Search results: soda tax

Chicago’s Mayor Rahm Emanuel is not exactly Michael Bloomberg when it comes to public health approaches to obesity and chronic disease prevention.

In October, he announced that he’d gotten Coca-Cola, PepsiCo, and Dr Pepper Snapple to agree to post calorie information on vending machines in Chicago government buildings (something that they will have to do anyway whenever the FDA ever gets around to issuing final rules for menu labeling).

At the same time, he announced a health competition between Chicago city workers and those in San Antonio with rewards paid by the American Beverage Association through a $5 million gift.  This partnership was widely interpreted as a ploy to stave off the kind of soda tax and cap initiatives proposed by the Bloomberg administration in New York City.

And now, in yet another deal with soda companies, Mayor Emanuel has accepted a $3 million grant from Coca-Cola to pay for a park district program “to fight obesity and diabetes by offering nutrition education as well as exercise classes run by armed forces veterans.”

If the idea of soda companies funding anti-obesity campaigns strikes you as ironic—don’t sodas have something to do with obesity in the first place?— you need to understand Mayor Emanuel’s point of view.

His stated philosophy is that it’s better “to give people personal responsibility and the information necessary to make the right choices about their health than it is to legislate their behavior.”

Maybe so, but when faced with today’s “eat more” food environment, personal responsibility doesn’t stand a chance.

But wait: Isn’t Chicago making an important environmental change?  Its public schools are banning energy drinks.

Well, almost.

The new policy sets nutrition standards for all vending machine food and a la carte items sold in cafeterias and excludes energy drinks—with one exception: Gatorade, a PepsiCo product, “can only be used after students have engaged in a school sports activity.”

Are public health partnerships with soda companies a good idea?  The money is nice and undoubtedly badly needed, but worth the price?  Mayor Emanuel thinks so.

I’m dubious.

My post-hurricane Manhattan apartment still does not have telephone, internet, or television service, so I followed the election results on Twitter.

I knew that President Obama had been reelected when the Empire State Building turned on blue lights.

What’s ahead for food politics?

With the election out of the way, maybe the FDA can now:

• Release final food safety rules (please!)
• Issue proposed rules for front-of-package labels
• Issue proposed rules for revising food labels
• Require “added sugars” to be listed on labels
• Define “natural”
• Clarify “whole grain”
• Release rules for menu labeling in fast-food restaurants

Maybe the USDA can

• Release nutrition standards for competitive foods served in schools

And maybe Congress can pass the farm bill?

As for lessons learned:

• The food industry has proven that it can defeat consumer initiatives by spending lots of money: $45 to $50 million on California’s Proposition 37 (GMO labeling), $4 million on soda tax initiatives in Richmond and El Monte.
• But if enough such initiatives get started, food companies might get the message?

Tuesday’s election has huge implications for food politics (see previous post).  I’ve been asked to state an opinion.  In case myviews are not obvious, here’s what I’m voting for and hoping you will too:

• If you care abou the issues discusssed here: Vote to reelect President Obama.
• If you live in California, lead the nation: Vote YES on 37 (GMO labels).
• If you live in Richmond, CA: Vote YES on Measures N and O (soda taxes and where that money will go).
• If you live in El Monte, CA: Vote YES on Measure H (soda taxes).

It’s great to vote with your fork.  But the food movement needs real votes.

Vote with your vote!

My monthly (first Sunday) Food Matters column in the San Francisco Chronicle deals with the implication of Tuesday’s election for food politics.

Q: Neither of the presidential candidates is saying much about food issues. Do you think the election will make any difference to Michelle Obama’s campaign to improve children’s health?

A: Of course it will. For anyone concerned about the health consequences of our current food system, the upcoming election raises an overriding issue: Given food industry marketing practices, should government use its regulatory powers to promote public health or leave it up to individuals to take responsibility for dealing with such practices?

Republicans generally oppose federal intervention in public health matters – witness debates over health care reform – whereas Democrats appear more amenable to an active federal role.

The Democratic platform states: “With prevention and treatment initiatives on obesity and public health, Democrats are leading the way on supporting healthier, more physically active families and healthy children.”

Policy or lifestyle?

In contrast, the Republican platform states: “When approximately 80 percent of health care costs are related to lifestyle – smoking, obesity, substance abuse – far greater emphasis has to be put upon personal responsibility for health maintenance.”

At issue is the disproportionate influence of food and beverage corporations over policies designed to address obesity and its consequences. Sugar-sweetened beverages (sodas, for short) are a good example of how the interests of food and beverage corporations dominate American politics.

Because regular consumption of sodas is associated with increased health risks, an obvious public health strategy is to discourage overconsumption. The job of soda companies, however, is to sell more soda, not less. As a federal health official explained last year, policies to reduce consumption of any food are “fraught with political challenges not associated with clinical interventions that focus on individuals.”

Corporate spending

One such challenge is corporate spending on contributions to election campaigns. Although soda political action committees tend to donate to incumbent candidates from both parties, soda company executives overwhelmingly favor the election of Mitt Romney.

As reported in the Oct. 12 issue of the newsletter Beverage Digest, soda executives view the re-election of President Obama as a “headwind” that could lead to greater regulation of advertising and product claims, aggressive safety inspections and characterizations of sodas as contributors to obesity. In contrast, they think a win by Mitt Romney likely to usher in “more beneficial regulatory and tax policies.”

As for lobbying, what concerns soda companies is revealed by disclosure forms filed with the Senate Public Records Office. Coca-Cola reports lobbying on, among other issues, agriculture, climate change, health and wellness, and competitive foods sold in schools. PepsiCo reports lobbying on marketing and advertising to children. Their opinions on such issues can be surmised.

But Coca-Cola also says it lobbies to “oppose programs and legislation that discriminate against specific foods and beverages” and to “promote programs that allow customers to make informed choices about the beverages they buy.”

Lobbyists

Soda companies have lobbied actively against public health interventions recommended by the White House Task Force on Childhood Obesity in 2010 and adopted as goals of Michelle Obama’s Let’s Move campaign to end childhood obesity within a generation.

Implementation of several interventions – more informative food labels, restrictions on misleading health claims, limits on sodas and snacks sold in schools, menu-labeling in fast-food restaurants, and food safety standards – has been delayed, reportedly to prevent nanny-state public health measures from becoming campaign issues.

To counter New York Mayor Michael Bloomberg’s 16-ounce cap on soda sales, the industry invested heavily in advertisements, a new website and more, all focused on “freedom of choice” – in my mind, a euphemism for protecting sales.

Soda tax

Although the obesity task force suggested that taxing sodas was worth studying, the American Beverage Association lobbied to “oppose proposals to tax sugary beverages” at the federal level. The soda industry reports spending more than $2 million to defeat Richmond’s soda tax ballot initiative Measure N, outspending tax advocates by 87 to 1.

In opposing measures to reduce obesity, the soda industry is promoting corporate health over public health and personal responsibility over public health.

Supporters of public health have real choices on Tuesday. I’m keeping my fingers crossed that Let’s Move will get another chance.

My monthly, first Sunday column in the San Francisco Chronicle:

Q: I still don’t get it. Why would a city government think that a food regulation would promote health when any one of them is so easy to evade?

A: Quick answer: because they work.

As I explained in my July discussion of Richmond’s proposed soda tax, regulations make it easier for people to eat healthfully without having to think about it. They make the default choice the healthy choice. Most people choose the default, no matter what it is.

Telling people cigarettes cause cancer hardly ever got anyone to stop. But regulations did. Taxing cigarettes, banning advertising, setting age limits for purchases, and restricting smoking in airplanes, workplaces, bars and restaurants made it easier for smokers to stop.

Economists say, obesity and its consequences cost our society $190 billion annually in health care and lost productivity, so health officials increasingly want to find equally effective strategies to discourage people from over-consuming sugary drinks and fast food.

Research backs up regulatory approaches. We know what makes us overeat: billions of dollars in advertising messages, food sold everywhere – in gas stations, vending machines, libraries and stores that sell clothing, books, office supplies, cosmetics and drugs – and huge portions of food at bargain prices.

Research also shows what sells food to kids: cartoons, celebrities, commercials on their favorite television programs, and toys in Happy Meals. This kind of marketing induces kids to want the products, pester their parents for them, and throw tantrums if parents say no. Marketing makes kids think they are supposed to eat advertised foods, and so undermines parental authority.

Public health officials look for ways to intervene, given their particular legislated mandates and authority. But much as they might like to, they can’t do much about marketing to children. Food and beverage companies invoke the First Amendment to protect their “right” to market junk foods to kids. They lobby Congress on this issue so effectively that they even managed to block the Federal Trade Commission‘s proposed nonbinding, voluntary nutrition standards for marketing food to kids.

Short of marketing restrictions, city officials are trying other options. They pass laws to require menu labeling for fast food, ban trans fats, prohibit toys in fast-food kids’ meals and restrict junk foods sold in schools. They propose taxes on sodas and caps on soda sizes.

Research demonstrating the value of regulatory approaches is now pouring in.

Studies of the effects of menu labeling show that not everyone pays attention, but those who do are more likely to reduce their calorie purchases. Menu labels certainly change my behavior. Do I really want a 600-calorie breakfast muffin? Not today, thanks.

New York City’s 2008 ban on use of hydrogenated oils containing trans fats means that New Yorkers get less trans fat with their fast food, even in low-income neighborhoods. Whether this reduction accounts for the recent decline in the city’s rates of heart disease remains to be demonstrated, but getting rid of trans fats certainly hasn’t hurt.

Canadian researchers report that kids are three times more likely to choose healthier meals if those meals come with a toy and the regular ones do not. When it comes to kids’ food choices, the meal with the toy is invariably the default.

A recent study in Pediatrics compared obesity rates in kids living in states with and without restrictions on the kinds of foods sold in schools. Guess what – the kids living in states where schools don’t sell junk food are not as overweight.

Circulation has just published an American Heart Association review of “evidence-based population approaches” to improving diets. It concludes that evidence supports the value of intense media campaigns, on-site educational programs in stores, subsidies for fruits and vegetables, taxes, school gardens, worksite wellness programs and restrictions on marketing to children.

The benefits of the approaches shown in these studies may appear small, but together they offer hope that current trends can be reversed.

Researchers also suggest other approaches, not yet tried. The Yale Rudd Center has just shown that color-coded food labels (“traffic lights”) encourage healthier food choices.

And Rand Corp. researchers propose initiatives like those that worked for alcoholic beverages: Limit the density of fast-food outlets, ban sales in places that are not food stores, insist that supermarkets put junk foods and sodas where they are hard to see, ban drive-through sales, restrict portion sizes and use warning labels.

These regulatory approaches are worth trying. If research continues to demonstrate their value, cities will have even more reason to use them. If the research becomes compelling enough, the federal government might need to act.

In the meantime, cities are leading the way, Richmond among them. Their initiatives are well worth trying, testing and supporting.

**Marion Nestle is the author of “Why Calories Count: From Science to Politics,” as well as “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at foodpolitics.com. E-mail: food@sfchronicle.com

The costs of obesity are personal, but also societal.

Economists love trying to figure out how to quantify such things.

The most widely used estimate for the United States is from Cawley and Meyerhoefer’s 2012 article in the Journal of Health Economics: $190 billion annually for health care and lost productivity (their 2010 working paper may be easier to access at the National Bureau of Economic Research site).

Now the Campaign to End Obesity has published its own analysis of these costs.

• $44.7 billion, for inpatient services.
• $45.2 billion, for non-inpatient services.
• $69.3 billion, for pharmaceutical services.
• $146.6 billion, across all services.

As the Campaign puts it:

the total economic cost of overweight and obesity in the United States and Canada caused by medical costs, excess mortality and disability is approximately $300 billion per year. The portion of this total due to overweight is approximately $80 billion, and approximately $220 billion is due to obesity. The portion of the total in the United States is approximately 90 percent of the total for the United States and Canada.

I don’t know what to make of such estimates.  They are always based on assumptions that may or may not be valid. 

One thing is clear: obesity is expensive, personally, economically, and politically.

That’s why it’s a good idea to support public health initiatives to make it easier for people to maintain a healthy weight.

Providing healthier food in schools, getting junk food out of schools, soda taxes, soda caps, and restrictions on marketing to kids are the kinds of ideas that are worth supporting.  

Now. 

Daniel Green, a student at Cornell, asked whether I intended to write about Paul Ryan’s views on food politics.  He volunteered to put something together with his colleague, Dr. Margaret Yufera-Leitch.  Here are their thoughts:

Few Americans had heard of Paul Ryan (R-Wisconsin) until last week when he was announced as Presidential-hopeful Mitt Romney’s November running mate. A Janesville, Wisconsin native, former personal trainer and Oscar Mayer Weinermobile driver during his college days, Ryan is a strong advocate on the Hill for the P90x exercise routine and avoids eating fried foods and desserts (yes, even on the campaign trail).

But how do Mr. Ryan’s personal beliefs impact his voting on food politics related matters?

Obesity prevention

In the case of obesity, prevention has been shown repeatedly to be the best medicine. Of the $2.6 trillion spent on US health care in 2010, 95% went for disease treatment leaving only $421 per American per year for prevention—not even enough money for a 1-year gym membership in most states.

In an interview with Politico, Mr. Ryan admitted to maintaining 6-8% body fat with a healthy BMI of 21, admirable for any working professional. But Mr. Ryan, who has voted against every Affordable Care Act related bill, takes the stance that what you eat and what you weigh are both matters of personal responsibility. In 2005, he voted for H.R. 554 “The Personal Responsibility in Food Consumption Act” also known as the cheeseburger bill, which aimed to ‘prohibit weight gain-related or obesity-related lawsuits from being brought in federal or state courts against the food industry.’ The bill was passed by the House but failed to even go up for vote in the Senate. The legislation was featured in the 2004 Morgan Spurlock documentary Super Size Me, where Marion Nestle also made her on-screen debut.

According to a recent report by the Bipartisan Policy Center, by 2020 Obesity will cost America $4.6 trillion dollars annually and healthcare costs related to obesity will consume 19.8% of U.S. GDP. The sudden rise of obesity is a clear sign that, as a country, we have fostered an obesogenic environment that will require commitments from both the public and private sectors to reform.

Given that 70% of Americans are overweight and obese, we have collectively demonstrated that public service announcements alone have not yet resulted in the significant population-wide behavior changes needed to reverse obesity and more importantly alleviate a strained U.S. Health Care system.

SNAP Benefits

One of the most important programs available to lower income Americans is the Supplemental Nutritional Assistance Program (SNAP), commonly referred to as Food Stamps, which provides access to fresh foods for low-income families. Given that increased fruit and vegetable consumption are cornerstone habits of the Preventative Medicine conversation, why has Mr. Ryan argued to cut SNAP by $33 billion over the next ten years?

Affordable Care Act

Paul Ryan’s choices to repeal $6.2 trillion dollars of support from the Affordable Care Act and obesity-related provisions, demonstrates a lesser degree of support for preventative care than his widely publicized exercise regime suggests.  Perhaps with unemployment still high and unsure economy, America has bigger fish to fry than fixing the food system and reversing obesity but at least for now, Paul Ryan will take his fish broiled.

 Paul Ryan Food Politics Fact Sheet

References and source materials are available from the authors:

• Daniel Green studies Applied Nutrition and Psychology at Cornell University.  dpg64@cornell.edu. You can follow him on Twitter at www.Twitter.com/dgrreen.
• Margaret Yufera-Leitch received her PhD in experimental psychology with a focus in eating behavior from the University of Sussex. She is currently a visiting assistant professor at the University of Calgary.   dr.leitch@impulsive-eating.com.  Her website is www.impulsive-eating.com.

I am in Brazil at meetings of World Nutrition Rio 2012 but was deluged yesterday by links to a lengthy Reuters’ Special Report: How Washington went soft on childhood obesity.

In an e-mail, Reuters explains that its report is about how food and beverage companies dominate policymaking in Washington, doubled lobbying expenditures during the past three years, and defeated government proposals aimed at changing the nation’s diet.

• The White House, despite First Lady Michelle Obama’s child obesity campaign, kept silent as Congress killed a plan by four federal agencies to recommend reductions to sugar, salt and fat in food marketed to children.
• Corporate lobbying last year led Congress to declare pizza a vegetable to protect it from a nutritional overhaul in the school lunch program.
• The Center for Science in the Public Interest, widely regarded as the lead lobbying force for healthier food, spent about $70,000 lobbying– roughly what companies opposing stricter food guidelines spent every 13 hours.
• The food and beverage industry has a near-perfect record in political battle even while health authorities link unhealthy food to the child obesity epidemic.
• During the past two years, each of the 24 states and five cities that considered “soda taxes” has seen the efforts dropped or defeated.

Reuters Investigates also has a video about how the food industry fought back when the White House sought healthier school lunches and Congress directed federal agencies to set nutrition standards.

Readers of this blog may recall my post last December fretting about the White House pullback, and the vigorous denial the next day by White House senior food policy advisor Sam Kass.

I attributed White House caution to the upcoming election.  Reuters does too, apparently, and so does the New York Times. 

If the First Lady is to make real progress on Let’s Move, she needs all the support she can get.  This might be a good time to send a note to the White House strongly encouraging more vigorous action on methods to address childhood obesity.