Several recent articles highlight concerns about food marketing to children.  Yesterday’s New York Times, for example, explained why obesity experts are increasingly concerned about advertising through new electronic media:

Like many marketers, General Mills and other food companies are rewriting the rules for reaching children in the Internet age. These companies, often selling sugar cereals and junk food, are using multimedia games, online quizzes and cellphone apps to build deep ties with young consumers. And children…are sharing their messages through e-mail and social networks, effectively acting as marketers.

…The sites can attract substantial audiences. HappyMeal.com and McWorld.com, sites from McDonald’s, received a total of 700,000 visitors in February, around half of whom were under 12, according to comScore, a market research firm. The firm says 549,000 people visited the Apple Jacks site from Kellogg’s, which offers games and promotes an iPhone application called “Race to the Bowl Rally.” General Mills’s Lucky Charms site, with virtual adventures starring Lucky the Leprechaun, had 227,000 visitors in February.

Advertising Age notes the use of cell phones, ipods, and ipads by younger and younger children:

Over half the parents in the survey say their children should be able to go online on their own by age 6, and by 5 should be able to play games on a cellphone or on a console or listen to a portable music player on their own.

And the Public Health Law Network explains takes up the question of parental responsibility vs. food industry responsibility.  It asks whether it is:

reasonable for food and beverage companies to spend hundreds of millions of dollars targeting children with marketing, mostly for obesogenic foods, placed literally everywhere and anywhere a child might eat, study, or play, and then demand that parents run interference against them?

Food companies think marketing to kids is plenty reasonable.

Here’s a situation in which some policy changes would be most helpful.  How about some restrictions on what food companies can do in order to make it easier for parents to manage what their kids eat?

Just a thought.  Happy weekend!

Among the many thoughtful comments on yesterday’s post is one from the Director of Oxfam America’s Private Sector Department, Chris Jochnick, who writes that I did not “quite capture the scope and intent of this project.”

As part of our work, Oxfam has a responsibility to engage with global corporations, through both collaboration and campaigns, in order to have constructive dialog on their business practices.

….Throughout the work, Oxfam has maintained complete independence including the ability to undertake advocacy against either company if the situation warranted. The Coca-Cola Company and Oxfam America shared the costs of the collaboration roughly in the proportion of 2:1, with The Coca-Cola Company contributing two-thirds of the costs (US $400,000) and Oxfam America contributing one-third of the costs in kind including staff time.

Unrelated to the study, The Coca-Cola Company made an earlier donation of $2,500,000 to Oxfam between 2008-2010 for humanitarian work in Sudan, with an emphasis on work related to water, sanitation and hygiene.

….Our independent voice keeps Oxfam’s approach to private sector collaborations dynamic and honest.

Let me add a bit more about what I think is wrong with this picture.

The goal of Coca-Cola is to sell more Coca-Cola.  The goal of Oxfam is to address world poverty.  I’m having trouble understanding how these goals could be mutually compatible.

Coke sales in the United States are flagging.  Last year, three quarters of Coke’s revenue derived from sales outside of North America in emerging economies where rates of obesity are increasing rapidly.

Sugary beverages like Coke are increasingly associated with obesity and its health consequences, problems now rampant in developing economies.

In the past year, Coke has embarked on an aggressive campaign of contributions to potentially critical groups such as the American Academy of Family Physicians, the Children’s Hospital of Philadelphia, Save the Children, and now Oxfam.

These groups are now highly unlikely to advise their constituents to cut down on sugary sodas.  If nothing else, sponsorship buys silence.

Oxfam may have done the work of its Poverty Footprint Report without company interference.  It is what is not in the report that is so much in Coke’s interest.

For just under $3 million, Coke has purchased an endorsement from Oxfam of its “anti-poverty” practices and silence on the role of sugary drinks in obesity.  This kind of public relations is well worth the price.

What does Oxfam get in this bargain?  The money, of course, but at the cost of serious questions about the credibility of its report and its independence.  Perhaps these are tolerable, but what about loss of respect?

I score this as a win for Coca-Cola.

I keep arguing that partnerships and alliances with food corporations put agriculture, food, nutrition, and public health advocacy groups in deep conflict of interest.

The latest example is Oxfam America’s partnership with Coca-Cola and bottler SAB Miller to evaluate the effectiveness of these corporations in reducing poverty (again, you can’t make these things up):

Despite the challenges involved, The Coca-Cola Company and SABMiller have each made ambitious and laudable commitments to labor rights, human rights, water, gender, and sustainability. However, there is little accountability to such commitments without the informed engagement of affected groups. By looking across all relevant issues (no cherry-picking) with an organization like Oxfam America and reporting out to stakeholders, these companies have opened themselves to heightened public scrutiny and hopefully increased accountability.

Hopefully, indeed.

The Oxfam Poverty Footprint Report describes the work Coca-Cola and SAB Miller are doing in Zambia and El Salvador to empower and promote sustainability.  It highlights Coca-Cola’s sustainability initiatives.

It does include some telling recommendations for follow-up.  For example:

• Engage sugar farmers and producers to improve safety and health of sugarcane harvesters.
• Investigate why independent truck drivers in Zambia work more than eight hours per day and discuss with drivers potential mechanisms to ensure safe driving.
• Ensure The Coca-Cola Company’s global Advertising and Marketing to Children Policies are being effectively and consistently implemented at a regional level.

You have to read between the lines to see what this report really says.

And what about health, obesity, or the shocking increase in childhood tooth decay that is occurring in Latin America these days as a result of the influx of sugary drinks?  Not a word.

Why is Oxfam America helping Coca-Cola to market its products in Latin America and Africa?  I can only guess that Coca-Cola’s grant to Oxfam must have been substantial.

And thanks to Kelly Moltzen for sending the links.

By this time, you must have heard about the study in Clinical Infectious Diseases sponsored by the Pew Charitable Trusts.  The study found nearly half of supermarket meat and poultry samples to be contaminated with Staphylococcus aureus. Half of the contaminated samples were resistant to multiple antibiotics.

Staph causes awful infections.  When I was a child, my mother had a Staph infection that kept her out of commission for what seemed like months in that pre-antibiotic era.  Antibiotics can keep Staph under control, but not if the Staph are antibiotic-resistant.   Staph resistant to multiple drugs are a clear-and-present danger.  No wonder this study got so much attention.

The study provides strong support for the idea that we ought to be reducing use of antibiotics as growth promoters in farm animals, an idea strongly supported by the CDC.

Even though 80% of U.S. antibiotic use is for farm animals, the meat industry strong opposes any proposal to change its practices.

The National Cattleman’s Beef Association responds by attacking the science:

Calling into question the safety of U.S. beef without conclusive scientific evidence is careless and misleads consumers. Pew Charitable Trusts, an agenda-driven organization on this issue, funded this study, which concludes that its extremely small sample size was ‘insufficient to accurately estimate prevalence rates’ and that ‘public health relevance of this finding is unclear.’ The study’s authors clearly call into question the validity of their own study. The bottom-line is U.S. beef is safe and is part of a healthy, well-balanced diet.

The American Meat Institute reassures the public that meat is safe.  After all, you are going to cook your meat, aren’t you?  In any case, the responsibility rests with you.

While the study claims that the many of the bacteria found were antibiotic resistant, it does note that they are not heat resistant.  These bacteria are destroyed through normal cooking procedures, which may account for the small percentage of foodborne illnesses linked to these bacteria.

As with any raw agricultural product, it is important to follow federal safe handling recommendations included on every meat and poultry package that urge consumers to wash hands and surfaces when handling raw meat and poultry and to separate raw from cooked foods to ensure that food is safe when served.

These sound like the arguments that the meat industry has made for years for Salmonella and E. coli O157:H7.

I see this study as another reason why we need better food safety regulation, and the sooner the better.

Postscript: Bill Marler reports that he had 100 samples of chicken tested from Seattle markets:

IEH Labs found S. aurea [sic], or staph, in 42 percent of the samples overall and Campylobacter in 65 percent. The supermarket chicken was contaminated with other pathogens as well: 19 percent of the samples tested positive for Salmonella, one tested positive for Listeria, and 10 percent showed the presence of the methicillin-resistant S. aureus (MRSA). In an unusual finding, one of the chicken samples tested positive for E. coli 0126, Shiga-toxin producing E. coli (STEC) bacteria more likely to be a contaminant of beef than poultry. Organic Chicken proved to be slightly less contaminated than nonorganic with 7 of the 13 (54%) testing positive for harmful bacteria.

As I said….

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.

This morning I received an e-mail query from Jan Poppendieck, author of three truly outstanding books that I often use in classes:

• Breadlines Knee Deep in Wheat: Food Assistance in the Great Depression
• Sweet Charity Emergency Food and the End of Entitlement
• Free for All: Fixing School Food in America

Q.  I am collecting opinions on the proposal to ban use of SNAP (food stamp) funds for buying sodas.  What do you think of that idea?

A.  I started out deeply uncomfortable with the idea of the soda ban but I now support it.   The discomfort came from my general discomfort with telling people what I think they should be eating. I never comment on what individuals eat (and I hope you won’t comment on what I eat). My work deals with nutrition for populations, not necessarily individuals. So banning sodas at first seemed to me to be too personal an approach.

But I changed my mind for several reasons:

• The increasingly strong evidence that sugary drinks predispose to obesity
• The disproportionately higher rates of obesity among the poor
• The suggestive evidence that sugars in liquid form are especially predisposing to obesity
• The comparison of the SNAP approach (the benefits can be used for most any food) with that of WIC (the benefits only work for a restricted number of foods)
• The focus of soda companies on marketing to children and youth in low-income areas
• The lack of grocery stores in low-income areas
• The intense marketing of sodas to children and youth in developing countries
• The increasingly successful efforts of soda companies to co-opt health professional groups with partnerships, alliances, and grants
• The astonishing amount of money and effort used by beverage companies and associations to fight soda taxes and, no doubt, this idea as well

Soft drink companies have gotten a free ride for years.  They moved into schools and created an environment that makes it socially acceptable for children to drink sodas all day long.  If sodas are now under scrutiny for their role in obesity, it is because soda companies are reaping what they have sown.

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.

It’s fun to watch lobbying in action, especially when it is so overt.  I’ve just been sent a copy of this “Dear Colleague” letter organized by the Corn Refiners’ Association.  The letter comes from two members of Congress.  It asks other members of Congress to write the FDA to change the name of High Fructose Corn Syrup to Corn Sugar.

From the Corn Refiners:

Dear [Member of Congress],

As your Member’s district has a strong interest in corn or corn sweetener, I am sending you this Dear Colleague letter for your consideration. Representatives Tom Latham and Daniel Lipinksi are circulating the letter, pasted below, for your boss’ consideration. The Corn Refiners Association, with support from the National Corn Growers Association has petitioned the FDA to allow use of the name ‘corn sugar’ as an alternative to High Fructose Corn Syrup on ingredient labels. This letter outlines our support for this petition.

From Representatives Tom Latham (Rep–Iowa) and Daniel Lipinski (Dem–Illinois):

Dear [FDA] Commissioner Margaret A. Hamburg,

We write to express our support for a petition to use “corn sugar” as an alternate name for high fructose corn syrup on ingredient labels that would help consumers avoid confusion about the foods they buy. We endorse prompt review and approval of petition FDA-2010-P-0491, which was submitted by the Corn Refiners Association.

The petition requests the term “corn sugar” be permitted as an optional name for high fructose corn syrup on ingredient labels to avoid customer misconceptions. Evidence suggests that current terminology encourages misunderstanding in the marketplace regarding the nutritional profile and composition of corn sweeteners, and the alternate name would help dispel some of the confusion. According to a recent nationwide MSR Group survey, around 70 percent of Americans surveyed could not correctly identify high fructose corn syrup when presented with the American Dietetic Association’s definition. The same research found that “corn sugar” is a better alternative because it gives consumers a more accurate understanding of the product’s fructose content, calories and sweetness.

The product used in most foods—including yogurts, baked goods, condiments, and salad dressings—actually has the lowest fructose content of any sweetener on the market. Despite this fact, MSR Group’s research showed that most Americans believe high fructose corn syrup to be higher in fructose than table sugar; misinformation perpetuated by the substance’s name.

High fructose corn syrup is made from corn grown here in the United States by a critical industry that provides Americans thousands of good jobs. Equally important, it enables American consumers greater choice and affordability at the grocery store. Unfortunately, significant misperceptions about this ingredient have circulated in the media, in large part due to its name.

The American Medical Association has indicated that sugar and high fructose corn syrup have similar compositions, while the American Dietetic Association has determined that these two sweeteners are nutritionally equivalent and indistinguishable to the human body. These facts are sometimes lost in the confusion surrounding the ingredient’s name, and we believe that allowing use of the alternate term, “corn sugar,” would allow consumers to make accurate decisions about added sugars in their diets.

We support expeditious review and approval of this petition.

If enough members of Congress write such letters, the FDA is likely to pay attention, no?