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The Rudd Center Health Digest

November 2009

Rudd Center Releases Cereal Rankings Based on Nutrition and Marketing Exposure

Cereal_FACTS

Companies market their least healthy breakfast cereals most frequently and aggressively directly to children, according to a new Rudd Center study released at the Obesity Society’s annual meeting in October. The study, supported in part by a Robert Wood Johnson Foundation grant, found that cereal companies pervasively market to children through the media and in stores.

The study is the first comprehensive examination of company marketing efforts and cereal nutrient composition. Of the 115 cereal brands and 277 individual cereal varieties examined, researchers identified nineteen brands (comprised of 47 varieties) as “child brands” because the cereals are marketed directly to children on television, the Web, and through licensed characters.

The Web site for the study, www.CerealFACTS.org, includes the full report, report summary, and tools for consumers and researchers.

Major media outlets covered the report, including Good Morning America, Today, Time, and USA Today.

Cereal companies spend nearly $156 million annually in television marketing to children. They also market extensively through the Web, social media, packaging, and in-store promotions.

“This research demonstrates just how far cereal companies have gone to target children in almost everything they do,” said lead researcher Jennifer L. Harris, PhD, MBA, and Rudd Center Director of Marketing Initiatives. ”The total amount of breakfast cereal marketing to children on television and computer screens, and at their eye-level in stores, combined with the appalling nutrient profile of the cereals most frequently marketed, is staggering.”

Key marketing exposure findings include:

  • The average preschooler sees 642 cereal ads per year on television — almost all for cereals with the worst nutrition rankings.
  • Companies make heavy use of online marketing through company-sponsored cereal Web sites and “advergames.” General Mills’ Web site, Millsberry.com, averages 767,000 unique young monthly visitors who stay an average of nearly 24 minutes per visit. Postopia.com averages nearly 265,000 young visitors.
  • Kellogg — the most frequent in-store advertiser — averaged 33.3 promotions per store and 9.5 special displays for its child and family brands during the four-week period examined.
  • General Mills markets to children more than any other cereal company. The company makes six of the ten least healthy cereals advertised to children, including the one with the worst nutrition score — Reese’s Puffs, which consists of 41 percent sugar.

Key nutrition findings include:

  • Cereals marketed directly to children have 85 percent more sugar, 65 percent less fiber, and 60 percent more sodium than cereals marketed to adults for adult consumption.
  • Forty-two percent of child-targeted cereals contain artificial food dyes, compared with 26 percent of family cereals and five percent of adult cereals.
  • Of the cereals targeted directly to children, only eight percent meet sugar limits to qualify for inclusion in the USDA’s Women, Infants and Children (WIC) program. Not one meets the nutrition standards required to advertise to children in the United Kingdom.
  • All cereals marketed directly to children meet industry’s own nutrition standards for “better-for-you” foods. They include Cocoa Puffs (44 percent sugar), Cap’n Crunch (44 percent sugar), Froot Loops (41 percent sugar), Lucky Charms (41 percent sugar), and Cinnamon Toast Crunch (32 percent sugar).

Most of the largest food marketers have pledged to reduce marketing of poor nutrition products to children through the Children’s Food and Beverage Advertising Initiative (CFBAI) sponsored by the Council of Better Business Bureaus. The Rudd Center research shows that the CFBAI has not significantly reduced the amount of cereal advertising to children on television.

“Ceding authority to the food companies to regulate themselves is a mistake,” said Kelly D. Brownell, PhD, Rudd Center Director. “The companies want to be seen as public health allies making good faith efforts to change, but their actions indicate otherwise.”

Added Jim Marks, MD, MPH, Senior Vice President and Director of the Health Group, Robert Wood Johnson Foundation: “While cereal can be a healthy and convenient breakfast for children, this study shows that cereal companies are targeting children with their least healthy products. Clearly there’s a lot of room for improvement.”

Yale Course on Food Offered to Public Online

An undergraduate Yale course, “The Psychology, Biology, and Politics of Food,” is offered for public viewing online through "Open Yale Courses," the University's free educational initiative. Recorded in its entirety and available in high definition video and audio formats, the Fall 2008 course was taught by Kelly D. Brownell, PhD, Rudd Center Director and Yale Professor of Psychology, and Epidemiology and Public Health.

The course covers the fundamental reasons people eat what they do; the psychological, health, social, economic, and political drivers of modern food practices; and how conditions can change to improve global health, personal well-being, and the environment. Topics include:

  • Food Preferences and Aversions
  • Impact of Biology on Eating
  • Nutrition and Health
  • Eating Disorders and Obesity
  • Effects of Food Advertising
  • The Economics of Nutrition
  • Sustainability and Genetically-Modified Foods
  • Global Food Politics

Guest lecturers include Brian Wansink, PhD, from Cornell University; B. Timothy Walsh, MD, from Columbia University; and Stephen Teret, JD, MPH, from Johns Hopkins University.

In addition to video and audio content, the Web site offers the course syllabus, searchable transcripts, and reading assignments. The content can also be accessed through YouTube and iTunes.

The California Soda Tax Solution

Kelly D. Brownell, PhD, Rudd Center Director, and David S. Ludwig, MD, Harvard Medical School, took to the Los Angeles Times opinion pages to urge California lawmakers to adopt a penny-per-ounce levy on sugar-sweetened beverages. Drs. Brownell and Ludwig, leading health experts, and are part of a prominent group that recently published a sugar-sweetened beverage tax policy strategy in the New England Journal of Medicine.

In their LA Times op-ed piece, “The Soda Tax Solution,” Brownell and Ludwig argued that a tax on sugar-sweetened beverages would raise the revenue needed to fund health care programs and lower health care costs in the future. California would serve as the “test case that proves it once and for all.” The penny-per-ounce tax would raise $150 billion nationally, and $18 billion in California alone. These numbers are striking particularly in light of the “Bubbling Over: Soda Consumption and Its Link to Obesity in California” report, which showed that 62 percent of adolescents drink at least one soda every day. The report also revealed that adults who drink a soda or more per day are 27 percent more likely to be overweight than those who do not drink sodas.

The California Center for Public Health Advocacy recently confirmed that the costs of adult overweight, obesity and physical activity in the state of California are now approximately $41 billion per annum. The California Senate Joint Hearing on Obesity and Diabetes held in early November provided a forum for government, industry, and healthy policy groups to gather and deliberate on this public health issue. Dr. Brownell provided testimony on the relationship between sugar-sweetened beverage consumption and health. He outlined the science behind the penny-per-ounce tax and implored government leaders to resist industry backlash and take action.

Federal Nutrition Programs to Receive Billions More in Funding

President Obama has signed a $121 billion agriculture appropriations bill for the current fiscal year. Nutrition programs will receive $82.8 billion, a $6.6 billion increase from 2009. The Women, Infants and Children (WIC) program, the Supplemental Nutrition Assistance Program (SNAP), the federal food stamp program, and U.S. dairy farmers are among the groups that will receive a significant increase in funds. This is welcome news as the market price of dairy products has dipped well below operating costs and more people are relying on government food programs because of high unemployment rates. Recent statistics show that almost one in eight Americans receives food stamps.

The agricultural appropriations bill, sponsored by Rep. Rosa DeLauro (D-CT), included $16.9 billion for child nutrition programs. The bill also provides an additional $209.5 million for the McGovern-Dole International Food for Education and Child Nutrition Program.
 
President Obama’s signature on this bill coincided with an event to promote healthy eating and exercise hosted by First Lady Michelle Obama and U.S. Agriculture Secretary Tom Vilsack on the White House lawn. Both moves strengthen the government’s commitment to help improve the nation’s health.

Upcoming Seminar Speakers

November 11, 12:30 pm: Boyd Swinburn, MD
Chair in Population Health; Director, WHO Collaborating Center for Obesity Prevention; Deakin University, Australia
Drivers of the Obesity Epidemic in the U.S. and Around the Globe

RESCHEDULED FOR SPRING SEMINAR SERIES
November 18: Dina Brewster

December 9, 12:30 pm: Gary E. Knell, JD
President and CEO, Sesame Workshop
Healthy Habits for Life

Our seminars are at the Rudd Center, located at 309 Edwards Street in New Haven, Connecticut, 06511. They are free and open to the public. Seating is limited. The full schedule for our Fall Seminar Series is available online and for download as a PDF document.

To receive a weekly E-mail from the Rudd Center detailing upcoming seminars and schedule changes, click here.

Spotlight on Rudd Center Affiliated Faculty: Robert L. Bell, MD, MA

BellRobert L. Bell, MD, MA, is Associate Professor of Surgery and Director of Bariatric Surgery at the Yale School of Medicine and Attending Surgeon at Yale-New Haven Hospital. Dr. Bell’s surgical specialty is gastrointestinal surgery. His clinical interests include gastrointestinal surgery with a particular focus on bariatric surgery for morbidly obese patients.

He performs most of his surgeries using a minimally invasive technique. He is one of a few surgeons in Connecticut who performs revisionary (“re-do”) obesity surgeries. Shortly after he arrived at Yale in 2002, he started the bariatric surgery program at Yale-New Haven Hospital where weight loss surgery had yet to be performed. He is the most senior bariatric surgeon at Yale-New Haven Hospital and has assumed leadership roles at both the Yale School of Medicine and Yale-New Haven Hospital. The American Society of Bariatric Surgery has recognized the Yale-New Haven Hospital as a bariatric surgery Center of Excellence. Oversight of the Center of Excellence includes preoperative counseling and review of potential weight loss surgery candidates, performance of a variety of weight loss surgical procedures, and post-operative follow-up. All long-term outcome measures are prospectively and longitudinally followed, including post-procedure weight loss and co-morbidity resolution. In addition, Dr. Bell’s bariatric practice is one of only 40 practices selected nationally to participate in the University HealthSystem Consortium (UHC). Participation in the UHC establishes “benchmarks” to improve clinical, operational, and patient safety performance.

Dr. Bell earned his medical degree from Texas A&M University College of Medicine, graduating with honors, and completed his internship and residency in general surgery at the Yale School of Medicine. He completed a fellowship in minimally-invasive and bariatric surgery at the University of Maryland. He has received many honors and awards for his work, including Outstanding Surgical House Staff Teacher at the Yale School of Medicine 2001 and the Edward H. Storer Award for excellence in surgical teaching in 2007.

World Food Day Highlights Global Food Security Issues

In light of global financial instability, this year’s World Food Day theme — achieving food security in times of crisis — was particularly relevant. U.N. Goodwill Ambassadors, Food and Agriculture Organization (FAO) representatives, and international leaders addressed the problem at the World Food Day ceremony at the FAO headquarters in Rome. A recent FAO report, “The State of Food Insecurity in the World,” found the number of food-insecure people has increased during the past decade and the financial crisis has exacerbated the problem.

World Food Day was October 16, the anniversary of the founding of the FAO in 1945.  The organization marks the day every year with ceremonies that serve as an opportunity to draw attention to global food issues.

New York University’s Marion Nestle gave the 6th annual George McGovern lecture on the “Future of Food” sponsored by the U.S. Embassy. George McGovern, a distinguished U.S. Senator, was instrumental in the Food for Peace Program and other international efforts to address hunger. In her lecture, Dr. Nestle discussed hunger, obesity, food safety, and stressed that “social solutions are necessary to address social problems.” Empowerment of women, education, and sustainable agriculture were among Nestle’s proposed solutions.

FAO Director-General Jacques Diouf called on world leaders to reach a “broad consensus on the total and rapid elimination of hunger.” World leaders will gather in Rome for the World Summit on Food Security between November 16 and 18.

The Latest Rudd Center Podcasts

Elaine D. Kolish, JD
Vice President and Director, Children's Food and Beverage Advertising Initiative, Council of Better Business Bureaus, Inc.
Linda J. Nagel, MSSA
President and CEO, Advertising Standards Canada
The Changing Face of Food Advertising to Children in North America

Elissa Epel, PhD
Associate Professor of Psychiatry; Founding Co-Director, Center for Obesity Assessment and Treatment; University of California at San Francisco

Lisa A. Sutherland, PhD
Assistant Professor of Pediatrics; Senior Nutrition Scientist, Hood Center for Families and Children; Dartmouth Medical School

Our collection of podcasts is available for download on iTunes U, under the Yale University Health & Medicine – Nutrition & Obesity section, or you may subscribe to an RSS Feed that will automatically update whenever new content is released. Podcasts can be listened to on a computer or downloaded to a music player.

Front Burner News

Kellogg Pulls Immunity Claims from Rice Krispies

Kellogg Co. pulled immunity claims from its Rice Krispies and Cocoa Krispies cereal boxes amid the public's growing concern about swine flu. Food makers have been facing increasing scrutiny for the labels that they put on their products, which have increased in number and scope in recent years. Read more.

Food Makers Suspend Promotion of Smart Choices Labeling

Cereal

The program that includes nine major firms has been criticized for promoting foods such as Froot Loops and Cracker Jack as nutritional. The FDA says such labeling systems may be misleading consumers. Read more.

New York Study Says Menu Labeling Affects Behavior

New York's mandate that fast-food restaurants post calorie information on their menus has changed consumer habits, according to the city's Department of Health and Mental Hygiene. Customers bought food with fewer calories at nine of the 13 fast-food and coffee chains. Read more.

Family Doctors Resign from AAFP over Coke Partnership

Twenty family physicians in Contra Costa County, California, ripped up their membership cards in the American Academy of Family Physicians in protest over the AAFP’s partnership with Coca-Cola. Read more.

Coke Partners with Doctors' Group

Can soft drinks ever be part of a healthy diet? Coca-Cola, whose sugar-laden products have contributed to a global obesity epidemic, has partnered with a leading medical group to promote healthy soft drink consumption. Read more.

Recommendations for New School Meal Nutrition Standards

The nutrition standards behind the National School Lunch Program and the School Breakfast Program have not been updated since 1995. The Institute of Medicine issued a report recommending new standards, calling for more produce, more whole grains, and a limit to calories. Read more.

American Dietetic Association Supports IOM Recommendations on School Meal Programs

The American Dietetic Association welcomes a report issued by the Institute of Medicine encouraging federal school meal programs to adopt standards that increase the nutrition content and limit the calories in meals served to school children. Read more.

Coca-Cola Unveils 90-Calorie Mini Can

The Coca-Cola Company has introduced a new 90-calorie mini can "to give consumers a better way to manage their calories." Read more.

Los Angeles Fast Food Restaurant Ban Unlikely to Cut Obesity

Restrictions on fast food chain restaurants in South Los Angeles are not addressing the main differences among neighborhood food environments and are unlikely to improve the diet of residents or reduce obesity, according to a new RAND Corporation study. Read more.

Bake Sales Banned in New York Schools

There shall be no cupcakes. In an effort to limit how much sugar and fat students put in their bellies at school, New York City’s Education Department has effectively banned most bake sales. Read more.

Cuts to Youth Sports Contribute to Obesity

Cuts of $2 billion to school-based sports and physical education programs are contributing to a range of problems afflicting the nation's youth, including obesity, violence, and academic failure, according to a report by Up2Us. Read more.

Depression Can Double Chances of Becoming Obese

People who are depressed or anxious are up to twice as likely to become obese as those without depression, a new study shows. Read more.

Obesity May Affect Fertility in Young Women

Women who become obese by the age of 18 are more likely to become infertile and develop polycystic ovarian syndrome than other women, new research suggests. Read more.

Half of US Kids Will Get Food Stamps

Nearly half of all U.S. children and 90 percent of black youthwill be on food stamps at some point during childhood, and fallout from the current recession could push those numbers even higher, according to researchers at Washington University. Read more.

Chicago Public Schools Breakfasts Are Big on Doughnuts, Sugary Cereals

This year for the first time, the Chicago Public Schools are offering free universal breakfast to nearly every student. But some nutrition experts warn that the sugary processed foods city schools feed to children are setting them up for unhealthy habits and other problems. Read more.

California Senators Consider Action on Sweetened Beverages

California legislators heard testimony about sugar-sweetened soft drinks as they consider possible legislation. It was, according to one of the country’s leading researchers on obesity, a “historic” hearing. Read more.

Crying over Spilt Chocolate Milk? Campaign Says Keep it in Schools, Experts Say Take it Out

The creators of the "Got Milk?" campaign are getting ready to make a big push to keep chocolate milk on kids' minds and on school lunch menus, a plan that has some educators and obesity activists none too pleased. Read more.

N.C. to Penalize Obese Workers, Those Who Smoke

Healthcare_Costs

North Carolina state employees who are overweight or smoke will pay more for health insurance. Read more.

VOICES


Soda Tax: A Lot of Froth over Freedom

Is taxing soda really an evil plan to curb your individual freedom? Conspiracy theories aside, perhaps it’s simply a sensible scheme to tackle obesity when personal choice has failed. Read more.

Should Morbidly Obese Kids Be Taken from Their Parents?

Removing children from their parents remains a last resort, but obesity experts are increasingly debating whether doing so can boost a child's chances for a healthier life. Read more.

Glutton Intolerance

A recent paper from the Rudd Center hints at the scope of this anti-fat prejudice. Read more.

Ambulances to Charge Extra for Obese Patients

Some ambulance companies have started charging higher fees for especially overweight people. Read more.

Pushing Fresh Produce Instead of Cookies at the Corner Market

As small corner grocery stores, which are predominantly family-owned, are often the sole source of groceries in areas with no full-size supermarket, the stores are becoming linchpins in public health campaigns. Read more.