Category Archives: Food & Beverage

As the US moves to limit consumption of sweetened beverages, producers focus on overseas markets and alternative product sales

Following recent efforts to address obesity by banning transfats and proposing a moratorium on the opening of new fast food restaurants, in late December of 2007 San Francisco Mayor Gavin Newsom proposed a tax on soda. The sweetened beverage fee would be applied to big box retailers who sell sweetened soda and other beverages; “Mom and Pop” stores would be exempt.

Newsom proposed the measure, which will be voted on by the Board of Supervisors early this year, as a means by which to address rising obesity rates and the attendant rising health care costs. Though the surcharge on sweetened beverages has yet to be defined, proceeds from the tax will support Newsom’s “Shape Up SF,” a program designed to encourage San Francisco residents to exercise.

Though the Mayor’s office argued that there was a well developed linkbetween obesity and the consumption of high-fructose corn syrup—a corn-based sweetener preferred over table sugar by the beverage industry because of its lower cost in production. Most researchers agree that carbonated sweetened beverages have played an important role in rising rates of obesity in the United States and elsewhere. Malik et al (2006) found evidence for this relationship in their meta-analysis of 30 publications. They state: “The weight of epidemiologic and experimental evidence indicates that a greater consumption of SSBs [sugar sweetened beverages] is associated with weight gain and obesity. Although more research is needed, sufficient evidence exists for public health strategies to discourage consumption of sugary drinks as part of a healthy lifestyle.”

Despite this emerging scientific consensus, the American Beverage Association (ABA), the trade association for the non-alcoholic beverage industry, argued that taxing soda would be ineffective given the complexity and multifaceted nature of obesity. An ABA press release stated: “It makes no sense to single out one food or beverage product to address an issue created by a lack of balance between calories consumed and calories burned. It would be just as silly to tax all the high-tech companies in San Francisco and blame them for contributing to childhood obesity through their video games, computer games and Internet search engines…This idea for taxing retailers sounds more like a thinly veiled attempt to raise revenues for more city spending than a sincere effort to reduce childhood obesity.” Others criticized the Mayor of behaving in a “Nanny State” manner, a charge that has been applied to other advocates of taxes on obesic foods and beverages.

In response to proposals such as Newsom’s, the beverage industry continues to fall back on the food industry’s stock line that obesity is caused by an imbalance of calories in and out and that all foods and beverages can have a place in a well-balanced diet accompanied by an active lifestyle. Yet according to an unreleased draft report by the San Francisco Department of Public Health, sweetened beverage consumption is the leading source of added sugar in children’s diets accounting for more than 10% of the total daily caloric intake for an average child. In addition, the consumption of sweetened beverages is more strongly associated with pediatric obesity than is high fat content or decreased physical activity.

While the industry publicly rejects any particular association between sweetened beverages and obesity, it is clear that beverage makers are concerned. In the spring of 2007, Coca Cola Company Chief Creative Officer Esther Lee described obesity as an “Achilles heel” and something that works against beverage makers’ marketing strategies. Although Americans spent$105 billion on “refreshment beverages” in 2007, US sales of soda are decreasing. During 2005, the number of cases of soda sold in the US declined by .07 percent. In April of 2007, Coca Cola first quarter profits report indicated that unit case volume had declined by 3 percent.

In response to declining sales and changing markets, Big Soda is shifting its marketing and distribution practices in two ways. First, the industry is promoting the sale of alternative beverages such as “enhanced” waters, juices and energy drinks. Sales of these products more than tripled in one year, from $80 million in 2001 to $245 million in 2002 and have continued to grow since. Odwalla juices and Glaceau Vitamin Water, (owned by Coca-Cola), SoBe’s Synergy Drinks, (owned by PepsiCo) and Snapple Juices (owned by Cadbury Schweppes) have become increasingly popular as Americans seek to substitute what they perceive as more healthful drinks for soda. However, critics such as Dump Soda, a global campaign whose goals include reducing soda consumption and eliminating the marketing of sweetened beverages to youth under 16, have illustrated that these “alternative” beverages are often just as sugar and calorie-laden as the soft drinks they seek to replace.

Second, as beverage makers promote “healthful” products in the US, they have refocused the marketing and sale of their traditional, sweetened soft drinks on the global south to maintain sales. According to Dump Soda, Coca-Cola has tremendously increased spending on non-US media, rising to $1,176 billion in 2000 from $500 million in 1994. Sales of Coke and Pepsi have also risen dramatically. In 2005, sales of Coca-Cola increased eleven percent in North Asia, Eurasia and the Middle East, case volume grew by seven percent in Latin America, and by four percent in Africa. In 2006, Pepsi’s international volume growth was up 9%.

With increasing sales comes increasing consumption, raising concerns about the spread of Western-style diet and disease in the global south. By linking local efforts such as those of San Francisco Mayor Newsom to tax high sugar beverages to global campaigns such as Dump Soda, public health advocates can ensure that a move toward a healthier US does not come at the expense of the global south.

Campaign Profile: The Public Health Advocacy Institute

Are the lessons learned in the legal and advocacy fights against Big Tobacco relevant to changing the practices of the food industry that contribute to obesity? What are the benefits and limitations of litigation against producers of unhealthy foods? On what legal grounds is the food industry most vulnerable to challenge? These are the questions that staff of the Public Health Advocacy Institute (PHAI), a legal “think-and-do” tank, seek to answer.

Forged in the legal battles against Big Tobacco, PHAI was originally founded in 1979 as a Massachusetts-based public health organization which became the Tobacco Control Resource Center (TCRC) and its legal research arm the Tobacco Products Liability Project (TPLP). In 2006, the TCRC and TPLP joined forces with the Boston-based Tufts/Northeastern University Obesity and Law Project, a public health law and research organization, to form PHAI.

In its current work, PHAI seeks to use legal strategies to achieve specific public health goals. Northeastern University’s School of Law serves as a home and resource for PHAI as it seeks to nurture a new generation of professionals. Lawyers, public health advocates, policy analysts and physicians are invited to take on the food industry’s role in obesity, collaborate at annual conferences, and stay updated with the tools necessary to continue the global fight for tobacco control.

First, the group seeks to expand the repertoire of legal arguments that public health lawyers can use to challenge corporate behavior that harms health. For example, PHAI lawyers are considering ways to use laws against deceptive advertising as grounds for legal action in much the same way product liability was used in tobacco litigation cases. In the case of tobacco, large punitive damages awards were intended to deter tobacco companies from further actions that harmed health.

Second, PHAI takes the campaign to reduce obesity into new settings such as public schools and after-school settings. Research produced by their School Food Project served as a catalyst for advocating to remove high sugar sodas from public schools.

Third, PHAI attorneys remain deeply committed to global tobacco control and work to expose the illegal activities of Big Tobacco by researching internal industry documents and producing scholarly publications and amicus briefs. The group’s newest work is expanding to the global arena as members engage the World Health Organization Framework Convention on Tobacco Control (WHOFCTC) to work to connect tobacco control and human rights with health policy decision-making processes.

New Tactics and the Next Generation of Public Health Law

Each year, PHAI hosts an international conference, Legal Approaches to the Obesity Epidemic, where an interdisciplinary gathering of advocates consider new strategies to change food and beverage industry’s influence on the health of the public. Each conference chooses a theme to highlight emerging issues. For example, during the 2005 conference, speakers emphasized the need for public health efforts to target advertising campaigns that contribute to childhood obesity and related illnesses.

Marking a shift away from personal injury litigation strategies used during the ‘tobacco wars’ [1], the shift to targeting advertising incited harsh reactions from industry groups. Groups like Consumer Freedom, a food and restaurant industry lobbying group, criticized the PHAI conferences, calling them a “cabal of activists” who “use junk-science in an attempt to erode consumer freedom and turn food companies into their newest cash cow” [2]. Despite these attacks, PHAI continues to support groups such as the Physician Committee for Responsible Medicine, which have successfully used lawsuits to change Kraft’s false advertising practices [3].

While PHAI sees tobacco litigation as one strategy for making corporations more responsible, the group’s recent work emphasizes broader, population and environment-based interventions to reduce obesity—namely, policy, regulation and legislation. In a 2002 article in the Journal of the American Medical Association, PHAI President Richard Daynard acknowledged litigation as a tool to control obesity and points to the key differences between tobacco and food. “In the absence of proof that particular food industry practices cause obesity, suits seeking compensation for obesity-related injury are unlikely to succeed, while suits seeking to protect consumers from unfair or deceptive food marketing techniques are more likely to succeed” [4]. In a 2004 interview with Medscape, Daynard argued that consumer responsibility and personal responsibility “would be much more credible if the consumer was actually being told how fattening the food was and [had] a chance to say, no, I think I won’t take that order; I’ll order something else” [5]. Legal work to combat unhealthy food consumption seeks to increase product labeling and hold companies responsible for quality regulations and monitoring the actual caloric content of food marketed as “low in fat” or “high in fiber.”

Negotiating with the Food Industry

In an effort to better understand how food industry practices contribute to childhood obesity, PHAI spearheads new research design and policy recommendations. Their work has contributed to large-scale changes, such as the 2006 negotiation arranged by former President Bill Clinton, Governor Mike Huckabee, and the American Heart Association that promises to remove many sweetened beverages including Coke and Pepsi products from schools by 2009 [6]. PHAI member and Tufts Professor of Public Health and Family Medicine Aviva Must says she “would prefer these machines carry just water and low-fat dairy products, but I think this is a good start.”

To inform these campaigns, in 2006 PHAI released a report, Raw Deal: A Report on School Beverage Contracts. In a collaborative project with the Center for Science in the Public Interest (CSPI), the group conducted a national survey of school beverage contracts evaluating whether the alleged financial benefits were realized by schools. The exclusive contracts between beverage companies and schools place soft drink vending machines in accessible locations throughout elementary, middle and high school settings, and provide schools with income in exchange for exclusive “pouring rights.” However, the study found that the majority of the revenue from the contracts, was going not to the schools, but to the beverage companies. “The study highlights the need for legal tools to assist school districts in negotiating relationships that put the health and welfare of children first” [7] says Jason Smith, Associate Executive Director and head of PHAI’s Healthy Eating Law and Policy Project.

PHAI’s Healthy Eating Law and Policy Research Project also investigated how the law affects the foods available in public schools. Research from this project led to a policy guide to assist schools to develop healthier food policies. The report, Mapping School Food, highlights the need for policy makers to create school food programs informed by public health prevention strategies, and presents practical suggestions on how to quickly achieve change. Funded by a grant from the Robert Wood Johnson Foundation, the Healthy Eating Law and Policy Research Project is also expanding its research to consider food availability in after-school activity programs [8].

Acting Locally and Globally on Tobacco

To continue its effort on tobacco, PHAI’s team of lawyers and public health advocates are arming tobacco control professionals with data from newly available internal industry documents released under the provisions of the 1998 Master Settlement Agreement.

In their analyses of the formerly secret tobacco documents, PHAI Senior Staff Attorney, Sara Guardino and President Richard Daynard uncovered some of the ways that tobacco lawyers used the law to keep information about the harm of smoking from reaching the public. In their recent publication, Tobacco industry lawyers as “disease vectors,” they present evidence showing industry lawyers had “taken steps to manufacture attorney-client privilege” including assisting in the concealment of documents and the use of aggressive litigation techniques. PHAI lawyers and researchers have helped to expose illegal techniques employed by industry lawyers, including ‘scorched earth’ strategies—wherein plaintiffs’ efforts to bring tobacco companies to trial are thwarted by superfluous litigation.

PHAI’s discoveries from internal tobacco document inquiries and its history with tobacco litigation inform tobacco control policy recommendations both nationally and globally. The Tobacco Control Resource Center at PHAI provides legal and policy information to local, state and national decision-makers, files amicus briefs, and helps to build global information networks among tobacco control advocates around the world.

PHAI recently joined efforts to advance the Framework Convention for Tobacco Control, the first international public health treaty for the control of tobacco products. In Viet Nam, for example, a nation that has signed the FCTC, PHAI is helping to link tobacco control advocates with human rights organizations. In their Fall 2007 newsletter, PHAI says this approach is critical to creating change; “Linking the broader range of women’s, children, and social, economic and cultural rights with the WHO FCTC helps to highlight the ways in which these rights are inextricably interlinked, interrelated and indivisible” [9].

The Institute is now also working with health departments, NGOs, and tobacco control organizations in several nations to develop long-term strategies to reduce the influence of tobacco companies on the health of the public. By carving out legal grounds on which to challenge tobacco and food industry’s health damaging practices, PHAI helps set the stage for a unified effort toward public health solutions. Whether countering Big Tobacco’s tactics of obfuscation, assisting public school food policy development, or facilitating global tobacco control dialogue, PHAI is creating an organized public health legal approach to counter corporate influences on well-being and setting precedents for a global movement for health.

 

References

1. Daynard RA, Hash LE, Robbins A. Food Litigation: Lessons from the tobacco wars. JAMA. 2002;288(17):2179.

2. Cabal Of Activists And Lawyers Plot To Sue Food Companies. Consumer Freedom. June 19, 2003. Available at: http://www.consumerfreedom.com/print.cfml?id=1975&page=headline.

3. Thorn B. Conference: obesity lawsuits should focus on ads, children. Nation’s Restaurant News. Oct 17, 2005.

4. Daynard RA, Hash LE, Robbins A. Food Litigation: Lessons from the tobacco wars. JAMA. 2002;288(17):2179.

5. Barclay L. Legal Approaches to Obesity: A newsmaker interview with Richard Daynard, JD, PhD.

6. Mohl B. After Soda Ban, Nutritionists Say More Can Be Done. The Boston Globe. May 4, 2006;A1.

7. School Beverage Contracts Leaving Districts With a Bad Aftertaste: The Public Health Advocacy Institute Releases First National Study of School Beverage Contracts. Press Release. Public Health Advocacy Institute. Dec. 6, 2006.

8. PHAI Fall 2007 Newsletter.

9. PHAI newsletter fall 2007 p. 7

 

Photo Credits:

1. Vending Machine by warpr
2. Urban Convenience Store by coyenator

Senators and Activists Agree: No Soda in Schools

Soft drink companies agreed to voluntary guidelines to remove sugar dense sodas from public schools in a deal brokered by the William J. Clinton Foundation and the American Heart Association in 2006, but advocates for healthy food choices are calling for tighter restrictions. The global campaign, Dump Soft Drinks, and new legislation being drafted in the Senate are calling for nutrition-based limitations in the food and beverages available in easy-to-reach school vending machines.

Proposed Amendment Seeks to Reduce Soda and Junk Food in Schools

After years of advocating for improved nutritional standards in schools, Senators Lisa Murkowski (R., AK) and Tom Harkin (D., IA) say they will offer an amendment to the Senate farm bill that will “improve the diets and nutrition of America’s school children by setting reasonable, common-sense standards for the foods and beverages that are sold in school vending machines and similar outlets” [1].

The nutritional standards for food sales haven’t changed since the late 1970’s, “when microwaves were considered cutting-edge, newfangled technology,” Harkin told The Wall Street Journal [2]. The proposed legislation would eliminate soft drinks and other high sugar beverages from elementary and middle school, but would allow low-fat flavored milk products, diet sodas, and sports drinks in high schools. It would also place limits on salty, high calorie and fatty snack foods.

 

Global Dump Soft Drinks Campaign

Setting nutrition standards for school vending machines is just one of Dump Soft Drinks‘ recommendations. The campaign is lead by two advocacy groups well versed in both national and global public health fights for healthy diets and food. With theDump Soft Drinks campaign, the Center for 

Science in the Public Interest (CSPI) and their global counterpart, theInternational Association of Consumer Food Organizations (IACFO), work to inform consumers about how soft drinks contribute to diet-related diseases like obesity and diabetes.

The campaign emphasizes global health effects beyond schools. In the US and Europe, rates of obesity and diabetes are increasing due to unhealthy diets and lack of physical activity, a trend now reaching global dimensions. In their report “Soft Drinks and Obesity—Global Threats to Diet and Health” [3], Dump Soft Drinks shows specific examples of the correlation between increasing soda consumption and rising diabetes rates in countries like Mexico and China. The report also points to the role played by transnational corporations that market nutritionally empty products in developing countries—many of which, paradoxically, continue to be burdened by under-nutrition.

The campaign calls for marketing restrictions on companies like Coca-Cola Co. and PepsiCo Inc. that spend billions on target marketing each year. Following the United Kingdom’s new legislation that limits marketing to younger audiences, Dump Soft Drinks wants to see the end of US soft drink marketing to children and teenagers under 16. They also advocate for labeling regulations and propose a value-added tax to soft drinks that would go toward boosting government health and nutrition education programs.

Dump Soft Drinks: Recommendations to limit soft drink companies’ contribution to diet-related disease

1. Increase the promotion of new lower-sugar products, sell existing high sugar products in smaller portions, and support independently funded research on the use of safe substitute sweeteners.

2. Cease all marketing of sugar-laden beverages to children under 16, including print and broadcast advertising, product placement, the Internet, mobile phones, athletic event sponsorship, signage, merchandising, and other means.

3. Prominently display the calorie content, per serving, of all beverages on the fronts of containers and the outer labels of multi-container packages, along with the number of servings per bottle or can as part of a comprehensive labeling system utilizing simple and uniform symbols to convey nutritional value. Sugary beverages should also include rotating consumer alerts such as “High sugar – drink only occasionally” or “For occasional consumption. Drink water to quench thirst.”

4. Stop promoting and selling sweetened beverages, including sports drinks and fruit flavored beverages and teas, in all public and private elementary, middle, and high schools; sell fruit juice in container sizes of 250 ml or less.

5. Pay a modest Value Added Tax on soft drinks – with governments using the proceeds for nutrition education and physical activity programs and to subsidize the costs of fruits and vegetables.

6. Ensure that sponsorships involving the promotion of physical activity and health be made in a transparent fashion only to independent health charities or government agencies which, in turn, use such funds for programs not associated with the company’s logo, brands, or other proprietary information. Physical activity and nutrition education programs sponsored by beverage companies should not convey the impression that all products produced by the company are healthful and nutritious.

Opponents cite declining US and European soft drink sales and ask “Why not let parents and children make their own food and beverage decisions?” In an interview with Fox News, CSPI spokesperson, Bruce Silverglade, addressed this concern. “Coca-cola and Pepsi spend almost $5 billion dollars a year advertising their products worldwide. That is a sum that is exponentially higher than the amount spent on nutrition education… Marketing undermines … parental authority and counteracts the efforts by parents to teach their children to live more healthily” [4].

Working to fight the childhood obesity epidemic, both The Global Dump Soft Drinks Campaign and the Senate farm bill amendment agree that as a learning environment, schools are obligated to model healthy food choices as nutrition education by limiting the sales of soft drinks and junk food.

CSPI worked with Senators Harkin and Murkowski to develop legislation that would receive broad support. Health advocates and food and beverage industry allies are now standing behind the proposed federal nutrition-based standards. Though battles to push the legislation through Congress remain to be fought, it is currently endorsed by the American Dietetic Association, the American Public Health Association and the National PTA, Coca-Cola, PepsiCo, Cadbury Schweppes and the American Beverage Association.

 

References

1. Harkin-Murkowski amendment will update decade-old nutrition standards in schools nationwide. Senator Lisa Murkowski, United States Senate Press Release. Dec 4, 2007. Available athttp://murkowski.senate.gov/pressapp/record.cfm?id=288191.

2.McKay B. Soda Makers Support Tougher Curbs. The Wall Street Journal. Nov 9, 2007:B2. Available athttp://online.wsj.com/article/SB119458164755287687.html.

3.Soft Drinks and Obesity—Global Threats to Diet and Health. The Global Dump Soft Drinks Campaign.http://www.dumpsoda.org.

4. Should Government Limit Marketing of Soft Drinks to Children? Fox TV News Debate. Washington, D.C. Nov 16, 2007. Available at http://www.dumpsoda.org/media.html.

 

Photo Credit:
United States Federal Government, Public Domain.

McDonald’s and Children’s Health: The Production of New Customers

In a recent study published in the Archives of Pediatrics and Adolescent Medicine, 1 researchers found that low income 3 to 5 year old children preferred the taste of hamburgers, chicken, French fries, carrots or low fat milk if they thought the products were from McDonald’s, whether or not they actually were. Thus, in their first years of life, children had come to associate McDonald’s branding with desirable foods, creating a lifetime potential for obesity and over consumption of the high fat, low nutrient products that McDonald’s features. To understand its success in imprinting even the youngest children, Corporations and Health Watch investigated the range of McDonald’s activities geared towards children. By focusing on the specific ways that one company goes about reaching children, we hope to gain insights that can guide public health strategies to reduce childhood obesity.

According to its 2006 Annual Report, McDonald’s is the leading global foodservice retailer with more than 30,000 local restaurants serving 52 million people in more than 100 countries each day. Its 2006 revenues were $ 21.6 billion, up 16% from 2004.

 

McDonald’s leads in food advertising to children

Marketing directly to children began in the 1960s. McDonald’s founder Ray Kroc, along with Walt Disney, has been credited with recognizing that children constitute a valuable and distinct market segment. Kroc observed that, “A child who loves our TV commercials and brings her grandparents to a McDonald’s gives us two more customers.” 2(p. 41) Developing brand loyalty in children influences both later purchases and the buying patterns of parents. At the forefront of marketing to children, McDonald’s spends more on advertising in general than any other brand. 2(p. 4) In 2006, McDonald’s spent almost $2.5 million a day on traditional advertising in the United States. About 40% of McDonald’s total advertising budget is directed at children. 3(p.102)

The use of cartoon characters and icons

Ronald McDonald, the face of McDonald’s, is a symbol of the corporation’s dedication to reaching young customers. The only fictional character with a higher degree of name recognition by children is Santa Claus. 2(p.4) A study of 9-10 year old Australian youth demonstrated that more than half believed that Ronald McDonald knew what was best for them to eat. 3(p.100) To reinforce the association of fun and entertainment with its fast food, McDonald’s offers a line of videos featuring Ronald McDonald and the McDonaldland characters. McDonald’s use of cartoons to market to children extends to the Internet as well. An earlier version of the McDonald’s children’s website told young visitors Ronald was the “ultimate authority on everything” and they were encouraged to send Ronald an email telling him their favorite food items, their favorite sports team, favorite book and their name. 2(p. 45) Directly soliciting children for personal information is now prohibited without parental approval thanks to the Children’s Online Privacy Protection Act of 2000. One of the McDonald’s current websites aimed at children, Ronald.com, tells children they can “learn, play and create while having fun.” On the site, children interact with “adver-games” which are designed to engage children with both the game and an advertisement. The site’s games all feature Ronald McDonald somewhere in the game. Happymeal.com, a site designed to encourage children toward physical activity, also prominently features the “Happy Meals” logo each time a new game is opened.

Restaurant design

The atmosphere of McDonald’s itself is designed to be “family friendly.” McDonald’s operates more than 8.000 playgrounds around the United States, more than any other private American corporation and far more than any municipality. Originally modeled on Disney World, the playgrounds provide an environment that is designed to appeal to children through bright colors, toys and clowns, and also to parents by providing a safe place for children to play. For children who live in low-income neighborhoods without safe or adequately maintained public parks and playgrounds, McDonald’s may offer one of the few opportunities for such forms of play and sociality. Birthday and other parties can be held at many McDonald’s which provides, on a cost per child basis, the food, invitations, paper and plastic wear, party entertainers, party favors and clean-up afterward. These design elements contribute to associating McDonald’s with fun and socialibility.

Toys and entertainment

In 1979, McDonald’s launched its first “Happy Meal,” which included numerous toys such as a “McDoodler stencil,” a puzzle book, and McDonaldland character eraser in a cardboard box with a circus theme. By 2003, 20% of McDonald’s meals sold were Happy Meals and they accounted for $3.5 billion in revenues. The fast food giant stands as one the United State’s largest distributors of toys. 2(p. 4) In addition to toys, McDonald’s appeals directly to children through cartoon characters, catchy jingles, and food shaped and colored to appeal to children. In addition, McDonald’s develops strategic partnerships, sponsorships, character licensing agreements and endorsements with celebrities and corporations such as NBA stars, Disney, the Fox Kids Network, DreamWorks and the Olympics. 2 Among the celebrities who have done product endorsements for McDonald’s are Venus and Serena Williams, Cedric the Entertainer, Kobe Bryant and Michael Jordan. Through such alliances, McDonald’s aims to have children associate the good feelings they have about celebrities, characters and companies with McDonald’s itself. That fit and celebrated athletes promote its products further associates McDonald’s with health and fitness.

In addition to television commercials featuring celebrities and promoting cartoon character toy give-a-ways, McDonald’s targets children through product placement and sponsorship. The fast food company has paid to have its food products featured in such children’s films as “George of the Jungle,” “The Flintstones,” and “Richie Rich.” 3(p.113) McDonald’s also sponsored the children’s show “The Teletubbies” and distributed toys representing the four characters. As with the Teletubbies, the company produces multiple versions of toys associated with movies and television. 4(p. 181) Children are encouraged to collect them all to obtain the full set, thus encouraging return visits—and more Happy Meals. In 1999 alone, McDonald’s released eighty different versions of Furby. 2(p.47)

McDonald’s marketing to children extends beyond television commercials, kid-friendly websites, toys and playgrounds. In 1987 McDonald’s launched their “McKids” line of clothing that was initially sold at Sears, Roebuck & Co. It was later picked up by Wal-Mart which dropped the line in 2003. Now McKids is offering a line of branded toys such as bikes, skateboards and scooters designed to encourage children to be more active between their visits to the Golden Arches.

McEducation

In their 2005 study of the clustering of fast food restaurants around public schools, Bryn et al reported that “Fast-food restaurants are concentrated within a short walking distance from schools, exposing children to poor-quality food environments in their school neighborhoods.” In the early years of McDonald’s, founder Ray Kroc actually flew in a Cessna scouting for new sites near schools. 2(p. 66) Like other fast food companies, McDonald’s does more than just place itself close to schools; in recent years it has opened outlets within high school cafeterias. According to a recent CDC survey, in 2006, 24% of the nation’s high schools and 19% of its middle schools offered on-site brand name fast foods.

McDonald’s also sponsors Channel One programming, provides educational curricula that feature information about working at McDonald’s and offers incentive programs, like “McSpellit Club,” whereby students can earn meals at the restaurant for spelling, reading and good attendance. 4,5 In addition, McDonald’s is a client of Cover Concepts, a company which provides branded textbook covers free to students and schools. 5 Finally, in 2005, with 31,000 elementary schools around the country, McDonald’s launched its “Passport to Play” program, aimed at encouraging physical fitness for third through fifth graders. Each time children play a game from around the country, they receive a golden arches stamp on a pretend passport. The website states, “Passport to Play is a fun way to keep kids’ minds engaged and bodies active. Teach your students how kids from around the world play, snack and grow [emphasis added].” Bryn Austin, assistant professor of pediatrics at the Boston Children’s Hospital suggested the program might be a “Trojan Horse” created to keep McDonald’s name in schools.

But McDonald’s doesn’t just take money from students; it raises money for them. In New Haven, CT, a group of teachers and staff from the New Haven Middle School participated in a McDonald’s educational program working a 4 hour shift at the counters and the drive-up window. By doing so, their school received 20% of the profits during the time they staffed the establishment. While the teachers worked, students decorated the walls of the restaurant with pictures of the golden arches. 3(p. 130) On October 13 of this year, 450 McDonald’s establishments in Tennessee participated in a similar “McTeachers Night” program. In addition, the corporation sponsors young people’s sports teams such as the McDonald’s All American High School Basketball Team.

Strategic Locations and Charity 

To keep its name in front of young people, McDonald’s develops partnerships with institutions where children are likely to be found. In August 2001, the fast food corporation began a 10 year, $16 million contract with the Smithsonian Institution’s Air and Space Museum. The museum features McDonald’s food as well as food from two other companies owned by McDonald’s, Boston Market and Donatos Pizzeria.3(p. 300) The Philadelphia Children’s Hospital and other children’s hospitals around the country feature a McDonald’s in their facilities. Finally, The Ronald McDonald House Charities has provided housing and meals to families with more than two million seriously ill children, further reinforcing the idea that Ronald McDonald and the McDonald’s corporation care about children’s health.

Influencing parents to reach children

Children are believed to influence approximately $500 billion of spending each year. 3(p. 101) Thus, while McDonald’s focuses much of its marketing on children, the fast food giant also seeks to influence parents’ purchasing decisions. Corporate memos discuss the company’s desire for adults to feel like “good parents” by taking their children to McDonald’s in order to make them happy. 2(p. 50). To counter criticism that fast and junk foods contribute to obesity and other health problems, McDonald’s recently launched a contest to recruit mothers for three day paid field trips where they will be given access to the farms “where our fresh ingredients are grown, to our world-class suppliers and to our restaurants.”

McWorld

As McDonald’s saturates US markets and succeeds in attracting young Americans as lifetime customers, growth increasingly depends on expanding its consumer base through overseas marketing. McDonald’s opens about four new restaurants every day overseas. 2(p.229) The table below shows the growth in McDonald’s outlets in various parts of the world between 1991 and 2001. 3(p.58)

Growth in McDonald’s Outlets by World Region, 1991-2001

In preparation for the 2008 Beijing Olympics, McDonald’s is promoting aninternational contest for 300 children, 100 from China, to win trips to the games.

The increased visibility and availability of McDonald’s around the world has succeeded in reaching greater numbers of children. At one primary school in Beijing, all of the children recognized and liked Ronald McDonald, and believed that “Uncle McDonald was funny, gentle, kind and…understood children’s hearts.” 2(p. 231) In Japan, 98% of children recognized Ronald McDonald; In England the figure was 93%. 3(p. 99) Ronald McDonald speaks to children in twenty-five languages including Russian, Portuguese, Tagalog, Hindi, Cantonese and Papiamento. 3(p. 13) A 1996 survey of children’s television programming in Australia, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Netherlands, Norway, Sweden, UK and the United States found that McDonald’s was the most prolific advertiser overall.

But does it work?

Commenting on the results of the previously mentioned study of children’s preference for food with a McDonald’s packaging, company spokesman Walt Riker stated that McDonald’s had been “actively addressing” the issue of children and nutrition and that McDonald’s was “providing solutions.” However, Dr. Victor Stasbuger, an author of American Academy of Pediatrics policy calling for limits on marketing to children argued that the study illustrated the success of fast food marketing to children: “Advertisers have tried to do exactly what this study is talking about–to brand younger and younger children, to instill in them an almost obsessional desire for a particular brand-name product.”

Impact on health

In 1998, 89% of children in the United States eight years of age or younger had visited a McDonald’s at least once a month. In response to this information, R.J. Milano, a McDonald’s Vice President stated that their goal for the following year was to reach 100%. He boasted “I’m going to own every kid transaction out there.” 3(p. 291). The health impact for both youth and adults of increased intake of salt, fat and sugar associated with the consumption of fast and junk foods has become clear as rates childhood obesity and type 2 diabetes have escalated. At least 30% of calories in the average child’s diet are currently derived from fast food, salty snacks, sweets and soft drinks. In response to increased media attention and legal action, fast food companies such as McDonald’s claim to be offering healthier alternatives. In addition, McDonald’s was one of 11 major food companies that recently agreed to limit voluntarily its food advertising to children . Recently McDonald’s began offering Happy Meals with slices of apples and milk. However, while the new Happy Meals did reduce overall fat and calorie content, the “Apple Dippers” included in the meal increased the sugar content. Additionally, while McDonald’s has done away with its “supersize” option for adults, in 2001 it introduced “Mighty Kids Meals” which offer more food for only slightly more money.

Regulations around the world

More than 50 other countries currently regulate marketing directed at children. Twenty-five European states prohibit advertising during children’s programming of a duration of 30 minutes or less. In 1992, Sweden banned all television marketing directed at children twelve and under. Similarly, advertising in children’s programming have been banned in Ireland, Norway, Belgium and Holland.1 Since 2001 Broadcasting Commission of Ireland has prohibited the use of celebrities and cartoon characters to advertise food. Regulations disallowing advertising to children 13 years or younger have been in effect since 1980 in the Canadian province of Quebec. In the United States, the Federal Trade Commission lacks the authority to restrict television advertising. Given the previous failure of voluntary guidelines to reduce growing rates of obesity, numerous advocacy and public health groups have called for government regulations.

Recommendations

Many public health organizations in the United States and elsewhere have made specific recommendations. In December 2005, the Institute of Medicine (IOM) released a comprehensive report on the impact of food marketing to children in the United States. The report found that American children are not achieving basic nutritional goals both in terms of underconsumption of important nutrients and overconsumption of fat, salt and sugar. While the dietary patterns of children are a complex in origin and include cultural values, economic status, social environments and media environments, the IOM concluded that food and beverage marketing “influences the preferences and purchase requests of children, influences consumption at least in the short term, is a likely contributor to less healthy diets, and may contribute to negative diet-related health outcomes and risks among children and youth.”

Strategic Alliance, a coalition of nutrition and physical activity advocates in California, recommends that all marketing and advertising of junk and fast foods be eliminated for children and youth. Amongst other measures, International Association of Consumer Food Organizations (IACFO)—an international association of non-governmental organizations representing consumer interests in the areas of nutrition, food safety, and food policy—urges governments to restrict or ban all food advertisements to children and prohibit the marketing of soda, junk and fast foods in schools. The IACFO also points to the importance of global action on this issue, noting that restrictions in the developed world often send multinational corporations overseas to the global south where they market unhealthy products with greater ease. Given escalating global rates of diet related chronic disease, public health and advocacy calls for more stringent and federally and globally enforceable standards seem warranted. In the words of Gro Harlem Brundtland , former Director General of the World Health Organization: “Marketing approaches matter for public health. They influence our own–and in particular our children’s–patterns of behavior. Given that they are designed to succeed, they have serious consequences for those at whom they are targeted.”

Zoe Meleo-Erwin, MA is graduate student in sociology at The Graduate Center, City University of New York.

 

References

1. Robinson, TN; Borzekowski, DLG; Matheson, DM & Kraemer, HC. Effects of Fast Food Branding on Young Children’s Taste Preferences. Archives of Pediatrics and Adolescent Medicine. 2007. 161(8):792-797.
2. Schlosser, E. Fast Food Nation: The Dark Side of the All-American Meal. 2001. Boston: Houghton Mifflin.
3. Brownell, K. & Horgen, KB. Food Fight: The Inside Story of the Food Industry, America’s Obesity Crisis & What We Can Do About It. 2004. New York: McGraw Hill.
4. Nestle, M. Food Politics: How the Food Industry Influences Nutrition and Health. 2002. Berkeley: University of California Press.
5. Story, M. & French, S. Food Advertising and Marketing Directed at Children and Adolescents in the US. International Journal of Behavioral Nutrition and Physical Activity. 2004;1:3. Available at: http://www.ijbnpa.org/content/1/1/3. Accessed October 21, 2007.

Photo credits:

1. La Fotodama 
2. Sama Sama – Massa
3. Petite-Tomo

New Report Calls on United Kingdom to Tackle Obesity More Forcefully; Advocates Urge Action Now

If current trends continue, warns a new British government report released in October 2007, 60% of men, 50% of women and 25 of children in the UK will be obese by 2050.  Changes in food production and marketing, fewer opportunities for physical activity, and current eating habits have made obesity the default option. “If we just behave normally we will become obese,” said Sir David King, the UK government’s chief science adviser.

The report, “Tackling Obesities: Future Choices” was prepared by Foresight, a government research group, to examine how the UK can deliver a sustainable response to obesity over the next 40 years.  The project has assembled evidence and expertise from academic disciplines as diverse as epidemiology, food science, genetics, psychology and sociology, and from professionals and interested organizations within and beyond Government.  While the report acknowledges that reducing the prevalence of obesity will require long-term action from numerous stakeholders at multiple levels, it concludes that “the lead must come from Government.”

The report attracted extensive media coverage and the UK health secretary Alan Johnson warned that the public health threat posed by obesity in the UK is a “potential crisis on the scale of climate change.”  However, in recognition of the report’s pessimistic outlook for obesity and the epidemic’s  deep roots in British society, UK public health minister Dawn Primarolo announced that the UK was delaying its goal of halting the rise in childhood obesity from 2010 to 2020.

Advocates charge report lacks blueprint

In response to the report, the Children’s Food Campaign, an alliance of more than 300 organizations, urged stronger and more immediate action.  It suggested three specific steps the government could take to reduce obesity.

First, the Campaign called on the government to ban all TV junk food advertising before 9 pm.  Second, the UK should act to reduce children’s exposure to online and cell phone junk food advertising. Third, it should enact a simpler “traffic light” food labeling system that provides consumers with clear guidance.

Finally, British schools should make food skills a required part of the curriculum so that every child leaves school knowing how to make simple nutritious meals.

According to Dr. Mike Rayner, Director of the British Heart Foundation Health Promotion Research Group at Oxford University and Chair of the Children’s Food Campaign, “the government has to make a philosophical leap.  It should no longer see its role as gently guiding the food industry towards more responsible behavior, but instead as the protector of children’s interests, ready to take action to improve children’s diet and well being.”

Sue Davies, chief policy adviser to the UK consumer organization Which? also urged the government to go “further and faster” by enacting tougher rules against promotion of unhealthy food to children within three months.  “Obesity is a complex problem, she said, “but the solutions currently on the table are not up to the task.”  Which? recently initiated a campaign to force the British food industry to market food more responsibly and produced a campaign toolkit to help parents groups and community organizations to pressure government and industry to act more forcefully.

New Public Debate on Food Policy and Role of Food Industry

In many ways, the British debate on food policy mirrors the discussions in the United States.  However, the new Foresight report and the forceful and widely covered criticism by public health and nutrition researchers and advocates has put the question about the roles of government and industry in reversing the obesity epidemic squarely on the public agenda.  Whether the US 2008 Presidential election as well as the local, regional and national mobilizations to improve children’s diet, promote food justice and reduce obesity can provide a similar opportunity here in the United States remains to be seen.

Interview with Richard Daynard

In March 2006, the newsletter Informed Eating interviewed Richard Daynard, professor at Northeastern University School of Law.

Food activists often ask what lessons they can learn from the fight against Big Tobacco. In this interview, published in March 2006 in Informed Eating, a newsletter of food politics and analysis, Richard Daynard, a professor at Northeastern University School of Law, chair of the Tobacco Products Liability Project, and director of the Public Health Advocacy Institute’s Law and Obesity Project, describes his views on the similarities and differences between the public health advocacy on food and tobacco.

Commentary: Voluntary Guidelines vs Public Oversight: Finding the right strategies to reduce harmful corporate practices

Last July, in an effort to reduce obesity, eleven major food and drink companies announced plans to restrict television advertisements to US children under the age of 12. Federal Trade Commission Chair Deborah Platt Majoras hailed this voluntary move, claiming that “industry action can bring change more quickly and effectively than government regulation of speech.” Since advocates seeking to reduce the harmful health consequences of the food, tobacco, alcohol, pharmaceuticals, firearms and automobile industries need to make decisions about the relative merits of voluntary industry action and public oversight, it is worth considering the evidence on this issue.

One way to assess the truth in Commissioner Majoras’s assertion is to examine other examples of industry self-regulation of products that harm health. For example, in his new history of the tobacco industry, The Cigarette Century, Harvard historian Allan Brandt explains that for decades, the tobacco industry claimed that its voluntary advertising guidelines precluded the need for stronger government regulation. For decades, until the 1970s, industry arguments  – and their political contributions – persuaded Congress not to act. Smoking continued to increase until restrictions on advertising, bans on public smoking, and tobacco tax hikes helped to bring smoking rates down. Had the government resisted tobacco industry pressure by instituting these measures two decades earlier, when most of the scientific evidence against tobacco was already established, hundreds of thousands of premature tobacco deaths could have been averted.

Beer industry self-regulation

To avoid regulation of alcohol marketing, the beer industry established voluntary guidelinessetting rules on advertising content and placement. A 2006 independent review of the beer industry’s compliance with these guidelines found that beer makers met three of its 15 recommended standards, partially met four and failed to meet eight, hardly strong evidence for compliance. Research shows that exposure to alcohol advertising contributes to increased youth drinking. Each year about 4,500 young people die in the United States from alcohol-related causes, and two million more are injured.

 

Oversight of global food companies

Returning to the food industry, in 2005, the World Health Organization asked three nutritionists to evaluate how well McDonalds and Kraft, signatories to this week’s agreement, had kept their own promises to improve practices related to obesity. The reviewers found that the companies had, at best, made modest changes and continued to market unhealthy products to children. They concluded that “for business reason alone,” food companies “cannot” and “will not” “stop making and marketing nutritionally questionable food products to children” and therefore only regulatory intervention could protect children’s health.

Corporate arguments against public oversight

Interference with free speech. Corporations offer three main arguments against stronger public oversight of their health practices. First, they claim limits on advertising interferes with their right to free speech. The legal theory that the First Amendment protects corporations – commercial activities is relatively recent. Not until 1976 did the Supreme Court assert that corporate commercial speech warranted constitutional protection (Virginia State Board of Pharmacy v. Virginia Citizens Council, 1976). In that decision, the court found that a Virginia regulation banning advertising of pharmaceutical prices was unconstitutional. A consumer group argued that people had a right to pricing information, and the Supreme Court agreed. However, whether the right to provide consumers with factual information about a product also applies to speech promoting unhealthy food to children or potentially dangerous drugs to patients raises different legal issues. Since the current Supreme Court is more favorably disposed to corporate interests than at any time in its history, in the short run, the prospects for reducing successful challenges to expanded protection are slim. In the long run, however, giving commercial speech similar protection to political speech has created new threats to public health that require public consideration. Public health professionals may have the credibility to initiate this debate.

Nor is the FTC the only regulatory agency to take on a more pro-business slant during the Bush Administration. On September 1, 2007, the New York Timespublished a story on its investigation of the capacity of the Consumer Products Safety Commission to fulfill its mission. According to the Times, under President Bush, the CPSC has “blocked enforcement actions, weakened industry oversight rules and promoted voluntary compliance over safety mandates.” At a time when imports from China and other Asian countries surged, creating an ever greater oversight challenge, the Bush-appointed commissioners voiced few objections as the already tiny agency – now just 420 workers – was pared almost to the bone. By weakening the agency and failing to enforce its legislative mandates, charge consumer advocates, this Administration has turned its belief in the superiority of voluntary guidelines versus public oversight into a self-fulfilling prophecy.

Restriction of personal choice. The second principal argument against public oversight of harmful corporate practices is that it will prevent Americans from enjoying their freedom to eat, drink, or smoke what they want. In fact, in past decades, the loudest and most consistent influence on health and lifestyle today comes not from the “nanny state” but from corporate America. McDonalds spends more than a billion dollars a year to persuade children and their parents to fill up on high-fat Happy Meals that contribute to the nation’s obesity and diabetes epidemics. Philip Morris targets young people with ads that show smoking is fun, sporty and sexy while warning them that smoking is only for adults, a sure way to encourage experimentation. While courts force governments to use the least restrictive method possible to regulate private behavior that harms public health, corporations face no such limits in their efforts to persuade us to consume. Advertisers expose children to more than 20,000 television ads a year, placing their advertising in formerly non-commercial spaces such as cell phones, school classrooms, the sides of busses, taxis and even private SUVs, and use “viral marketing” techniques in which teens are hired to persuade their friends to buy certain products.

Leave it to Markets. The third argument against public oversight is that market forces are sufficient to modify harmful corporate practices and that well-intentioned but inadequately informed oversight will disrupt the market and produce unwanted and unintended side effects. The most frequently invoked historical example is the prohibition of alcohol, which is alleged to have created a black market, encouraged organized crime and promoted disrespect for the law. In the case of tobacco, however, market forces appear to have played a small role in controlling a product that contributed to 100 million premature deaths in the twentieth century. In fact, the market has been the principal savior of the tobacco industry, allowing it to find new populations to addict when public oversight restricted access in one place or to one group.

Public Health Arguments for Voluntary Guidelines

If only corporate leaders and their allies supported voluntary guidelines over public oversight, the task of public health advocates would be straightforward albeit challenging. We would need to make public arguments for oversight, mobilize constituencies who supported this position and convince policy makers to enact measures to protect public health. In fact, however, the public health community itself is divided on this question. Thus, it is necessary to examine the public health arguments for voluntary guidelines and to encourage open dialogue on this question within the profession.

Useful step in the right direction. Supporters of voluntary guidelines to modify corporate behavior advance several arguments. First, some claim that voluntary guidelines, even if inadequate, are a useful step in the right direction. When the advertising industry revised its voluntary guidelines for ads targeting children last November and several major food companies announced a new “healthy lifestyle” marketing campaign aimed at children, Dr. J. Michael McGinnis, a distinguished public health leader who served as chair of the Institute of Medicine’s Children’s Food Marketing Committee, said, “This is a move in the right direction. . . . It would be a pretty substantial change.” Critics responded that the guidelines didn’t go far enough. “I don’t see any substantial changes,” commented Susan Linn, a Harvard psychologist and author of Consuming Kids. Companies “will continue to be able to market junk food to children — and their marketing is going to be even more confusing for children because it will be linked to ‘healthy lifestyle’ messages.” In the case of tobacco, advocates argued that the industry crafted its voluntary guidelines to advance its business interests, limit future liability and avoid future regulation, not to protect public health, making the guidelines a step in the wrong direction.

Best possible deal under circumstances. A more pragmatic defense of voluntary guidelines is that however inadequate, such rules are better than nothing and perhaps the best option possible given political and economic constraints. Proponents of this position maintain that public disclosure of voluntary guidelines encourages political debate on the issue or sets the stage for later regulation. For example, in 2005, the New York City Department of Health and Mental Hygiene called on the restaurant industry to reduce voluntarily the use of trans fats. When a later survey showed that its call had gone unheeded, the Board of Health successfully instituted mandatory rules to eliminate trans fat.

Only public private partnerships have power to make meaningful changes. The belief that any public health successes require collaborative partnerships between the public and private sectors is deeply ingrained in mainstream American ideology. For example, Drs. Simon and Fielding, two leaders of the Los Angeles County Department of Health Services, assert that “all businesses and public health agencies share an interest: ensuring a healthy population. Businesses should have a financial interest in supporting organized public health efforts, and collaborative efforts can increase the reach and effectiveness of public health.” For those who believe that business and public health have an inherent confluence of interest, it is natural to seek partnerships. By allying with the power of big business, say the supporters of this approach, public health has a better chance of achieving its objectives.

Some advocates have a more critical view of partnerships. They argue that business can just as easily co-opt as support public health and that voluntary partnerships can be used as a substitute for more substantive protection. In a review of lessons for reducing obesity from advocacy efforts to modify tobacco, alcohol, firearms and automobile industry practices, Dorfman and her colleagues conclude:

Clearly both extremes – working too closely with the industry, or considering the entire industry a monolithic enemy – have downfalls. The best approach is to deal with the industry from a base of power. After the community organizing effort gels and there is a strong base of support in the community and solid strategic direction, then advocates can talk with the industry on their own terms.

In this view, the question is not whether to engage in discussions with industry about voluntary changes but rather under what circumstances, when and with what goals.

Conclusions

In summary, public health professionals offer compelling but contradictory arguments for and against voluntary corporate guidelines and stronger public oversight as strategies to reduce harmful corporate practices. To move beyond ideological assertions of the merits of one path or another will require systematic evidence that analyzes the outcomes of each option in a variety of circumstances. By focusing public health research on this question, public health officials and advocates can move towards evidence-based decisions that are based on concrete analyses of specific situations.

The stakes for finding the right balance between the two could not be higher. A recent study in the New England Journal of Medicine warned that if current trends on obesity and diabetes continue, our children and grandchildren will have shorter lifespans than we do. Choosing the right path to reduce the promotion of unhealthy food can help us avoid this prediction. Similarly, it is estimated that one billion people will die from tobacco-related diseases in the 21st century, a fate that can be changed only if the tobacco industry plays a different role in this century than in the last one.

Thus, providing more definitive guidance on how to choose when to support voluntary industry initiatives and when to insist on strong public oversight is literally a matter of life and death.

Nicholas Freudenberg is Distinguished Professor of Public Health at Hunter College, City University of New York.

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