‘Big Food’ needs scrutiny – experts

The reach and impact of the multinational food and beverage industry – ‘Big Food’-  has been thoroughly under-examined, according to the authors of a new series of articles calling  for greater scrutiny of the industry.

The journal PLoS Medicine is launching a special series of articles highlighting the influence and impact of the food industry.

In an editorial to launch the new series on Big Food the PLoS Medicine editors  argue that the multinational food and beverage industry has a growing influence on the global health agenda and a major role in the obesity crisis, but that its activities have not been met with sufficient scrutiny or skepticism.

The first articles in the series, published today, include  an essay from guest editors Marion Nestle and David Stuckler, which describes the public health response so far to Big Food as a “failure to act.”

In a third policy forum article, media and public health experts draw parallels between the public relations efforts of soda drink companies and those used by tobacco product manufacturers, highlighting several ‘Corporate Social Responsibility’ (CSR) campaigns that distract from their products’ health risks.

They conclude: “Public health advocates must continue to monitor the CSR activities of soda companies, and remind the public and policymakers that, similar to Big Tobacco, soda industry CSR aims to position the companies, and their products, as socially acceptable rather than contributing to a social ill.”

The Science Media Centre contacted New Zealand experts for further comment on the issues put forward in the PLoS Medicine series on Big Food.

Dr Gabrielle Jenkin, Department of Public Health, University of Otago Wellington, comments:

“I would have to agree with those three papers and I agree with the critical view in the paper by Stuckler & Nestle.

“There are New Zealand examples of the undue influence of ‘Big Food’ in NZ. Their influence is everywhere.

  • The food industry in NZ dominates nutrition policy – this is why we don’t have any government regulation of junk food advertising (only very weak voluntary codes) and why we still don’t have front of pack traffic light labelling.
  • The food industry position on individual responsibility dominates the media discourse (think of all the TV shows on weight loss that blame individuals – The Biggest Loser, Honey We’re Killing the Kids, the Evil Diet Witch, Embarrassing Fat Bodies etc ) and very little on the food industry and the obesogenic environment (with the exception of Morgan Spurlock). How can two thirds of the population be suffering from an epidemic of lack of will power and personal irresponsibility? The fact is, it is now abnormal to be a healthy weight!
  • We also have some of the dubious industry-‘health’ partnerships- the NZ Dietetic Association (NZDA) for instance, was last time I looked sponsored by the sugar industry.
  • We also have the food industry co-opting nutrition experts and commissioning their own research (some of this was presented to the Health Select Committee Inquiry into obesity). Also Phillip Morris owns Kraft food, and there are interesting cross company ownerships between the diet industry and the food industry as well.
  • The food industry also influences the policy makers (bureaucrats and politicians especially) –  in the past via the Food Industry Group. As a recent example the new Health Promotion Agency (which takes over from ALAC and the Health Sponsorship Council), has strong food industry representation via Katherine Rich.

“The food industry (and the advertising industry) still promulgates the position of ‘individual responsibility’ as the papers argue, and as my colleagues and I have previously reported. I think a really important point to raise, is how the PLoS Medicine editorial points out how the Journal of Public Health Policy now discourages research articles of research on individual eating and activity (i.e. that suggest individual responsibility)!

“I think it would be better to consider framing the issue not as one of ‘obesity’, but one of ‘unhealthy food’ (energy-dense nutrient poor food). That way you avoid the stigmatising impact of the obesity frame AND its individualising implications. This turns to focus to real problem… the food industry.”

The key areas in NZ where there needs to be urgent action are:

1. Introduce Traffic Light labelling on the front of food.

2. Get junk food out of schools- schools should not be profiting from child obesity

3. Ban junk food marketing to children at least, preferably ban it all together, across all mediums including the internet and emergent media. This includes sponsorship of sport.

4. Regulate food composition (fat, salt and sugar and where practicable regulate portion size- by this I mean what they have done in NY which is ban the very large beverage sizes.

5. Get the food industry out of policy making – health policy is a conflict of interest for much of the food industry.

Prof Elaine Rush, Professor of Nutrition, AUT, comments:

“Globally children are being robbed of their future and responsible players need to be held accountable. This is the moral stand that cannot; should not be argued.  Who are the responsible players?  This is where it becomes more difficult.  What is known is that personal and individual behaviour and responsibility are NOT causes of the obesity epidemic  It is very pleasing that the role and responsibility of Big Food is being scrutinized and questioned.

“The basic needs for food (including water), clothing and shelter must be met across the lifecycle for physical well-being. A focus on food is important as is a focus on the BIG responsible players and their corporate social policy.  BIG food suppliers, multinationals, do control what people eat.  Accessibility and availability of food determine what goes into the mouth.  Coca cola is one of the most common words in the world and the golden arches of McDonalds are ubiquitous.  From early in life children learn to recognize these symbols and also to appreciate the palatability and consistency of the products.  The problem is that the food is energy dense, nutrient poor and ingredients such as sugar have addictive and toxic properties.  The addiction is further enhanced when caffeine is added. The proof that more of these products are being consumed is found in the supermarket where many metres of shelf space are given to sugar added beverages and many of these have caffeine added.

“In New Zealand we produce sufficient food to feed seventeen million people yet we import a large proportion of the food consumed by New Zealand children and a large proportion of food is processed. We need to ask why?  What is the role of agriculture and business in what goes from the farm to the fork and how does this impact on the nutrient status of our children? Why do we allow so much passive and active marketing to children of foods and screen time? We insist children are safely strapped into cars but allow more children than older people to live in poverty and be denied access to whole, nutrient-dense foods, shelter and clothing.  We elect governments to provide regulation and policy, to protect our human rights. The need is to protect children and their children and BIG food and food systems need to be held accountable and take responsibility.”

Prof Jim Mann, Director of the Edgar National Centre for Diabetes and Obesity Research (ENCDOR) and the WHO Collaborating Centre for Human Nutrition, comments:

When it comes to comparing sugary beverages to tobacco, we know that tobacco is the major cause of lung cancer, and we know that tobacco is major a contributor to many other diseases, including heart disease. But the contribution of sugar to obesity – although obesity is incredibly important – is probably much smaller.

“Another problem is that by hammering all the blame on sugary beverages, you take the blame away from everything else. What obesity really results from is an excess intake of energy dense foods over and above what the body can burn – plus genetics and a whole lot of other things. And if you focus down on one thing and lead people to believe that if they just stop drinking sugary beverages, the obesity problem will go away, it almost certainly will not.

“Sugary beverages are just one contributing factor.

“I think the articles published in PLoS Medicine don’t provide the overall perspective – although I wouldn’t want to be seen to be saying “I don’t think sugary beverages are not important” – I think they are important. But they are not the same as the tobacco industry; they are not the whole explanation to obesity.

“My concern is that by giving them a heavy emphasis – PLoS Medicine is a major platform – you lose the big picture of obesity which is a package deal. I don’t want to say sugary drinks are not important, but they are not the be all end all, that’s really the bottom line.
“Regarding food industry lobbying, there are good points raised of the industry doing all sorts of things to cover up their activities. There is no doubt the food industry is involved in very concerning activities because they are there not working for the health of humankind but for the share holders’ profits.

“While I do have concerns over the industry, my concern is equally directed at the government. There are many things government could be doing to limit obesity, for example controlling food in schools. I would put those issues ahead of being too bothered if the food industry do or do not sponsor some good causes (but people should be aware that the food industry sponsors such causes purely for advertising purposes).

“Important initiatives the government should be undertaking were outlined in an article published in the New Zealand Medical Journal last year.”

Prof Janet Hoek, Department of Marketing, University of Otago, responded to our questions:

Is it fair to compare food with tobacco?

“While food and tobacco are different (tobacco is unambiguously harmful, good food is important to life), not all foods are ‘healthy’.  Energy-dense and nutrient-poor (EDNP) foods are linked to obesity which, in turn, increases the risk of serious chronic illnesses such as diabetes.  Where products present risks to public health, it seems reasonable to review the marketing used to promote them with the marketing used to promote other unhealthy products, such as tobacco.”

Most of the corporate examples presented by PLoS Medicine are American, do we see similar activities here (e.g. social responsibility campaigns from fast food companies)?

“Food companies employ many of the strategies used previously by tobacco companies; these are evident in many areas (Hoek & Maubach, 2006).  Despite questions about the effectiveness of industry self-regulation, food advertising remains self-regulated and complainants do not find the process easy to navigate (Hoek & King, 2008).

“Food companies make extensive use of corporate social responsibility campaigns (CSR).  Coca Cola’s Christmas in the Park pairs a drink with few, if any, nutritional benefits to an iconic childhood character. Ronald McDonald visits schools to promote road safety, reaches into many children’s sports with “Player of the Day” vouchers, and provides parents whose children are ill with a home away from home via the Ronald McDonald houses.  If these gestures did not address a marketing objective, they would be unbranded and the pairings that have been so carefully developed would not be the subject of extensive advertising and PR activity.”

Should we be supporting fast food de-normalisation campaigns?

“We should look at the Ottawa Charter on Health Promotion, which calls for healthy public policy; it is disappointing that New Zealand has seen the dismantling of some healthy public policies.  For example, the decision to rescind a guideline requiring schools to provide only healthy food in canteens was not informed by research.  We have also not taken opportunities to use research to implement sound policy.  For example, we have very good New Zealand evidence that traffic light food labelling would improve consumers’ ability to differentiate between foods with different nutritional profiles, yet the government has not acted on this evidence, and appears unlikely to do so (Maubach, Hoek, & Gendall, 2009; McLean, Hoek, & Hedderley). The opposition shown by some food manufacturers to this labelling scheme is reminiscent of tobacco manufacturers’ opposition to health warnings and plain packaging.

“We should develop supportive policy environments that restrain the more rampant marketing activities known to influence people’s choices and, at the same time, introduce measures that help consumers make better food choices.  The wide availability of fast food and its dominant commercial presence will make fast food denormalisation campaigns difficult to undertake, unless these are funded at the same level. We need first to change the food marketing environment so healthy eating (or unhealthy food avoidance) campaigns can have more effect.”

Do we focus too much on individual responsibility and not enough on corporate accountability when it comes to diet?

“Calls for people to exert greater individual responsibility are ironic, given the triggers that predispose them to poorer food choices.  These include the price discounting of EDNP foods, the relative costs of foods such as carbonated soft drinks and milk, the visual salience and accessibility of EDNP foods in stores (the facings devoted to these products and their in-store location relative to, say, milk), and the sophisticated and highly integrated marketing campaigns used to promote EDNP foods.

“We need to realise that people do not engage in rational or detailed assessments before they purchase food (or anything else).  They spend a few seconds, at most, assessing the options available to them and, for the most part, nutrition information is hidden in plain view.  It is present, but on the back or side of pack, where it has little visual impact, and it appears in a form most people find incomprehensible (either as part of the mandatory nutrition information panel or in the voluntary percent daily intake information).

“As Stuckler and Nestle point out in their essay, food manufacturers have a goal of maximising the profit they deliver to their shareholders, so it is unrealistic to expect them to be accountable for public health goals as well as profit goals.  The best option is for governments to show leadership (Crampton, Hoek, & Beaglehole, 2011), draw on the available research evidence, restrain the marketing that can be undertaken, and provide consumers with information they can actually see and use.   ”

Crampton, P., Hoek, J., & Beaglehole, R. (2011). Leadership for health: developing a canny nanny state. New Zealand Medical Journal, 124(1329), 66-72.

Hoek, J., & King, B. (2008). Food advertising and self-regulation: a view from the trenches. Australian and New Zealand Journal of Public Health, 32(3), 261-265.

Hoek, J., & Maubach, N. (2006). Self-regulation, marketing communications and childhood obesity: A critical review from New Zealand. Loyola of Los Angeles Law Review, 39(1), 139-168.

Maubach, N., Hoek, J., & Gendall, P. (2009, May 28-30). The effect of front-of-package nutrition information and product claims on consumers’ attitudinal evaluations and choice behaviours. Paper presented at the American Marketing Association Marketing and Public Policy Conference, Washington DC.