by Marion Nestle

Currently browsing posts about: WHO(World Health Organization)

Jul 13 2023

WHO recommends policies to restrict food marketing to kids

The World Health Organization has just come out with a new report on protecting children from the harms of marketing unhealthy food to kids.

Some conclusions from research on the effects of marketing unhealthy foods to kids:

  • Across studies, the most frequently marketed food categories were fast food, sugar-sweetened beverages, chocolate and confectionery, salty and savoury snacks, sweet bakery items and snacks, breakfast cereals, and desserts.
  • Reductions in children’s exposure to food marketing were more often found with: mandatory policies; policies designed to restrict food marketing to children, including those older than 12 years; and policies that used a government-led nutrient profile model to determine the foods for which marketing was to be restricted.
  • Reductions in the power of food marketing were more often found with: mandatory policies; and policies designed to restrict food marketing to children, including those older than 12 years.
  • Policies to protect children from the harmful impacts of food marketing would be highly cost-effective or cost-saving.
  • Policies to protect children from the harmful impacts of food marketing can be expected to reduce health inequities.
  • In HICs [high-income countries], policies to protect children from the harmful impact of food marketing are largely acceptable to
    the public, but industry has generally opposed government-led restrictions.
  • Some countries have successfully implemented policies, demonstrating that policies are acceptable to government and policy-makers and feasible to implement.

Therefore, WHO recommends that policies:

  • Be mandatory
  • Protect children of all ages
  • Use a government-led nutrient profile model to classify foods to be restricted from marketing;
  • Be sufficiently comprehensive to minimize the risk of migration of marketing to other media, to other spaces within the same medium or to other age groups
  • Restrict the power of food marketing to persuade.


WHO has just given governments a mandate to take action.  Go for it!

Jul 6 2023

What’s up with aspartame?

I was deluged with interview requests last week over the rumor that the World Health Organization will soon release reports stating that the artificial sweetener aspartame is “possibly” carcinogenic.

I say rumor, because the reports will not be released until July 14.

According to Reuters—Exclusive: WHO’s cancer research agency to say aspartame sweetener a possible carcinogen -sources—two sources leaked the conclusion.

Aspartame, used in products from Coca-Cola diet sodas to Mars’ Extra chewing gum and some Snapple drinks, will be listed in July as “possibly carcinogenic to humans” for the first time by the International Agency for Research on Cancer (IARC), the World Health Organization’s (WHO) cancer research arm, the sources told Reuters…. Last month, the WHO published guidelines advising consumers not to use non-sugar sweeteners for weight control. The guidelines caused a furore in the food industry, which argues they can be helpful for consumers wanting to reduce the amount of sugar in their diet.

From what I hear from my own sources, everyone involved in the forthcoming reports is bound by confidentiality agreements.  They suspect that food industry representatives did the leaking.

This gives the industry plenty of time to complain and lobby.  As one report has it, “Industry experts and trade groups are decrying the World Health Organization’s International Agency for Research on Cancer’s pending addition of aspartame to a list of possible carcinogens for humans as unscientific and politically motivated.

Aspartame has been under scrutiny for its potential harm to health practically from the time it first appeared. (see Laura Reiley in the Washington Post on how aspartame has come under scrutiny lately).

Center for Science in the Public Interest has long said of aspartame, Avoid.

Aspartame (sometimes marketed under the brand names Equal, NutraSweet, or AminoSweet) is a chemical combination of two amino acids and methanol. Questions of cancer and neurological problems, such as dizziness or hallucinations, have swirled around aspartame for decades…In 2005, researchers at the Ramazzini Foundation in Bologna, Italy…found that rats exposed to aspartame starting at eight weeks of age and continuing through their entire lifetimes developed lymphomas, leukemias, and other tumors, including kidney tumors, which are extremely rare in the strain of rat used. In 2007, the same researchers published a follow-up study that exposed rats to aspartame beginning in the womb and continuing through their entire lifetimes. That study, too, found that aspartame caused leukemias/lymphomas, as well as mammary (breast) cancer. Then in 2010, they published a study that exposed mice to aspartame, starting in the womb and continuing throughout their entire lifetimes. That third study found that aspartame caused liver and lung cancer in male mice.

US Right to Know says of Aspartame, “Decades of Science Point to Serious Health Risks.

But the FDA says “aspartame is safe for the general population when made under good manufacturing practices and used under the approved conditions of use.”

And the American Cancer Society says you would have to drink 36 cans of diet soda a day to excede the Acceptable Daily Intake level.

Rumors and concerns about aspartame causing a number of health problems, including cancer, have been around for many years. Some of the concerns about cancer stem from the results of studies in rats published by a group of Italian researchers, which suggested aspartame might increase the risk of some blood-related cancers (leukemias and lymphomas). However, later reviews of the data from these studies have called these results into question. The results of epidemiologic studies (studies of groups of people) of possible links between aspartame and cancer (including blood-related cancers) have not been consistent.

A recent review says “The consumption of ASBs [artifically sweetened beverages] was associated with a higher risk of obesity, type 2 diabetes, all-cause mortality, hypertension, and cardiovascular disease incidence.”

As I mentioned a month or so ago, artificial sweeteners are taking a big hit these days and it looks like they are about to take another one.

In my intereviews, I pointed out that what’s news here is the level of authority.  It’s a big deal that WHO is saying this.

Two other points.

  • Aspartame is not essential in the diet.  Nobody (except soft drink companies) need it.
  • It and other artificial sweeteners are artificial and, therefore, ultra-processed.
  • I’m already seeing “no aspartame” labels on soft drinks and food products.

I am looking forward to seeing the data when the reports are published.

Jun 27 2023

The UNICEF-WHO Congress on infant formula marketing: a brief report

Last week, I attended and spoke at the UNICEF-WHO Global Congress on Implementation of the International Code of Marketing of Breast-Milk Substitutes at WHO headquarters in Geneva.

The meeting was attended by more than 400 government, health, and advocacy representatives from more than 100 countries.  Representatives of infant formula companies were not invited to participate.

Its purpose was to encourage governments to promote and enforce the International Code, which nearly all U.N. member states ratified and committed to in 1981 (the U.S. was a long-standing holdout).

This meant they would control inappropriate marketing of infant formulas by banning advertising to people who are pregnant or nursing, gifts of formula samples, and doing anything to make formula appear superior to breastfeeding.

The logic of the Congress:

  • Breastfeeding is the superior method for feeding human babies.
  • Successful breastfeeding requires support from families, society, and government.
  • It is quite easy to undermine confidence in the ability to breastfeed.
  • Formula companies do all they can to undermine confidence in breastfeeding.
  • Formula companies’ main goal is to sell more formula.
  • Formula companies promote their products as normal and superior.
  • Breastfeeding is easier when formula marketing is controlled.y

I talked about the food industry “playbook”—strategies and tactics used by industries (tobacco, chemical, drug, alcohol, and food as well as infant formula) to cast doubt on unfavorable research, fund their own research, and lobby against public health recommendations (photo: Arum Gupta).

Many country representatives discussed the effects of the playbook in their areas, and what they are trying to do to stop formula companies from using  the playbook to get around the Code.

The general consensus:  Formula companies should NOT be allowed to:

  • Advertise or market products in violation of the Code.
  • Participate in public health policymaking.
  • Partner with relevant government agencies or non-governmental groups.

Obviously, formula companies are not happy with such recommendations.  If you would like to see an example of the playbook in action, take a look at the response  from the International Special Dietary Foods Industries.

It was exciting to be with so many people who cared so deeply about this issue.



May 19 2023

Weekend reading: WHO’s new guidance on artificial sweeteners

A press release from the World Health Organization announces recommendations on the use of artificial, non-nutritive (meaning no-calorie) sweeteners: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline.

The recommendation is based on the findings of a systematic review of the available evidence which suggests that use of NSS does not confer any long-term benefit in reducing body fat in adults or children. Results of the review also suggest that there may be potential undesirable effects from long-term use of NSS, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults.

The recommendation not to use artificial sweeteners for weight control or chronic disease prevention applies to:

all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars. Common NSS include acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives.

The guideline document notes:

The recommendation in this guideline was made based on evidence that suggests that there may be health effects associated with NSS use irrespective of which NSS is being used – that is, NSS as a class of compounds, despite individual NSS having different chemical structures, may have an impact on health…individual NSS have different sweetness intensities and organoleptic properties, and are processed differently by the body. Although limited  evidence suggests that individual NSS may also differ in some of their physiological effects in humans, the evidence is currently insufficient to make
recommendations for individual NSS.

Overall, the evidence summarized in the document shows benefits from short-term studies but not ones that last longer than three months or so.  After that, use of non-nutritive sweeteners is associated with potential harm.

At issue, of course, is the mechanism.  These remain speculative: calorie compensation? mainenance of taste preference?  microbiome?

Much of the research into biological mechanisms has been carried out in in vitro and rodent models, and further research is needed to determine whether observations in non-human models translate to humans.  Although there are as yet no conclusive mechanistic links between NSS use and many of the associations observed in prospective cohort studies, that plausible mechanisms have been identified, tested and in some cases validated (albeit mostly in non-human models) reinforces the seriousness with which the associations observed in prospective cohort studies should be considered and highlights the need for further exploration of possible mechanisms with additional research.

Until then, it seems best to avoid them (I don’t like their taste anyway).

  • View the press release here
  • Access the guideline here


Apr 26 2023

The latest sugar recommendation

The latest review of sugars and health has created quite a stir.

  • The study:  Dietary sugar consumption and health: umbrella review.  BMJ 2023381 doi: (Published 05 April 2023).
  • Method:  The authors evaluated 73 meta-analyses that included 8601 studies, most of them observational (meaning they indicate associations but not necessarily causation).
  • Findings: Significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental, hepatic, osteal, and allergic) were detected.
  • Implications: Low-quality evidence linked each additional serving of a sugar-sweetened beverage per week with a 4% higher risk of gout. Each extra cup per day of a sugar-sweetened drink was associated with a 17% and a 4% higher risk of coronary heart disease and all-cause mortality, respectively.
  • Recommendations: (1) Reduce the consumption of free sugars or added sugars to below 25 g/day (this translates to about 6 teaspoons daily). (2) Limit sugar-sweetened beverages to less than 1 a week.

Here’s the headline about the stir:

Experts recommend 6-teapsoon limit to added sugar following BMJ review, industry weighs in:  Recently published research in The BMJ is providing fresh concerns about sugar consumption levels, as some industry stakeholders disagree with the conclusion and CPG brand look to innovate in the low- and no-sugar space…. Read more

And one of the quotes from an industry representative:

…This is a review of existing evidence, and even a well-executed systematic review is only as good as the studies that are inputted. Essentially, garbage in equals garbage out, and it is known that added sugars literature suffers from significant variability when it comes to definitions, intake measurements and control of energy and other diet and lifestyle variables.

Comment: The six-teaspoon recommendation is consistent with World Health Organization guidelines to reduce daily intake of free sugar to less than 10% of their total energy intake, and preferably 5 percent.  The authors admit the evidence is not strong.  But there’s just so much of it, and it’s not going away.

When it comes to sugars, less is better, alas.


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Jul 1 2022

Weekend reading: Discouraging breastfeeding: digital strategies

Here’s a recent report from WHO: Scope and impact of digital marketing strategies for promoting breastmilk substitutes


The report’s findings:

Why should we care?  Because it is so easy to discourage breastfeeding, and digital marketing does just that.

Here are some comments on this report:

And here are links to the first WHO report and to other reports on digital marketing.

Feb 16 2022

WHO report on food marketing

The World Health Organization has just published “Food marketing exposure and power and their associations with food-related attitudes, beliefs and behaviours: a narrative review

This is an update of a review WHO published in 2009 on the extent, nature and effects of food marketing.

The update includes a review of studies from 2009 to 2020 of

  • Where food marketing occurs
  • How much there is,
  • Which brands and products are marketed
  • How they are marketed
  • How consumers react to food marketing

The report, which covers digital and social media,  concludes

Food marketing remains prevalent

  • It is especially prevalent where children are and what they watch on TV
  • It predominantly promotes “fast food”, sugar-sweetened beverages, and chocolate and confectionery
  • It uses a wide range of creative strategies  aimed at young audiences (celebrity/sports endorsements, promotional characters, games)
  • Its exposure is positively associated with habitual consumption of marketed foods or less healthy foods

The report confirms what advocates have been saying for years

  • Food marketing is pervasive
  • Food marketing is persuasive
  • Food marketing is bad for health

The bottom line: Food marketing, especially to children, must be stopped

Jan 24 2019

Palm oil politics: corporate effects on health

The World Health Organization is about to publish a report on how the palm oil industry is promoting obesity and chronic disease as well as environmental degradation as integral parts of its business model.

The draft report gets right to the point.

We highlight the industry’s mutually profitable relationship with the processed food industry and its impact on human and planetary health, including detrimental cultivation practices that are linked to respiratory illnesses, deforestation, loss of biodiversity and pollution. This analysis illustrates many parallels to the contested nature of practices adopted by the alcohol and tobacco industries.

The research behind the report supports the analytical framework for examining industry’s effects on health.

The report documents how the palm oil industry, working with the food industry, acts to maximize profits at the expense of health and the environment, through marketing, supply chain management, lobbying, and corporate “citizenship.”

The report calls for

  • More research on the effects of palm oil on health
  • Actions to mitigate industry influences to protect producers and sellers from needed regulations
  • Use of the Sustainable Development Goals to aid these actions

You don’t get why palm oil raises health and environmental concerns?  Read this.  Now.