional journal, Childhood Obesity, asked several people to contribute to its new “Industry Watch” column.  The question: “Will private sector companies “step up to the plate” to protect children’s health?

Enjoy!  I file links to these and other writings under Publications on this site.

FoodNavigator.com has a special issue on obesity research.  Its reports are based on single studies that may or may not agree with previous research and, therefore, require some interpretation.

Zero-calorie sweeteners do not prompt overeating, finds study: People do not compensate with extra calories after consuming foods and drinks sweetened with zero-calorie sweeteners, suggests a new study published in the journal Appetite…

Fruit flies help explain why diet success varies: A study on fruit flies has indicated that genetic interaction with diet has a greater impact on body weight than diet alone, which the researchers say can help explain different reactions to similar diets….

Sucralose does not promote weight gain: Human study: Consumption of sucralose and sucralose-sweetened products does not affect gut hormones linked to hunger, or detrimentally affect blood sugar levels, says a new study from Australia….

Food addiction: Fat may rewire brain like hard drugs: Overeating may be driven by a same neurobiological mechanism in the brain as drug addition, says a new study from the US that adds clout to the theory ‘food addiction’….

Overeating drives fat gain at the hips, says obesity-related study: Fat tissues in the upper and lower body may gain weight differently, says a new study which deepens our understanding of fat accumulation and obesity….

Two of these studies are about the effects of artificial sweeteners on hunger, satiety, calorie intake, and weight gain.  In contrast to previous studies, both of these find that sweeteners do not cause people to eat more to compensate for the reduced calories.

I’m guessing we will be hearing more about this topic, as new research results come in.  Stay tuned.

Jeffrey Koplan (Emory) and Kelly Brownell (Yale) have a commentary in JAMA (October 6) titled “Response of the food and beverage industry to the obesity threat.”   They describe how the food and beverage industries:

• Associate their products with health
• Frame the issues to emphasize balance or physical activity
• Pick and choose the science
• Reformulate products to make them appear healthier
• Defend themselves and attack critics

Sound familiar?  For details, see  Michele Simon’s excellent book, Appetite for Profit: How the Food Industry Undermines Our Health and How to Fight Back (Nation Books, 2006).

Addition, October 10: Lori Dorfman of the Berkeley Media Studies Group reminds me about its 2007 Framing Brief, “Reading between the lines: understanding food industry responses to concerns about nutrition.”  This group’s publications are always terrific resources for educating and taking action on food issues.

OECD (the Organization for Economic Cooperation and Development), a group of 33 countries “committed to democracy and the market economy,” has just released a major report on obesity.

Its main conclusion?  The United States population has the highest percentage of overweight and obesity in the democratic, market-economy world.

The report’s conclusion?

Individual interventions have a relatively limited impact; therefore, comprehensive strategies involving multiple interventions to address a range of determinants are required to reach a “critical mass” – one that can have a meaningful impact on the obesity epidemic by generating fundamental changes in social norms. The development of comprehensive prevention strategies against obesity needs to focus on how social norms are defined and how they change; on the influence of education and information on obesity but also on the potential for government regulation to affect behaviours; and on the role of individual choice and values. A sensible prevention strategy against obesity would combine population and individual (high-risk) approaches.

Buried in this paragraph are some important concepts: societies need to change social norms as well as individual behavior, and governments need to intervene to make the social environment more conducive to healthier practices.

Nancy Hellmich of USA Today attempted a translation of some of the recommendations for individuals:

• Individual lifestyle counseling by family doctors and dietitians may be the most effective to increase the life expectancy and quality of life for people who are obese or at risk of becoming so.
• Individual counseling should be supplemented with health-promotion campaigns, compulsory food labeling and cooperation between industry and government in the regulation of food advertising to kids.

The report breaks down data by country.  Here are ours.

Anti-tobacco advocates have been worried for years that concerns about obesity would draw funding away from anti-smoking initiatives (see previous posts).  Their fears are justified, as described in today’s New York Times and in a recent editorial in the New England Journal of Medicine.

Years of experience have taught anti-smoking advocates that countering the marketing efforts of cigarette companies required constant vigilance.  It also taught them that cigarette companies take immediate advantage of any weakening of resistance to their efforts.

Cigarettes remain the leading cause of preventable deaths among Americans.  Cigarette marketing aimed at children remains a national—and international—public health scandal.

Health should not be a zero-sum game.  Anti-obesity advocates have much to learn from anti-smoking advocates.  How about joining forces to improve the health of Americans?

I’m in California but fortunately was up early enough to participate in an unexpected White House conference call.  This was a preview of the press conference held this afternoon to announce food company pledges to reduce the calories in their products by 1.5 trillion by 2015.  As the press release explains, the 16 food company members of the  Healthy Weight Commitment Foundation (HWCF)

are pledging to take actions aimed at reducing 1.5 trillion product calories by the end of 2015. As an interim step to this goal, HWCF will seek to reduce calories by 1 trillion in 2012.

The energy gap?  That’s the 1.5 trillion excess calories that Americans consume each year on average.  This number assumes that the American population consumes an excess of 100 calories a day (the kids’ gap is less).  This number comes from some unexplained manipulation of 100 calories x 365 days per year x 300 million Americans.

How will food companies do this?

Healthy Weight Commitment Foundation manufacturing companies will pursue their calorie reduction goals by growing and introducing lower-calorie options; changing product recipes where possible to lower the calorie content of current products; or reducing portion sizes of existing single-serve products. These changes will help Americans reduce their calorie intake, improve their overall nutrition and close the energy gap.

How will we know they will actually do this?

To assess the impact of the pledge, the Robert Wood Johnson Foundation (RWJF) will support a rigorous, independent evaluation of how the Healthy Weight Commitment Foundation’s efforts to reduce calories in the marketplace affect calories consumed by children and adolescents. RWJF will publicly report its findings.

What are we to make of all this?  Is this a great step forward or a crass food industry publicity stunt?*  History suggests the latter possibility.  Food companies have gotten great press from announcing changes to their products without doing anything, and every promise helps stave off regulation.

On the other hand, the RWJF evaluation sounds plenty serious, and top-notch people are involved in it.  If the companies fail to do as promised, this will be evident and evidence for the need for regulation.

As I explained to Jane Black of the Washington Post, the White House efforts to tackle childhood obesity have been consistent and relentless.  What the White House is doing is holding food companies to the fire for making kids fat. That’s awkward for the companies.  They don’t see it as good for business.  Hence the agreement to change.

What the White House has not been able to get are similar pledges about marketing to kids, but that – and front-of-package labeling – are clearly the next targets.

So let’s give Michelle Obama a big hand for taking this on.  I will be watching for the evaluation with great interest although I hate the idea that we have to wait until 2015 to see the results.

*Added comment: see Michele Simon’s considerably less optimistic post on this.  As she puts it, “who needs policy when you’ve got promises?”

Update May 18: FoodSafetyNews covered the event.  The Atlantic’s political editor is skeptical and notes the absence of a

Calorie Measuring Authority, and the science of counting calories is not as exact as one might think. The Grocery Manufacturers Association, which helped to put together today’s event, spent $1 million in the first quarter of 2010 on lobbying, much of it for the maintenance of corn subsidies.

Food politics makes strange bedfellows.

The Associated Press reports that an organization of retired military personnel, Mission Readiness, is upset about obesity.  American youth, it says, are  Too Fat to Fight. Obesity may be a threat to personal health, but this group sees the problem as a threat to national security (see note below).

Here’s the irony.  The exact opposite was true in World War II.  Then, the army had trouble finding recruits who were not undernourished.

How did we go from lean to fat?  TV food commercials, for one thing, says Jane Brody in a review of recent studies.   Kids eat what they see.  The Rudd Center at Yale has even more recent data on the number of commercials watched by young children.

The Federal Trade Commission (FTC) is responsible for regulating advertising.  It has been making noises lately about taking on food marketing to kids.  I’ve heard rumors that the FTC is ready to release a report on the topic but food marketer’ complaints are holding it up.  Many marketers (not just of food) are worried that the FTC might move to restrict Internet marketing.

This might be a good time to ask the FTC what it is doing about food marketing to kids.

Note: Thanks to Bob Bannister for reminding me of George Saunders’ Shouts & Murmurs piece on this topic in the New Yorker.

Addition, April 22: The rumors about food industry pressures on the FTC turn out to be true.  Margo Wootan of CSPI reports on a meeting today with representatives of the FTC:

A number of members of the Food Marketing Workgroup met with FTC Chairman Jon Leibowitz today and delivered the letter [urging the FTC to publish standards for marketing to children]. It was a good meeting.They said that the standards are not in jeopardy and should be out in the near future. All the industry opposition has caused the agencies to go through a more thorough (i.e., slow) clearance process.

If you can’t block action, you can always delay it as long as possible.

In the latest issue of the American Journal of Public Health, Derek Yach and his colleagues at PepsiCo in Purchase, NY, say yes, it can, in answer to the question they pose in their article, “Can the food industry help tackle the growing global burden of undernutrition?”

If we are to successfully combat global undernutrition, efforts must be sustained by multiple stakeholders from various sectors. We believe that trust is built through industry’s demonstration of practical actions that improve health, and recognition of these actions by governments and nongovernmental organizations. Only through new and innovative public–private sector partnerships can we truly make a difference.

Three international public health leaders counter with no, it can’t, in an article entitled “The snack attack.”  They point to irreconcilable differences between the the goals of private industry and public health:

The problem lies with food, drink, and associated companies whose profits depend on products that damage public health and that also have damaging social, economic, and environmental impacts. These most of all include transnational companies, of which PepsiCo is one. To succeed, big business must sustain and increase annual turnover, profit, and share price…We suggest that public health professionals see papers such as those of Yach et al. as part of the marketing strategies of transnational food and drink companies…The privatization of public health does not work.

This argument reminds me of the editorial that David Ludwig and I wrote for JAMA late in 2008: “Can the food industry play a constructive role in the obesity epidemic?”  We concluded:

With respect to obesity, the food industry has acted at times constructively, at times outrageously. But inferences from any one action miss a fundamental point: in a market-driven economy, industry tends to act opportunistically in the interests of maximizing profit. Problems arise when society fails to perceive this situation accurately.

While visionary CEOs and enlightened food company cultures may exist, society cannot depend on them to address obesity voluntarily, any more than it can base national strategies to reduce highway fatalities and global warming solely on the goodwill of the automobile industry. Rather, appropriate checks and balances are needed to align the financial interests of the food industry with the goals of public health.

PepsiCo owns Pepsi Cola, of course, but also Gatorade, Frito-Lay snacks, and Aquafina water, among many other brands.  According to Advertising Age (June 22, 2009), PepsiCo earned $43 billion in worldwide sales in 2008. Its product-specific advertising expenditures in 2008, just for “measured media” (meaning run through advertising agencies) were, for example:

• $162 million for Gatorade
• $145 million for Pepsi Cola
• $27 million for Tostitos
• $14 million for Doritos
• $11 million for Fritos.

These figures, staggering as they may be, do not include the amounts Pepsi spends on lobbying, supporting the American Beverage Association’s efforts to fight soda taxes, funding medical research at Yale, or marketing to children and adults in India and other developing countries, as previously discussed on this site.

Is corporate “social responsibility” really responsible?  Or is it just marketing?  And what should be the checks and balances?  You decide.

Added April 17: This comes from a former employee of PepsiCo who asks that I post this anonymously:

I think you probably know that the “marketing dollars,” the share (ads/direct marketing), of companies like Pepsico are only a fraction of what are their actually marketing/promotions budgets.  Many years ago, PepsiCo made a conscious effort to redefine/shift budgets to what is called promotional spending from traditional marketing spending.  In doing so though, they keep the control and allocation of the funds in the hands of the marketing teams.

For Pepsi I know that the $145 million you mention is probably only 25% of what Pepsi “internally” considers consumer marketing spending.  For example, direct to retails “incentive” bonus funds are given for moving volume — those funds are almost entirely funneled into the retails increasing consumer marketing to their direct customers.  There are even examples where they can hide 10’s of millions of dollars at a time by linking event sponsorships (stadiums, etc.) to retailer agreements, thus moving those dollars to long-term “capital expenditures.”  I would guess that for Pepsi alone that that $145 million could be as much as a billion a year for direct and indirect consumer marketing spending.

It is not just obscene how much gets spent to increase volume… since, for companies like PepsiCo, Coke, etc.  Volume is the only way they generate higher profit to their shareholders.  As you say, to expect a corporation to do things for the good of the consumer just shows a misunderstanding of their primary function when they are a for-profit entity.