Search results: soft drink tax

In what Bloomberg News terms an “epidemic battle,” food companies are doing everything they can to prevent the United Nations from issuing a statement that says anything about how food marketing promotes obesity and related chronic diseases.

The U.N. General Assembly meets in New York on September 19 and 20 to develop a global response to the obesity-related increase in non-communicable, chronic diseases (cancer, cardiovascular disease, respiratory disease, type 2 diabetes) now experienced by both rich and poor countries throughout the world.

As the Bloomberg account explains,

Company officials join political leaders and health groups to come up with a plan to reverse the rising tide of non- communicable diseases….On the table are proposals to fight obesity, cut tobacco and alcohol use and expand access to lifesaving drugs in an effort to tackle unhealthy diets and lifestyles that drive three of every five deaths worldwide. At stake for the makers of snacks, drinks, cigarettes and drugs is a market with combined sales of more than $2 trillion worldwide last year.

Commenting on the collaboration of food companies in this effort:

“It’s kind of like letting Dracula advise on blood bank security,” said Jorge Alday, associate director of policy with World Lung Foundation, which lobbies for tobacco control.

The lobbying, to understate the matter, is intense.  On one side are food corporations with a heavy financial stake in selling products in developing countries.  Derek Yach, for example, a senior executive of PepsiCo, argues in the British Medical Journal that it’s too simplistic to recommend nutritional changes to reduce chronic disease risk.  [Of course it is, but surely cutting down on fast food, junk food, and sodas ought to be a good first step?]

On the other side are public health advocates concerned about conflicts of interest in the World Health Organization.  So is the United Nations’ special rapporteur for  the right to food, Olivier De Schutter.  Mr. De Schutter writes that the “chance to crack down on bad diets must not be missed.”

On the basis of several investigative visits to developing countries,  De Schutter calls for “the adoption of a host of initiatives, such as taxing unhealthy products and regulating harmful food marketing practices…Voluntary guidelines are not enough. World leaders must not bow to industry pressure.”

If we are serious about tackling the rise of cancer and heart disease, we need to make ambitious, binding commitments to tackle one of the root causes – the food that we eat.

The World Health Organization’s (WHO) 2004 Global Strategy on Diet, Physical Activity and Health must be translated into concrete action: it is unacceptable that when lives are at stake, we go no further than soft, promotional measures that ultimately rely on consumer choice, without addressing the supply side of the food chain.

It is crucial for world leaders to counter food industry efforts to sell unbalanced processed products and ready-to-serve meals too rich in trans fats and saturated fats, salt and sugars. Food advertising is proven to have a strong impact on children, and must be strictly regulated in order to avoid the development of bad eating habits early in life.

A comprehensive strategy on combating bad diets should also address the farm policies which make some types of food more available than others…Currently, agricultural policies encourage the production of grains, rich in carbohydrates but relatively poor in micronutrients, at the expense of the production of fruits and vegetables.

We need to question how subsidies are targeted and improve access to markets for the most nutritious foods.…The public health consequences are dramatic, and they affect disproportionately those with the lowest incomes.

In 2004, the U.N. caved in to pressures from food companies and weakened its guidelines and recommendations.  The health situation is worse now and affects people in developing as well as industrialized countries.  Let’s hope the General Assembly puts health above politics this time.

My monthly (first-Sunday) Food Matters column in the San Francisco Chronicle continues the conversation about use of food stamps to buy sodas.

Food stamps should not be valid for soda purchases

Q: When I see people in grocery stores using food stamp benefits to buy sodas, I get upset. Why does the government allow this?

A: My quick answer is lobbying, but discomfort about whether welfare benefits should permit the poor to eat as badly as those who are better off dates back to the English Poor Laws of the 16th century.

New York City’s proposed pilot project banning the use of food stamps for buying sugary sodas is only the latest event in this long and complicated history.

Welfare policies have always been designed to give the poor just enough to keep them off the streets, but not enough to induce dependency. The tension between these goals has resulted in scanty benefits – and endless debates.

Today, the debit cards provided by SNAP (Supplemental Nutrition Assistance Program) can be used for all foods with these exceptions: alcoholic beverages, pet foods, nutrient supplements and on-site prepared foods.

New York’s proposal to add sodas to the “can’t buy” list is based on evidence linking sugary sodas to obesity, their lack of nutritional value, and estimates that SNAP recipients spend $75 million to $135 million in city benefits each year.

The proposed ban does not stop SNAP recipients from buying sodas. They just won’t be able to use SNAP benefits for them.

Soda companies strongly oppose this idea, of course, but so do many advocates for the poor. Advocates argue that the restrictions are insensitive and condescending in assuming that the poor are uniquely unable to make sensible dietary decisions.

The real problem, they correctly point out, is that low-income Americans – with or without SNAP benefits – cannot afford to buy healthy foods or do not have access to them.

As a result of such arguments, I have long been uncomfortable with the idea of the soda ban. But in recent months, I have come to support it. Here’s why:

Evidence is strong that sugary drinks predispose to obesity, and obesity rates are higher among low-income households. In New York City, for example, obesity and Type 2 diabetes are twice as prevalent among the poorest households compared with the wealthiest. Preliminary evidence suggests that sugars in liquid form may especially predispose to obesity.

Overall, soda companies have worked hard to create an environment in which drinking sugary beverages all day is normal. They lobby to introduce and retain vending machines in schools. As sales in the United States have declined, they increasingly market their products to people in developing countries.

They put millions of dollars to work fighting soda taxes and, no doubt, the proposed SNAP ban.

I’m impressed by the comparison of the SNAP approach, which allows benefits to be used for most foods, to that of the WIC (Women, Infants and Children) program. The USDA runs both programs. WIC, the most demonstrably nutritionally successful of all food assistance programs, allows benefits to be used only for a restricted number of nutrient-rich foods.

In 2010, SNAP benefits went to more than 40 million people at a total cost of more than $68 billion. We need to focus on finding ways to make healthful foods more affordable and accessible to low-income families – doubling the value of SNAP benefits when used for fruits and vegetables, for example, or promoting incentives to move grocery stores, and community gardens into inner-city areas.

Still, soft drink companies have had a free ride for decades.

I hope the USDA will approve New York’s proposed ban.

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.

As a commentary on my recent post on soft drink marketing, Jerry Gross Yisroel sends this photo, which he took a week or so ago in front of the emergency entrance to Beth Israel Medical Center, Brooklyn.

They do say that a picture is worth a thousand words….

The most thoughtful comments I’ve seen on the proposal to block food stamp recipients from buying sodas come from Andy Fisher’s post on Civil Eats.

Mr. Fisher is currently a Kellogg Food and Society Fellow with the Institute for Agriculture and Trade Policy in Minneapolis.  He is the Co-Founder/Executive Director of the Community Food Security Coalition (CFSC).

I have added the red-highlighted emphases:

Banning Soda for Food Stamps’ Recipients Raises Tough Questions

October 8th, 2010  By Andy Fisher

On Thursday, New York City Mayor Michael Bloomberg announced that he had asked the US Department of Agriculture to allow the city to exempt soda from the permitted list of items its 1.7 million food stamp recipients can purchase with their benefits. This ban would last for two years, enough time to assess its effects and determine whether the ban should be continued on a permanent basis. New York City food stamp recipients spend an estimated $75 million to $135 million of their $2.7 billion in food stamps annually on soda, according to AP.

Anti-hunger and public health advocates at odds over proposal

Public health advocates contend the obesity epidemic is costing the US hundreds of billions of dollars per year in increased health care costs, and sugar sweetened drinks are a major factor.   They correctly note that low income persons tend to have higher rates of diet related diseases than the general public: poor New Yorkers have twice the rate of adult-onset diabetes than compared to the wealthiest. Mayor Bloomberg noted, “Sugar-sweetened drinks are not worth the cost to our health, and government shouldn’t be promoting or subsidizing them.”

On the other hand, anti-hunger advocates argue that food stamp recipients should have the same freedom of choice at the supermarket checkout counter as any middle class person. Exercising that freedom is a matter of personal dignity that the poor all too often are not afforded. Restricting soda is the first step in a slippery slope toward further demeaning regulations on what food stamp recipients can buy.  They correctly point out that poor people often can’t afford produce, as nutritious foods tend to be more expensive per calorie than less healthy food.

The anti-hunger community is correct that historically, as a nation, we have treated the poor paternalistically. American social, educational and health policy is littered with countless examples of this failed approach. Regulating what food stamp recipients can and can’t buy with their benefits puts forth the message that they are not capable of making good decisions, and the government needs to set forth boundaries to protect them from their own poor choices. To the contrary, some studies have shown that food stamp recipients actually buy more nutritious food per dollar than non-food stamp recipients.

Anti-hunger advocates are also right that poor people typically can’t afford nutritious foods. Highly processed foods, such as ramen, fill up a belly more cheaply than broccoli and whole wheat pasta.  In our food system, high calorie foods with low nutritional value are cheaper than nutrient dense foods. For example, a 12 pack of 12 ounce cans of Coke (144 oz) at Kroger’s costs $2.79 on sale, while a half gallon (64 ounces) of Minute Maid orange juice (also a Coca Cola Inc. product) is $2.49. The bad choice is the cheap choice.

On the other hand, public health groups are dead-on accurate that it is irresponsible public policy to be subsidizing with tax dollars the purchase of unhealthy products that will burden society with increased health care costs in the future.  As a nation, we’re subsidizing soda companies $4 billion annually through the food stamp program. In return, decades later, the public will be stiffed with the hospital bill for billions of dollars more for extra health care costs from these poor dietary choices.

Thorny issue raises questions

Why are anti-hunger advocates in the absurdly precarious position of protecting the right of poor people to drink soda? Do I have a right as an American to poison myself with “soft” drinks that can dissolve the rust off a car? Does it matter whether I use my own money or tax dollars?  Should freedom of choice apply to products of marginal utility if not harmful products?

Why does it cost Coca-Cola more to produce a half-gallon of orange juice than a half gallon of Coke? How do we reverse this situation, such that healthful products are more affordable and unhealthy products are more costly?

Are food stamps an income support program- or as the program’s new name indicates, a Supplemental Nutrition Assistance Program? If it is a “supplemental nutrition” program, then shouldn’t USDA define which products are nutritious based on Institute of Medicine standards, and limit purchases to these products? USDA does this with the Women Infants and Children (WIC) program, which is widely touted for saving billions in health care costs.

If food stamps are an income support program, and anti-hunger advocates want to maximize poor people’s freedom of choice, then why shouldn’t food stamps be distributed as cash rather than as a debit card good for food purchases? Doesn’t receiving cash maximize a person’s dignity as it bestows trust upon that person that he or she will make the right choice with their money?  Would food stamps not then become a welfare program, and be subject to the negative public perception of welfare?

The real story behind food stamps is that it is neither a nutrition program nor an income support program. It is a massive subsidy for the food retailers, grocery manufacturers, and industrial growers. That is why commodity groups, the Grocery Manufacturers of America and the Food Marketing Institute all line up behind the food stamp program every five years when the Farm Bill is being debated. They know the extra buying power food stamps provides to low income Americans will end up in their pockets.

In their noble effort to reduce human suffering and to improve the livelihood of the 41 million Americans on food stamps, anti-hunger advocates are caught in an ever-tightening bind. They frame food stamps as a nutrition program, because a nutrition program has more public support and more powerful allies in Congress than a welfare or income support program. Yet, burgeoning rates of chronic diseases and the growing presence of the public health community as a player in federal food and farm policy, translates into increased accountability for the nutritional impact of the food stamp program.

What boat are both camps missing?

There is one very important point neither the anti-hunger nor the public health advocates are making. Our tax dollars, especially the $80-90 billion spent annually on federal food programs, are a powerful force in shaping the food system. Food stamps, like school meals and WIC, should be the cornerstone of a food system that is grounded in principles of environmental sustainability, social justice, and health. Directed toward the small farm economy, community-oriented retailers, brokers, and processors, even a modest percentage of these funds could ignite a transformation of our food system.

Consider this. While nationally food stamp recipients are spending $4 BILLION per year on soda, in 2009, only $4 MILLION of food stamps were redeemed at farmers markets. This difference is shaped by the fact that USDA has not equipped farmers markets with free debit card terminals (which are needed to accept food stamp benefits), and prohibited federal nutrition education programs to promote farmers markets. Does this mean the Department of Agriculture values soft drinks one thousand times more than farmers markets?

Mayor Bloomberg has proposed only half the solution. USDA should grant him the waiver he requests if and only if New York City agrees to redirect the $75-$135 million that would have otherwise been spent on soda to programs that encourage food stamp recipients to purchase locally grown foods at farmers markets, community supported agriculture farms, and other community-oriented venues.

New York City is serious about trying to reduce rates of obesity and the expensive and debilitating conditions for which obesity raises risks.  Its latest move?  It is asking the USDA for a Food Stamp waiver for two years during which recipients would not be allowed to use their benefit cards to buy sodas.

I hardly know where to begin on this one.  I learned about this from the front page of this morning’s New York Times and from reading the accompanying op-ed by city Health Commissioner Tom Farley and New York State Health Commissioner Richard Daines.

This is an old, old idea that has been consistently rejected by USDA and by public health advocates for the poor.  It is based on the commonly held notion—never conclusively demonstrated by independent data—that recipients of Food Stamps (now called SNAP, the Supplemental Nutrition Assistance Program)–make worse food choices than everyone else.

New York City, according to the Times account, has 1.7 million people who receive SNAP benefits.  The rationale for banning soda purchases?

City statistics released last month showed that nearly 40 percent of public-school children in kindergarten through eighth grade were overweight or obese, and that obesity rates were substantially higher in poor neighborhoods. City studies show that consumption of sugared beverages is consistently higher in those neighborhoods….Anticipating such criticism, Dr. Farley and Dr. Daines said that the food-stamp program already prohibited the use of benefits to buy cigarettes, beer, wine, liquor or prepared foods.

The op-ed points out:

Every year, tens of millions of federal dollars are spent on sweetened beverages in New York City through the food stamp program — far more than is spent on obesity prevention. This amounts to an enormous subsidy to the sweetened beverage industry.

I asked for data on soda purchases by New York City SNAP recipients, and was sent the city’s waiver request to USDA:

An estimated $75 to $135 million dollars of SNAP funds were spent on sweetened beverages in New York City (NYC) alone in 2009 [Based on Nielsen beverage market data for 2009, the prevalence of SNAP participants in NYC, and prior studies of SNAP purchasing behavior].   This use of federal funds to purchase a group of products that are leading contributors to the diabetes and obesity epidemics (and whose extensive consumption contradicts the USDA’s own recommended dietary guidelines) far outstrips current federal funding for prevention of these health problems.

I am, as readers of this blog well know, no fan of sodas.   If people want to do something about controlling body weight, the best place to begin is by cutting out sodas.  Soft drinks contain sugars and, therefore, calories, but nothing else.  As the Center for Science in the Public Interest has long maintained, sodas are liquid candy.   And I am on record as favoring soda taxes (see previous posts) as a strategy to discourage use, especially among young people.

But if I were in charge of Food Stamps, I would much prefer incentives: make the benefit worth twice as much when spent for fresh (or single-ingredient frozen) fruits and vegetables.

How far will the city get with this request?  I can’t wait to find out.  If you want to watch lobbying in action, keep an eye on this one, as I certainly will.

As for this proposal?

The New York Times Magazine has a long article this week about Plumpy’nut,  the peanut butter-based product designed to feed malnourished kids in emergency situations.  The product is made and patented by Nutriset, a French company.

You might think that a food product aimed at saving the lives of starving kids would be uncontroversial, but not when patents are involved.  Nutriset holds intellectual property rights to this product and defends them to the hilt.   The company extends its patent to line extensions of the product, as well.

Patents mean that people in developing countries who want to produce their own product based on local ingredients can’t do it.  It also means that anyone making the product has to follow the formula, even if ingredients are expensive and not locally available.

In September 2007, I wrote about Plumpy’nut, describing how peanut butter had become the basis of a “ready-to-use therapeutic food” (RUTF) for aiding recovery of severely malnourished children in Africa.

The study itself is published in Maternal and Child Nutrition and the authors make the point that people administering this RUTF do not need to be medically trained so this therapy can be used at home. I’m always amazed when researchers discover that feeding malnourished children helps them to recover. Peanut butter is highly concentrated in calories and the investigators mixed in some vitamins along with it, so I guess it can be considered a superfood.

Since then, much has been written about the controversy over this product, particularly about its formula, cost, and sustainability.

Its formula includes:

• Peanut Butter
• Dry Skim Milk
• Vegetable oil
• Powdered sugar
• Minerals & vitamins

It contains about 500 calories in a 92-gram foil package.

Of these calories, one-quarter to one-third are from the added sugar.  No wonder kids like it!

What about its cost? A recent article about local production of Plumpy’ nut in Niger illustrates this particular problem.

UNICEF pays US$60 to purchase and ship a box of 150 packets from the main producer and patent holder of Plumpy’nut, Nutriset, in France. It costs $65 in Niger. The difference adds up to an extra $15,000 for the 3,000 boxes purchased in Niamey every week.

“The luxury of having no production delays and not fully depending on an external provider is a price we are willing to pay,” UNICEF’s nutrition manager, Eric-Alain Ategbo, told IRIN. Ategbo said it took at least eight weeks for the nutritious peanut butter-like paste to arrive from France.

Here are some other cost concerns:

Electricity is expensive, taxes are high and money is expensive as interest rates are high. It would be cheaper if the products we use were bought locally, but they are not available.  Peanuts are the only ingredient from Niger. Others, such as milk, sugar and oil, are purchased internationally. We also have the obligation to buy specific products [such as micronutrients and packaging] from Nutriset in order to respect the formula.

As for its sustainability:

• Who is going to pay for these products?  And for how long?
• Does it make sense to promote a peanut-based product in countries that do not grow peanuts?
• Is it a good idea to give packaged, sweetened products to kids whose families cannot continue to provide such things once the crisis is over?
• Is it a good idea to give kids the idea that sweet things in packages are what they supposed to eat?
• Will products like this pave the way for other sweetened products in packages—soft drinks, for example?

These are all complicated issues.  Read the article and ponder.