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….
I keep telling you. You can’t make this stuff up. Try these for food politics–in this case, soda politics–in action.
From the Philadelphia Inquirer blog (March 16):
In keeping with a controversial pledge to made last year to City Council as part of an effort to ward off Mayor Nutter’s steep tax on sugar-sweetened beverages, the soft-drink industry will donate $10 million to the Children’s Hospital of Philadelphia to fund research into and prevention of childhood obesity.
The three-year grant is funded by a new organization, the Foundation for a Healthy America, created by the American Beverage Association, the national trade group representing manufacturers and bottlers. The ABA was instrumental in lobbying Philadelphia City Council to reject Nutter’s proposal to tax sugary drinks at 2-cents per ounce as a way to cut consumption and raise money for the general fund.
In a press release Wednesday, CHOP insisted that it will “retain absolute clinical and research independence,” as the source of its funding for the research is likely to come under attack from those wary of the beverage industry’s influence. That includes funding for clinical studies to be submitted to peer-reviewed publications.
In a delicious irony, the latest review of this topic comes from the Atkins Center at Berkeley. Yes, the Atkins Diet Atkins, the one that promotes high-fat, low-carbohydrates, and has everything to gain from proving that sugars are bad for you.
With that duly noted, set the irony aside. The review was funded by independent agencies and organizations. Let’s take its results at face value.
The reviewers looked at five kinds of evidence: secular trends, mechanisms, observational studies, intervention trials and meta-analyses. All supported the idea that
The currently available evidence is extensive and consistently supports the hypothesis that sweetened beverage intake is a risk factor for the development of obesity and has made a substantive contribution to the obesity epidemic experienced in the USA in recent decades.
Sweetened beverages are an especially promising focus for efforts to prevent and reduce obesity for two reasons: (i) the evidence supporting the association between sweetened beverage intake and excess weight is stronger than for any other single type of food or beverage; and (ii) sweetened beverages provide no nutritional benefit other than energy and water.
Isn’t that nice of them? The apparently unironical slogan of the campaign : “Everything in moderation.”
Melanie Warner, writing on bNET, explains that the RWJ Foundation is usually scrupulously independent but that putting Pepsi’s PR piece into its document makes no sense.
A third of the way into the report, up pops a bizarre “personal perspective” from PepsiCo’s (PEP) CEO Indra Nooyi in which she details the many ways her company is working to make America healthier. “Helping consumers by building on our portfolio of wholesome and enjoyable foods is not just good business for PepsiCo -– it’s the right thing to do for people everywhere,” Nooyi chirps in a two-page soliloquy that reads like a press release and touts everything from Pepsi’s pledge to reduce the sodium in its products by 25% by 2015 to its reduced sugar drinks like Trop50 and G2. No other food company is mentioned, just Pepsi.
[This inclusion]…also ties into the ongoing debate about what role the food industry should play in helping Americans slim down. Are food companies trusted partners who are committed to fundamental changes, or is getting people to eat healthier versions of processed food really a whole lot of Titanic deck chairs?
As the research linking soft drinks to obesity gets stronger and stronger, it is no wonder that the Beverage Association is buying off city councils, and soft drink companies are eager to position themselves as helping to solve the problem of childhood obesity, not cause it.
Do these actions remind you of any other industry’s behavior? Cigarette companies, anyone?
Here is another one you can’t make up. An article in Pediatrics, entitled “Malnutrition and the role of the soft drink industry in improving child health in sub-Saharan Africa,” advocates for fortifying soft drinks with micronutrients (vitamins and minerals).
Oddly, it does this after explaining how consumption of soft drinks actually”perpetuates problems of undernutrition in children, pregnant women, and other vulnerable populations in the developing world.” Why? Because in “sub-Saharan Africa, for example, distribution of soft drinks and other beverages produced by soft drink companies is extensive, and consumption is high given the extensive poverty in this part of the world.”
The authors justifiably complain about how little attention has been paid to the ways in which soft drink companies perpetuate malnutrition.
But instead of suggesting public health measures to counter the well documented effects of soft drinks on rising rates of obesity or on tooth decay rates among children in developing countries, the authors want soft drink companies to add vitamins and minerals to the drinks.
The Bill Gates foundation recently partnered with Coca-Cola in Uganda to increase production and distribution of mango and passion fruit juice as a way to stimulate production of local mango and passion fruit juice and meet Coca-Cola’s demand for
increased fruit to stimulate sales; however, such a partnership should also ideally involve micronutrient fortification, because Coca-Cola estimates that this partnership will extend sales in coming years. The World Economic Forum recommends fortification of food and beverages by private companies as an approach to reduce malnutrition, to
boost a productive workforce, and to stimulate the global economy.
Translation: Coca-Cola’s economy.
Fortunately, colleagues in Brazil have written a letter in response: “Can the soft drink industry prevent child malnutrition? No way.”
What the impoverished populations of Africa, Asia and Latin America need, are the means with which to lead a decent life. These include secure local food systems and supplies, access to safe water and adequate sanitation, decently resourced primary health care services, ability to produce and prepare meals from immediate and local resources, universal primary education, and empowered mothers and other caretakers. Substantial reduction of child undernutrition can be achieved in a relatively short period of time with improved income distribution, population and community self-determination, and public investments in public goods such as education, health, social security, water supplies and sanitation.
What they do not need is more Coca-Cola.
Or, for that matter, Pepsi Cola, which tried the same ploy earlier this year (see previous post).
Sales of Coke and Pepsi are declining in the United States. What better way to protect sales than to foist these products on the poor populations of emerging economies.
We need to be exporting health, self-determination, and democracy, not sugary drinks.
For shame!
The Pop-Tarts store in Times Square (see yesterday’s post) is only the loudest example of innovative food marketing to come out recently. I’ve been collecting more subtle examples:
Using social media (and getting customers to pay for it): For 99 cents to I-tunes, you can buy an app that gives nutritional information for products at Jack-in-the-Box or at McDonald’s. As Mark Douglas of Culinate explains: “They want $0.99 to tell you what you probably already know… Watch Out!”
Co-opting health professionals: Michele Simon (author of Appetite for Profit) writes on AlterNet about how PepsiCo hires distinguished health professionals and experts to give a company that sells snack foods and soft drinks an aura of health and wellness.
Co-opting professional organizations: Lisa Young (the Portion Teller) points me to a Webinar on August 25 run by the industry-sponsored School Nutrition Foundation and the Milk Processor Education Program on what is surely an urgent issue for sellers of chocolate (sugar-added) milk: “Keep flavored milk from dropping out of school!”
Deflecting attention from diet: Lisa sends another Webinar notice for September 14, this one for “skills & tools to enhance change in physical activity behavior.” Its sponsor?
The Coca-Cola Company’s Beverage Institute For Health & Wellness is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR) – provider number BF001.
Plain, old-fashioned lobbying: Food Safety News has a nifty report on food company lobbying expenditures (huge), mainly on the food safety bill but also on many other bills that might affect labeling or sales of food products.
I reviewed these methods in my book, Food Politics. A revised edition came out in 2007. Not much change, alas.
Addition: Attracting school kids: Michele Simon sends this Pepsi partnership with Hy-Vee stores in Iowa. Parents buy five Pepsi products; Pepsi buys backpacks for their kids.
I went to the reception last week for Diet Coke’s red dress event,:
Diet Coke and the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health have joined forces to raise awareness about women’s risk of heart disease — in support of NHLBI’s The Heart Truth campaign — with a multi-faceted program that will reach consumers across the nation.
To celebrate American Heart Month in February, Diet Coke’s Red Dress Program will take center stage at high-profile events, including sponsorship of The Heart Truth’s, Red Dress Collection fashion show at Fashion Week 2008. Diet Coke will also unveil new packaging and programs featuring The Heart Truth and Red Dress logos and messages on heart health.
The Center for Science in the Public Interest points out that Coca-Cola, whose products are not exactly heart healthy, is a strange partner for the NHLBI. The agency should reconsider. It wrote NHLBI to say so.
New York Times reporter Tara Parker-Pope asks: “Should Coke talk about heart health?”
I don’t know how long Diet Coke and NHLBI have been engaged in this partnership but it is surely more than five years. From NHLBI’s point of view, the partnership publicizes the risk of heart disease to women. For Coca-Cola, the benefits are obvious.
Are such partnerships a benign win-win? History suggests otherwise. In 1984, Kellogg cooked up a partnership with the National Cancer Institute to put health claims for fiber on the boxes of All-Bran cereals (I discuss this incident in Food Politics). In doing so, Kellogg (and NCI) went around the FDA and undermined that agency’s control over health claims on food packages. This let to the current mess over health claims, which the FDA is now trying to clean up.
Update March 3: The Public Health Advocacy Institute at Northeastern University has filed a petition to NHLBI to give up the partnership.
I received this note yesterday from Michael Jacobson, director of the Center for Science in the Public Interest, about his latest column in The Huffington Post:
How would you feel if you had to pay $8.50 a gallon for gasoline?
Then why on Earth would you pay that much for water and high-fructose corn syrup?
That’s how much Coke costs in those new 7.5-ounce, 90-calorie cans. Calorie-counters may appreciate the small size (90 calories) but dollar-counters beware: We did a little math and it turns out that Coke in the new can costs between 50- and 140-percent more than Coke in the old 12-ounce cans. Basically, Coke is charging two or three cents more per ounce for Coke in a smaller can—and this from a company that throws temper tantrums when lawmakers propose a one-cent-per-ounce tax on soda!
I once asked a group of retailing executives why the cost of smaller size containers was so high (surely the containers don’t cost that much. They said: “if customers want smaller portions they ought to be willing to pay for them.” Oh.
I greatly admire the work of Jared Diamond. His book, Guns, Germs, and Steel: The Fate of Human Societies, is as clear an explanation as you will ever get of how the inequitable distribution of favorable geography, climate, and natural resources affects the development and maintenance of human societies.
But here he is, incredibly, in the Sunday New York Times writing a fan letter to corporate social responsibility for protecting those favorable environments. He writes:
There is a widespread view, particularly among environmentalists and liberals, that big businesses are environmentally destructive, greedy, evil and driven by short-term profits. I know — because I used to share that view. But today I have more nuanced feelings…I’ve discovered that while some businesses are indeed as destructive as many suspect, others are among the world’s strongest positive forces for environmental sustainability.
And which corporations does he include as “strongest positive forces?” Chevron, Walmart, and Coca-Cola. I’ll leave discussion of Chevron and Walmart to others, but Coca-Cola?
Coca-Cola, Diamond says, is protecting the world’s water supplies. The company needs clean water in the 200 countries in which it operates. This, says Diamond:
compels it to be deeply concerned with problems of water scarcity, energy, climate change and agriculture. One company goal is to make its plants water-neutral, returning to the environment water in quantities equal to the amount used in beverages and their production. Another goal is to work on the conservation of seven of the world’s river basins, including the Rio Grande, Yangtze, Mekong and Danube — all of them sites of major environmental concerns besides supplying water for Coca-Cola. These long-term goals are in addition to Coca-Cola’s short-term cost-saving environmental practices, like recycling plastic bottles, replacing petroleum-based plastic in bottles with organic material, reducing energy consumption and increasing sales volume while decreasing water use.
Please note the future tense. These are things Coke says it plans to do. As for what the company is doing now, Diamond does not say. His piece does not mention Coke’s negotiating with officials in developing countries to buy water at rates significantly below those charged to local communities, a topic under much discussion when I was in India last year. It does not mention campaigns in India to hold Coke accountable for its abuse of local water rights or any of the similar campaigns in other countries.
Diamond’s piece does not talk about the efforts Coke puts into selling bottled water at the expense of local water supplies. As described by Elizabeth Royte in her book, Bottlemania, companies like Coke exhibit every one of of the characteristics formerly deplored by Diamond in attempting to secure plentiful and reliable sources of cheap local water: in his words, “environmentally destructive, greedy, evil and driven by short-term profits.”
Diamond says he sits along side and has gotten to know and appreciate the motives of many corporate executives. Me too. Personally, many of them mean well and wish that they could do more to be socially responsible. But they work for businesses that are required, by law, to make short-term profit their reason for existence. This means that corporate social responsibility is necessarily limited to actions that bring visible – and immediate – returns on investment.
We need some critical thinking here. If Diamond gave any thought at all to what Coca-Cola produces – bottled water and sodas – he would surely have to agree that less of both would be good for our own health and that of the planet.
Yesterday, 20 family physicians in Contra Costa County, California, ripped up their membership cards in the American Academy of Family Physicians in protest over the AAFP’s partnership with Coca-Cola.
The director of the Contra Costa Department of Health Services, Dr. William Walker, announced that he was resigning his 25-year membership in AAFP. In his statement, Dr. Walker said:
…I am appalled and ashamed of this partnership between Coca-Cola and the American Academy of Family Physicians. How can any organization that claims to promote public health join forces with a company that promotes products that put our children at risk for obesity, heart disease and early death.
…The AAFP is supposed to be an organization that works to protect the health of children not put them at risk. Their decision to take soda money is all the more unconscionable because, unlike doctors in the 40s, they well know the negative health impact of soda. There is no shortage of documentation that soda is a major contributor to our nation’s obesity epidemic.
…Let me be clear about something: as disappointed as I am with the American Academy of Family Physicians for being duped into thinking that Coca Cola wants to help promote health, the real problem here is our children are being put at risk.
Companies like Coca Cola are polluting our communities with deceptive advertising promoting products that put our children’s health at risk.
…as a family practice doctor and the Health Officer for Contra Costa, I do have a prescription for every parent, teacher, community leader and student:
Look beyond the glitzy advertising that makes you think pouring liquid containing sugar into your body is healthy. Read the label. Look at the ingredients. I’m not suggesting that you boycott sugared drinks, but please make an informed decision about what you are consuming.
I’m calling on every city and neighborhood in our County to fight back against the industry that pushes these harmful products. I ask the American Academy of Family Physicians to end this unhealthy partnership and to join us in leading this important campaign to take back the health of our residents and end the obesity epidemic.
Strong words, indeed. I hope that the AAFP – and other health and nutrition organizations that might consider food industry partnerships – pay close attention to these words.
* The event was covered in the Contra Costa Times. The Health Department’s website includes the press release and also a video and podcast.
Addendum:
Dr. Wendel Brunner, PhD, MD, Director of Public Health in the Contra Costa Department of Health Services has given me permission to post excerpts from his letter to a representative of the California Association of Family Physicians who had asked for more information about the protest:
“The epidemic of obesity is the greatest public health and clinical medicine issue of our time, and will lead to untold disease, shortened life spans, and medical cost. That epidemic took off rapidly in the 80’s. While genes and personal choices do have an impact on obesity, only profound environmental changes could lead to such a rapid development of the epidemic, and it will only be stopped by policy development and environmental and norm change. We need to create an environment that supports people in making good choices for themselves and their families.
One of the best choices families can make is to pretty much eliminate sweetened beverages. And the soda industry doesn’t want that to happen, so they are looking for credible groups who will say that drinking soda is OK for your health. But you know all that already, which makes this even more frustrating.
I am an old county doctor, but I still believe that physicians have a responsibility to advocate for their patients and fight to protect their health, and to first of all, do no harm. I am truly gratified to see that our younger physicians in Contra Costa have those same values too. The responsibility of a physician to their patient is a sacred trust; physicians should never sell out their patients’ health and well-being for a price, not even one “in the mid six figures”.
The AAFP needs to change their policy and thereby begin to redeem themselves. In the process, they would educate the country and do something valuable for the nations health, as well as for their own integrity. If they do not, they will continue an unfortunately long and sordid tradition of professionals and their organizations forgetting their purpose and their ethics and putting their narrow organizational financial interest above the interest of the public that they serve. Resigning membership seems to be the most effective way for physicians to provide a wake-up call to the AAFP, and at this point is the best thing a physician could do to benefit the organization.We anticipate that there will be more resignations as this story develops.
Everything cannot be blamed on the environment or peer pressures or economic factors; patients do have a personal responsibility to make good choices for their health and the health of their families. But physicians have the personal responsibility to make good choices too, and so do the professionals who work for them.
The AAFP and the individuals in it made a bad choice. They now have the responsibility to fix it.”
