Currently browsing posts about: Soft drinks

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.

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.

Concerns that highly caffeinated Monster Energy drinks might be responsible for the recent deaths of at least five young adults are, as I see it, a direct result of deregulation of food oversight.

Here’s my version of the history leading up to the present situation:

• In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), which in essence deregulated dietary supplements, permitted them to be labeled and regulated as supplements, not foods, and removed much of FDA’s authority over their contents and health claims.
• The dietary supplement industry, as I explain in Food Politics, wrote much of the key language of this law.
• When the FDA tried to enforce its food rules for supplements, the courts ruled in favor of manufacturers on First Amendment grounds.
• Because rules for supplements are less restrictive than those for foods, some manufacturers prefer labeling their products as supplements.
• Monster Energy drinks are labeled as supplements, removing them from much of FDA’s authority.

The results of DSHEA, in this case, are explained by the New York Times:

But while the F.D.A. regularly makes adverse event reports about drugs and medical devices publicly available, it does not do so for dietary supplements like energy drinks. Because of that policy, consumers had no way of knowing of the complaints about Monster Energy drinks before incident reports were released by the F.D.A. in response to a formal Freedom of Information Act request.

Also, while supplement makers have been required since late 2007 to alert the F.D.A. to possible product-related deaths and injuries, Monster Beverage submitted just one such report to the agency over the last four years, agency officials said.

Most likely because of their high caffeine content, sales of energy drinks are rising rapidly, as shown in this graphic from the Times:

Booming sales means booming profits, and the makers of energy drinks are under pressure to cash in.  That sometimes means cutting corners or not always matching contents to labels.

For example, a Consumer Reports investigation of the caffeine content of energy drinks identified some discrepancies.

Caffeine levels per serving ranged from about 6 milligrams to 242 milligrams per serving—and some containers have more than one serving. The highest level was in 5-hour Energy Extra Strength; the lowest in the seemingly oxymoronic 5-hour Energy Decaf…By comparison, an 8-ounce cup of coffee has about 100 milligrams; a 16-ounce Starbucks Grande, 330 milligrams.

Consumer Reports noted one other key point: the FDA considers caffeine as GRAS (Generally Recognized As Safe) and does not require amounts to be listed on labels.

A representative of the Monster Beverage Corporation explained that his company does not list caffeine levels “because there is no legal or commercial business requirement to do so, and also because our products are completely safe, and the actual numbers are not meaningful to most consumers.”

Consumer Reports points out that Monster drinks—like those of 16 other products—warn against use by children, pregnant or nursing women, and people sensitive to caffeine, and recommend a daily limit.

Whether the Monster Energy drinks are really responsible for the reported deaths will not be easy to establish.  One victim, age 14, is said to have consumed two 24-ounce Monster drinks containing 240 mg caffeine each within a day or two.

That energy drinks are labeled as supplements ties the FDA’s hands in dealing with such products.

Here are some suggestions to consider:

• Label energy drinks with standard Nutrition Facts panels.
• Require amounts of caffeine to be stated on the label.
• Limit the amount of caffeine that can be included in soft drinks.

Two Senators (Durban and Blumenthal)—not for the first time—are pushing the FDA to investigate.  Good idea.  I can only speculate about why the FDA isn’t responding, but I’m guessing that this issue, like so many others, is too controversial to take up during an election campaign.

Soon, please.

Last week’s New England Journal of Medicine weighs in with several commentaries and research articles.  Some of these were published earlier in online versions:

• Candy at the Cash Register — A Risk Factor for Obesity and Chronic Disease, D.A. Cohen and S.H. Babey | N Engl J Med 2012;367:1381-1383
• Portion Sizes and Beyond — Government’s Legal Authority to Regulate Food-Industry Practices, J.L. Pomeranz and K.D. Brownell | N Engl J Med 2012;367:1383-1385 | Published Online September 21, 2012
• Sugar-Sweetened Beverages and Genetic Risk of Obesity, Q. Qi and Others | N Engl J Med 2012;367:1387-1396 | Published Online September 21, 2012
• A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children, J.C. de Ruyter, M.R. Olthof, J.C. Seidell, and M.B. Katan | N Engl J Med 2012;367:1397-1406 | Published Online September 21, 2012
• A Randomized Trial of Sugar-Sweetened Beverages and Adolescent Body Weight, C.B. Ebbeling and Others | N Engl J Med 2012;367:1407-1416 | Published Online September 21, 2012
• Calories from Soft Drinks — Do They Matter? S. Caprio | N Engl J Med 2012;367:1462-1463 | Published Online September 21, 2012
• Regulation of Sugar-Sweetened Beverages,T. Farley, D.R. Just, and B. Wansink | N Engl J Med 2012;367:1464-1466 | Published Online September 21, 2012

And this week, it has another on using tax strategies to promote public health.

• Perspective: The Taxing Power and the Public’s Health, M.M. Mello and I.G. Cohen /October 17, 2012 | DOI: 10.1056/NEJMp1209648

It looks to me as though the health establishment is finally catching on to what obesity is really about and giving serious thought to what to do about it.  This is important work.

Mayor Bloomberg’s cap on soda sizes at 16 ounces has elicited a hard-hitting, Friday-afternoon (let’s hide it if we can), but otherwise well organized cease-and-desist lawsuit from the soft drink industry.

The suit, New York Statewide Coalition of Hispanic Chambers of Commerce et al. v. The New York City Department of Health and Mental Hygiene et al., is represented by Latham & Watkins, a law firm that often represents the American Beverage Association (ABA), the leading soft-drink trade group and one of the plaintiffs in this case.

Other plaintiffs are the Teamsters Local 812, the Korean-American Grocers Association of New York, the National Association of Theatre Owners of New York State, and—-no surprise—the National Restaurant Association.

These groups are all concerned that the soda cap might encourage people to reduce soda sales (its point, after all).  This would drive down profits for stores, concession stands in movie theaters, restaurants, and the people who distribute sugary beverages.

The basis of the suit includes these complaints [with my comments]:

• The Board of Health does not have the legal authority to cap soda sizes at 16 ounces (only the City Council does): “This case is not about obesity in New York City,” the plaintiffs wrote in the opening sentence of the suit. “This case is about the Board of Health, appointed by the mayor, bypassing the proper legislative process for governing the city.” [Legal experts think that cities do have the authority to regulate public health, witness smoking bans, helmet laws, and seatbelt requirements]
• The cap is a ban on personal freedom. [Nobody is stopping people from buying more soda if they want it]
• Most New Yorkers oppose the soda cap. [Perhaps because of the extraordinarily expensive campaign conducted by the soda industry]
• The cap is “arbitrary and capricious,” because it applies only to some businesses and targets only certain types of beverages: “Delis and hotdog stands are barred from selling a 20-ounce lemonade, but the 7-Eleven a few feet away remains free to sell Big Gulps.”  [The rule applies to all businesses over which the city has jurisdiction, so there is nothing arbitrary about it] 

This lawsuit is clearly about profits, not health.  Let’s hope the Court throws it out.

The first 14 of the documents are available in a zip file here (but only for the next week or so).

The latest disclosure figures show that Big Soda, in the guise of a community coalition, has spent $2.2 million to defeat the Richmond, CA soda tax initiative in November.

The pro-tax group report spending $25,293 so far.

This means Big Soda is outspending public health advocacy by 87 to 1—along with filing a successful lawsuit to keep from having to disclose its funding of the “community coalition.”

I can think of lots of good things Big Soda could do with that money in this community, none of them having to do with selling more soda.

David vs. Goliath on the November ballot?

Center for Science in the Public Interest (CSPI) has just launched its new drink-less-soda initiative, “The Real Bears” video, just in time for Food Day on October 24.

According to USA Today, CSPI teamed up with

Alex Bogusky, the culturally influential ad legend whose former agency, Crispin Porter + Bogusky, has created ads for such hot-button clients as Burger King, Domino’s and, yes, Coca-Cola.

Bogusky left the agency world in disgust two years ago. Now, he’s back in a new role: taking on the cola industry….

The video is, to say the least, hard hitting.  I’m waiting for soda industry responses and will post them here.  Stay tuned.