Currently browsing posts about: Obesity

Food politics makes strange bedfellows.

The Associated Press reports that an organization of retired military personnel, Mission Readiness, is upset about obesity.  American youth, it says, are  Too Fat to Fight. Obesity may be a threat to personal health, but this group sees the problem as a threat to national security (see note below).

Here’s the irony.  The exact opposite was true in World War II.  Then, the army had trouble finding recruits who were not undernourished.

How did we go from lean to fat?  TV food commercials, for one thing, says Jane Brody in a review of recent studies.   Kids eat what they see.  The Rudd Center at Yale has even more recent data on the number of commercials watched by young children.

The Federal Trade Commission (FTC) is responsible for regulating advertising.  It has been making noises lately about taking on food marketing to kids.  I’ve heard rumors that the FTC is ready to release a report on the topic but food marketer’ complaints are holding it up.  Many marketers (not just of food) are worried that the FTC might move to restrict Internet marketing.

This might be a good time to ask the FTC what it is doing about food marketing to kids.

Note: Thanks to Bob Bannister for reminding me of George Saunders’ Shouts & Murmurs piece on this topic in the New Yorker.

Addition, April 22: The rumors about food industry pressures on the FTC turn out to be true.  Margo Wootan of CSPI reports on a meeting today with representatives of the FTC:

A number of members of the Food Marketing Workgroup met with FTC Chairman Jon Leibowitz today and delivered the letter [urging the FTC to publish standards for marketing to children]. It was a good meeting.They said that the standards are not in jeopardy and should be out in the near future. All the industry opposition has caused the agencies to go through a more thorough (i.e., slow) clearance process.

If you can’t block action, you can always delay it as long as possible.

In the latest issue of the American Journal of Public Health, Derek Yach and his colleagues at PepsiCo in Purchase, NY, say yes, it can, in answer to the question they pose in their article, “Can the food industry help tackle the growing global burden of undernutrition?”

If we are to successfully combat global undernutrition, efforts must be sustained by multiple stakeholders from various sectors. We believe that trust is built through industry’s demonstration of practical actions that improve health, and recognition of these actions by governments and nongovernmental organizations. Only through new and innovative public–private sector partnerships can we truly make a difference.

Three international public health leaders counter with no, it can’t, in an article entitled “The snack attack.”  They point to irreconcilable differences between the the goals of private industry and public health:

The problem lies with food, drink, and associated companies whose profits depend on products that damage public health and that also have damaging social, economic, and environmental impacts. These most of all include transnational companies, of which PepsiCo is one. To succeed, big business must sustain and increase annual turnover, profit, and share price…We suggest that public health professionals see papers such as those of Yach et al. as part of the marketing strategies of transnational food and drink companies…The privatization of public health does not work.

This argument reminds me of the editorial that David Ludwig and I wrote for JAMA late in 2008: “Can the food industry play a constructive role in the obesity epidemic?”  We concluded:

With respect to obesity, the food industry has acted at times constructively, at times outrageously. But inferences from any one action miss a fundamental point: in a market-driven economy, industry tends to act opportunistically in the interests of maximizing profit. Problems arise when society fails to perceive this situation accurately.

While visionary CEOs and enlightened food company cultures may exist, society cannot depend on them to address obesity voluntarily, any more than it can base national strategies to reduce highway fatalities and global warming solely on the goodwill of the automobile industry. Rather, appropriate checks and balances are needed to align the financial interests of the food industry with the goals of public health.

PepsiCo owns Pepsi Cola, of course, but also Gatorade, Frito-Lay snacks, and Aquafina water, among many other brands.  According to Advertising Age (June 22, 2009), PepsiCo earned $43 billion in worldwide sales in 2008. Its product-specific advertising expenditures in 2008, just for “measured media” (meaning run through advertising agencies) were, for example:

• $162 million for Gatorade
• $145 million for Pepsi Cola
• $27 million for Tostitos
• $14 million for Doritos
• $11 million for Fritos.

These figures, staggering as they may be, do not include the amounts Pepsi spends on lobbying, supporting the American Beverage Association’s efforts to fight soda taxes, funding medical research at Yale, or marketing to children and adults in India and other developing countries, as previously discussed on this site.

Is corporate “social responsibility” really responsible?  Or is it just marketing?  And what should be the checks and balances?  You decide.

Added April 17: This comes from a former employee of PepsiCo who asks that I post this anonymously:

I think you probably know that the “marketing dollars,” the share (ads/direct marketing), of companies like Pepsico are only a fraction of what are their actually marketing/promotions budgets.  Many years ago, PepsiCo made a conscious effort to redefine/shift budgets to what is called promotional spending from traditional marketing spending.  In doing so though, they keep the control and allocation of the funds in the hands of the marketing teams.

For Pepsi I know that the $145 million you mention is probably only 25% of what Pepsi “internally” considers consumer marketing spending.  For example, direct to retails “incentive” bonus funds are given for moving volume — those funds are almost entirely funneled into the retails increasing consumer marketing to their direct customers.  There are even examples where they can hide 10’s of millions of dollars at a time by linking event sponsorships (stadiums, etc.) to retailer agreements, thus moving those dollars to long-term “capital expenditures.”  I would guess that for Pepsi alone that that $145 million could be as much as a billion a year for direct and indirect consumer marketing spending.

It is not just obscene how much gets spent to increase volume… since, for companies like PepsiCo, Coke, etc.  Volume is the only way they generate higher profit to their shareholders.  As you say, to expect a corporation to do things for the good of the consumer just shows a misunderstanding of their primary function when they are a for-profit entity.

If you are wondering why the idea of soda taxes causes so much controversy, try this: research published in the Archives of Internal Medicine estimates that a $1.00 price increase on soda and pizza would reduce daily calorie consumption by nearly 200 per day and would help people lose weight.

Or, as USA Today puts it, an 18% increase in the price of soda would be associated with a weight loss of 5 pounds per year.

I recently received this request from Daniel posted to Feedback:

Would you mind writing a blog post on the new surgeon general’s obesity report? …Is there a food politic element to why this has gone under the radar? …I find it ironic that Michael Pollan’s Food Rules generated substantially more press than a report by the United States Surgeon General.

I’m not surprised.  Pollan’s book is a hot best seller (it’s #1 on Amazon books, and for good reason, in my opinion).   The need to prevent obesity and how to do it is not exactly front-page news.  And the new Surgeon General, Dr. Regina Benjamin, is still relatively unknown as a political force.

But let’s give Dr. Benjamin credit for taking on obesity in one of her first public actions: the release of “Vision for a Healthy and Fit Nation.”   The Vision, which comes with a press release and a fact sheet, recommends these actions to prevent obesity:

1. Reduce consumption of sodas and juices with added sugars.
2. Reduce consumption of energy dense foods that primarily contain added sugars or solid fats.
3. Eat more fruits, vegetables, whole grains, and lean proteins.
4. Control your portions.
5. Drink more water.
6. Choose low-fat or non-fat dairy products.
7. Limit television viewing time and consider keeping televisions out of children’s rooms.
8. Become more physically active throughout the day.
9. Breastfeed exclusively to 6 months.

These are all useful suggestions but we have heard them before.  The real issue is how to achieve them.  Here, the report disappoints.

The first two items should have grabbed attention: targeting soda reduction as as the first line of defense against obesity, and eating less junk food (my translation) as the second.

But Dr. Benjamin assigns parents the responsibility for feeding kids healthfully.  Fine, but what about about public health approaches to reducing soda consumption?  To pick a non-random example, soda  taxes are under intense debate right now.  Does Dr. Benjamin weigh in on such approaches?  Alas, no.  Only on the second-to-last page does she summarize suggestions from the Centers for Disease Control and Promotion (CDC), among them:

• Increase availability of healthy, affordable food and beverage choices in public service venues.
• Improve geographic availability of supermarkets in underserved areas.
• Improve access to fresh fruits and vegetables by providing incentives for the production, distribution, and procurement of foods from local farms.
• Limit advertisements of less-healthy foods and beverages.

I wish the report had focused on such ideas, instead of leaving them to an afterthought and personal responsibility. It’s great that the nation’s doctor cares about obesity but her Vision isn’t nearly as tough or realistic as it needs to be.  For that, we need the CDC or the report on food marketing to kids that the Institute of Medicine produced in 2005.

In 2001, Surgeon General David Satcher released the first government report on preventing obesity.  It got press. If this one didn’t, it could well be because it doesn’t break enough new ground.  Surely, it’s high time we got beyond blaming parents and instead started focusing on the need to create a food environment that makes it easier for parents and everyone else to make better food choices and be more active.

I hear that Michelle Obama will soon announce (tomorrow?) a new program to address childhood obesity.  I’m hoping that her program will take on some of the factors in the food environment that make it so difficult for everyone to eat healthfully.

Recent news reports encouraged me to take a quick look at the January 2010 American Journal of Clinical Nutrition where investigators have attempted to identify the proportion of human obesity accounted for by genetic variation.  Their conclusion: probably no more than 1% (we used to think it was 5%).  I don’t know why anyone would be surprised.  Obesity rates rose sharply in the early 1980s, with no possibility for so rapid a change in the genetic composition of the population.

I don’t think we need complicated genetic explanations for obesity.  We have so much evidence that people started consuming more calories at about that time and are continuing to do so.  Why more calories?  Portion sizes got bigger, and – hard as it may be to believe – larger portions have more calories!

In a commentary on the study, Claude Bouchard puts it this way:

The obesity epidemic we are facing today unfolded over the past few decades and can clearly not be explained by changes in the frequency of risk alleles. It is more likely due to a changing social and physical environment that encourages consumption and discourages expenditure of energy, behaviors that are poorly compatible with the genome that we have inherited.

Hence: eat less, move more!  And have an active weekend!

The research demonstrating the not-so-great effects of sodas just pours in, as it were.  The Robert Wood Johnson Foundation has two new research reports, one on justification for taxation of soft drinks, and the other on the negative effects of soft drinks on kids’ health.

David Ludwig writes in JAMA that artificially sweetened drinks are unlikely to help the situation.  They just make people want sweeter foods.

And the New York City Health Department has put its anti-soda campaign online.   This is its controversial “drinking fat” campaign designed to make the point that excess calories from sugary soft drinks will put on the pounds.  Why controversial?  Take a look at the cute guy demonstrating the drinking-fat point on the YouTube video.

What’s your take on this?

It’s post-Thanksgiving so I suppose I must say something about overeating.  Fad diets contribute to obesity, says the president of the British Society of Gastroenterology.  He singles out Atkins, Raw, Hallelujah (fruits and seeds mentioned in the Book of Genesis), and Grapefruit diets for particular scorn.  Why?  He doesn’t say.  His otherwise sensible conclusion: “The problem facing society is not the content of our diet but it’s the quantity we are consuming and the consequential impact of obesity.”

Ah yes, quantity.  Probably best not to mention it this week.  Enjoy the weekend!

I don’t usually take estimates of the cost of bad diets and obesity too seriously because they are necessarily based on multiple assumptions, none of them verifiable.  But I do like to collect them.  Here are two papers from the American Journal of Health Promotion estimating such costs.  One estimates the health benefits and savings in medical costs from diets reduced in saturated fat, sodium, and calories (a savings of $60-120 billion), and the other estimates cost savings and productivity increases for reduction in calories and sodium ($109-256 billion).  Whatever the real savings are, they are likely to be enormous.  And that’s just money.  It’s harder to put a value on quality of life.  Maybe that’s all we need to know at this point.

Yale’s Rudd Center for Food Policy has invented a Revenue Calculator for Soft Drink Taxes for estimating the amounts of money states and cities could raise from taxes on soft drinks.  You type in the state or city, estimate the size of the tax, decide what kinds of drinks it’s for, and push the  button.  Bingo.  California could raise about $1.8 billion a year from a 1 cent tax.

And the Department of Health and Human Service has hooked up with the Advertising Council for a new kids’ activity campaign on the Internet, this one using Maurice Sendak’s Wild Things tied in to a movie coming out in October.  I wasn’t so happy about the last such campaign, which featured Shrek and is still up on the site.  Shrek also advertises junk foods.  Maybe this one will work better?