Category Archives: Food & Beverage

To Save Lives, Limit Salt In Processed Food

Imagine a mysterious but pervasive substance that contributed to tens of millions of deaths around the world. Imagine that simple new public rules limiting human exposure to this substance could prevent almost nine million deaths in the developing world in the next ten years. Wouldn’t you expect that governments around the word would implement such rules? Well, these facts describe the current scientific situation on salt. [1]

To answer the question requires a closer examination of the ongoing clashes on salt policy. On one side are health, scientific and advocacy bodies such as the American Medical Association, [2-3] the National Academy of Sciences, [4] the World Health Organization, [1,5] Consensus Action on Salt and Health, [6] and Center for Science in the Public Interest, [7-10] all arguing for global and national regulations to lower salt content in processed food. On the other side are groups such as the European Union Salt Producers Association and The Salt Institute, a U.S.-based salt industry trade association, who claim in scientific, policy and legal settings that excess salt intake is not harmful to human health. [11-13]

Late last year, the US Food and Drug Administration held a public hearing on this issue with a request for public comments. [10] (The transcript of this hearing will soon be available at http://www.fda.gov/ohrms/dockets.) If the FDA decides to reclassify salt (also known as sodium chloride) as a food “additive,” then it can place limits on the amount of sodium contained in prepared foods and foods served in restaurants.

In this report, Corporations and Health Watch reviews the evidence on the adverse health consequences of excess dietary salt, describes some of the policy proposals to reduce salt intake and the extent to which various jurisdictions have implemented such policies, and analyzes the political strategies that the salt industry has used to oppose or delay new limits on dietary salt.

The adverse health consequences of excess dietary salt consumption

How much salt does the average adult in the United States consume a day? Although many people consider only the amount of salt that they add to their food while cooking or at the dinner table, approximately 75% of the sodium we consume is already in the food we buy. The National Academy of Sciences recommends that adults consume no more than 2,300 milligrams of sodium daily, roughly one teaspoon of salt. The recommended maximum intake for people at risk of high blood pressure, such as adults over age 50, is 1,500 milligrams of sodium per day.

The average U.S. adult consumes about 4,000 milligrams of sodium per day—as noted above, about 75% of this intake comes from sodium added by food manufacturers and restaurants. Canned and processed foods often contain 1,000 milligrams or more per 8 ounce serving, and typical meals served in restaurants contain between 2,300 and 4,600 milligrams of sodium. [14] In addition, sodium is present in foods such as bread, diced tomatoes, and cereals,8 important sources of sodium intake often overlooked by consumers. Jeremiah Stamler, M.D., professor emeritus of Preventive Medicine, Northwestern University Medical School in Chicago, observed, “If we reduce our salt intake [at the table] that won’t solve the problem. There’s salt in bread, processed meat, cheese, canned vegetables—these are all hidden sources of salt.” [15]

Although experts debate the precise threshold for maximum daily salt intake, there is little controversy that excess salt intake is a major contributor to high blood pressure, a major risk factor for stroke, heart failure, heart attack, and kidney and vision problems. [16-18] In the United States alone, it is estimated that nearly 30% of all adults are affected by hypertension, with another third of adults affected by pre-hypertension. [17] One important way to control hypertension is to lower salt intake.

Policy proposals to reduce dietary salt intake

Many scientific and professional organizations have come to the consensus that the public would benefit from a reduction in the sodium in products sold by the food and restaurant industries. For example, in November 2002, the American Public Health Association called for a 50% reduction in the nation’s food supply over the next 10 years. [14] In June 2006, the American Medical Association also advocated lower levels of salt in processed food, observing “[i] n the continued absence of voluntary measures adopted by the food industry, new regulations will be required to achieve lower sodium concentrations in processed and prepared foods.”

Similar positions have been reached by the National Institutes of Health, National Academy of Sciences, U.S. Department of Agriculture, U.S. Department of Health and Human Services, and at least 40 other professional organizations in the U.S. [3] The American Medical Association states that “substantial public health benefits accrue from small reductions in the population blood pressure distribution.” The AMA noted that a 1.3 grams per day lower lifetime sodium intake is estimated to save 150,000 lives annually as individuals advance form age 25 to 55. [17]

Policy recommendations include: (1) broad public and consumer education on salt, new food labeling systems, e.g. the use of red, yellow and green traffic light symbols to show levels of salt in a product, (2) a requirement that some foods must be labeled as high sodium, or (3) regulations that would limit the amount of sodium in processed and some restaurant food.

What has been the national and international response to excess dietary salt consumption?

In the United States, the Center for Science in the Public Interest has petitioned since 1978 for measures to regulate sodium. In 1994, in a partial victory, the US Food and Drug Administration required that food manufacturers disclose to consumers sodium the amount of sodium and its percent of Daily Value. [9] The FDA also established guidelines for using sodium- and salt-related food claims such as “sodium free,” “low sodium,” “reduced sodium,” “salt free,” and “unsalted.” Back in 1982, the FDA had recommended that food manufacturers voluntarily reduce the amount of added salt in processed foods. However, despite these measures, it is estimated that salt intake has actually increased by in the United States by 55% from the early 1970s to 2000, [17,19] during which time the age-adjusted prevalence of high blood pressure increased substantially. [17]

Efforts are underway in several countries to reduce the amount of sodium consumed. For example, in the UK, The Food Commission has launched a campaign for safer, healthier food called the Healthy Hexagon, Eat less salt project. [20] This project aims to provide healthy eating education to more than 3,000 residents of the Hexagon Housing Association in south east London. Also, in the UK, the Sainsbury’s supermarket chain has voluntarily reduced the sodium content of its store brand products without protest by consumers. [14]

The government in the UK has divided foods into approximately 70 categories and has set target sodium reductions for each of these categories. The government hopes that sodium consumption in the UK will decrease by 33% in 5 years with these measures. The UK is also encouraging a “traffic light labeling system” for use by the food industry—with high sodium products being labeled with a red light, medium sodium products a yellow light, and low sodium products a green light.

The governments of Ireland, New Zealand, Australia and France have set similar standards to reduce the sodium intake in their populations. Finland’s government, which has focused on reducing sodium since the 1970s, has achieved a 30% reduction in average sodium consumption, from approximately 4,700 milligrams daily to approximately 3,300 milligrams daily. Researchers credit these efforts with decreasing deaths among 30 to 59-year-old men and women by 60%. [14, 21]

Strategies used by salt industry groups to oppose or delay new limits on dietary salt

The current FDA salt review was sparked by a petition filed in November 2005 by the Center for Science in the Public Interest (Docket No. 2005P-0450). [9,10] The petition seeks to have the GRAS (Generally Regarded as Safe) status of salt modified so that salt may be regulated. CSPI argues that voluntary measures over the past two and a half decades have not lowered the sodium content of foods and that more aggressive regulatory action is needed.

Under current law, sodium would need to be reclassified as an “additive” in order for it to be legally regulated. The CSPI petition further calls for food labeling requirements and ceilings on the amount of sodium in processed foods, among other measures.

Several salt industry groups, notably the European Union Salt Producers’ Association and The Salt Institute (a U.S.-based salt industry trade association) have argued against the scientific evidence and claimed that excess salt intake is not harmful to human health. [11, 12] In a clear conflict of interest, these salt industry groups have paid for medical and scientific opinions from “experts,” and they have used their popular websites to misinform the public. People without medical backgrounds may view their statements on salt and hypertension and make decisions that are contrary to medical advice. For example, the European Union Salt Producers’ Association, which represents salt producers in the EU who currently produce 45 million tons of salt per year, has issued several position papers on salt and health. In their position paper Salt and blood pressure: Controversial and misunderstood they state that “alarmist media reports and general recommendations to reduce salt intake” have the potential to cause harm. And The Salt Institute, which represents the interests of all major U.S. salt producers who produce approximately 46 million tons of salt per year, has similar statements on salt and health on its consumer website, including recommendations to adhere to a salty, Mediterranean diet.

In the December 2007 newsletter published by The Salt Institute, the authors comment on the proposed FDA regulations, likening them to the actions of Joseph Stalin, Adolf Hitler, Orwell’s “Big Brother,” and The Spanish Inquisition.[13] In this newsletter, they denounce “pathological science,” quoting John Horgan who said: “Pathological science kills people and ruins lives. Such fake science is still peddled by the PC establishment in Europe and America.” The proposed federal regulations, which would impose labeling requirements and limit the amount of sodium in processed foods, would not interfere with the ability of consumers to purchase salt and use it as they wish. The proposed regulations would simply protect U.S. adults from processed foods that increasingly contain excessive amounts of sodium. By reducing hypertension, the new rules would also reduce the burden of chronic disease in the United States. [1, 17]

In May 2007, the European Salt Producers’ Association held a conference that promoted their scientifically questionable views on salt. David McCarron, a hypertension specialist, spoke at the European Union Salt Producers’ conference. He is the same person hired by The Salt Institute to request immediate access to the complete data from the DASH study. [22] The DASH study, published in the New England Journal of Medicine in January 2001, demonstrated that reducing dietary salt could lower blood pressure, even in people without hypertension. [23] The Salt Institute filed a petition under the Data Quality Act, claiming that the researchers must turn over their data so that a “qualified member of the public” can reconduct the analysis. [21] A district court dismissed The Salt Institute’s petition, and when The Salt Institute appealed to the U.S. Court of Appeals for the 4th Circuit the petition was again dismissed. [22,24]

In the case of salt, industry opposition has prevented governments from instituting simple policies that could, over the years, prevent millions of premature deaths. In the coming weeks, the FDA has an opportunity to change the ending of this familiar story.

 

References

1. Asaria P, Chisholm D, Mathers C, Ezzati M, Beaglehole R. Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use. Lancet. 2007; 15;370(9604):2044-53.

2. American Medical Association. “AMA calls for measures to reduce sodium intake in U.S. diet: urges FDA to revoke ‘generally regarded as safe’ status.” June 13, 2006. Accessed December 22, 2007 at http://www.ama-assn.org/ama/pub/category/print/16461.html

3. CRohack, JJ. Letter from AMA to Boston Globe: Cutting sodium beneficial to Americans’ health. July 3, 2006 (published).

4. Institute of Medicine, Food and Nutrition Board. Accessed January 9, 2008 at http://www.iom.edu

5. World Health Organization, Global Strategy on Diet, Physical Activity and Health. Cardiovascular Disease: Prevention and Control. Accessed January 9, 2008 at http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/

6. Consensus Action on Salt and Health. Accessed January 9, 2008 at http://www.actiononsalt.org.uk

7. Center for Science in the Public Interest. Salt: the forgotten killer. . . and the FDA’s failure to protect the public’s health. Accessed December 22, 2007 at http://www.cspinet.org/salt/saltreport.pdf

8. Salt Assault: Brand-Name Comparisons of Processed Foods. Washington, DC: Center for Science in the Public Interest.http://www.cspinet.org/salt/updated_saltreport.pdf

9. Center for Science in the Public Interest. Petition to Revoke the GRAS Status of Salt, to Set Ceilings on the Amount of Sodium in Processed Foods, to Require a Health Warning on Packaged Salt, and to Reduce the Daily Value for Sodium (Docket no. 2005P-0450, U.S. Department of Health and Human Services Food and Drug Administration). Submitted November 8, 2005 by Michael F. Jacobson, Ph.D.

10. U.S. Food and Drug Administration (FDA). October 19, 2007 Notice of Public Hearing: Salt and Sodium. Petition to Revise the Regulatory Status and Establish Food Labeling Requirements Regarding Salt and Sodium. Docket No. 2005P-0450. Accessed December 22, 2007 at http://www.cfsan.fda.gov/~comm/registe7.html

11. EU Salt, European Salt Producer’s Association. Accessed December 22, 2007 at http://www.eusalt.com

12. The Salt Institute. Accessed December 22, 2007 at http://www.saltinstitute.org/2.html

13. The Salt Institute. December 2007 Newsletter. Accessed December 22, 2007 at http://www.saltinstitute.org/news07-dec.html#article1

14. Havas SH, Roccella EJ, Lenfant C. Reducing the public health burden from elevated blood pressure levels in the United States by lowering intake of dietary sodium. Am J Public Health. 2004; 94(1):19-22.

15. Greeley A. A pinch of controversy shakes up dietary salt. FDA Consumer Magazine, November-December 1997.

16. Food and Nutrition Board. Dietary Reference Intakes for Water, Potassium, Sodium Chloride, and Sulfate. Institute of Medicine, 2004.

17. Dickinson BD, Havas S, for the Council on Science and Public Health. Reducing the population burden of cardiovascular disease by reducing sodium intake. Archives of Internal Medicine. 2007; 167(14):1460-1468.

18. Cappuccio FP. Salt and cardiovascular disease: Reducing sodium intake improves cardiovascular outcomes but few countries have effective policies. BMJ. 2007; 334: 859-860.

19. Briefel RR, Johnson CL. Secular trends in dietary intake in the United States. Annu Rev Nutr. 2004; 24: 401-431.

20. The Food Commission, Healthy Hexagon Eat Less Salt Project. Accessed December 22, 2007 athttp://www.foodcomm.org.uk/hexagon.htm

21. Krappanen H, Mervaala E. Adherence to and population impact on non-pharmacological and pharmacological anti-hypertensive therapy. J Hum Hypertens. 1996;10(Supp 1): S57-S61.

22. Kaiser J. Data access. Industry groups petition for data on salt and hypertension. Science. 2003 May 30;300(5624):1350.

23. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, Simons-Morton DG, Karanja N, Lin PH; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. NEJM. 2001; 344: 3-10.

24. Raeburn P. A regulation on regulations. Sci Am. 2006 Jul;295(1):18, 20.

 

Photo Credit:

Salt Shaker, Supa mb

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.