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The Rudd Center Health Digest

July 2011

Just Published by the Rudd Center

Health Experts Challenge Industry’s Front-of-Package Nutrition Labeling

At first glance, the food industry’s latest labeling system, Nutrition Keys, seems promising because it would create a single system with objective nutrition information. However, in an analysis of the Nutrition Keys system, the approach is found to be contrary to what research shows would be helpful to consumers, wrote authors Rudd Center Director Kelly Brownell, PhD, and Emory University's Jeffrey Koplan, MD, MPH, in a Perspective piece recently published in the New England Journal of Medicine.

Drs. Brownell and Koplan also noted that the implementation of the system preemptively undermines the deliberations of the Food and Drug Administration and the Institute of Medicine (IOM), which are scheduled to release a report on food labeling in the fall.

The authors asserted that Nutrition Keys is too complex and has too many symbols. By comparison, the British have developed an easy-to-understand traffic-light approach. Red, green, and yellow symbols are used to show which foods might be eaten freely, in moderation, or sparingly. The Nutrition Keys system may also cause confusion because a high score is considered good for some nutrients such as fiber and bad for others such as saturated fat.

"Industry leaders who profess to be responsible partners in preventing and controlling the obesity epidemic have an opportunity now to reject this noncollaborative, premature approach and show good faith by awaiting the IOM report and endorsing the best evidence-based approach to front-of-package labeling," wrote the authors. “Otherwise industry may have proven itself untrustworthy again and raised the risk of what it wishes to avoid – government's exercising of its authority to mandate some types of labeling and to restrict others."

Rudd Report Responds to Food and Beverage Industry Self-Regulating Policies

A recently released Rudd Report, “Trends in Television Food Advertising to Young People,” documents an increase in children’s total exposure to food marketing between 2008 and 2010. Between 2004 and 2008, children's exposure to food ads on television decreased by 12%, but in 2010 children viewed 9% more ads than in 2008 and just 4% fewer than those viewed in 2004. The report was created in response to findings from the Grocery Manufacturers Association (GMA), which claim that the Children's Food and Beverage Advertising Initiative (CFBAI), a self-regulatory program, is working to reduce ads aimed at children.

According to the GMA, reductions of 68% or more occurred between 2004 and 2010 in numbers of ads viewed on children’s television for many food categories, including cookies, candy, soft drinks, snack bars, snacks, and packaged pizzas.

The Rudd Report examined children’s exposure to food advertising on all television programming and found smaller improvements and some troublesome trends.

  • Children were exposed to 43% fewer ads in 2004 vs. 2010 for soft drinks in total, compared to the 96% decline on children’s programming reported by the GMA.
  • Children viewed 4% more ads in 2004 vs. 2010 for candy in total, compared to the 68% decline on children’s programming reported by the GMA.
  • Children’s exposure to advertising for some of the least nutritious products has increased since 2008, the first year that companies implemented their CFBAI pledges, including a 70% increase in exposure to soft drink ads and a 97% increase in exposure to candy ads.
  • Candy is now the #2 packaged food advertised to children (cereal remains #1) and #1 for adolescents.
  • Hershey, one of the companies with the strictest CFBAI pledges, increased their advertising to children by five times – from 34 ads viewed in 2008 to 183 in 2010. The products advertised most in 2008 to 2010 were Reese’s Pieces, Reese’s Peanut Butter Cups, and Twizzlers.
  • Child exposure to advertising for fast food in 2010 continued its upward trend, increasing by 7% compared to 2008 and 29% vs. 2004.

Dramatic increases in certain areas of food marketing to children substantially offset the progress made in other areas and show limitations of the CFBAI, according to the report. These findings show the need for substantial improvement in food-industry self-regulatory policies. However, food and beverage companies are fighting voluntary improvements in nutritional quality of products advertised to children recommended by the federal government.

The Rudd Center’s database of pledges on food marketing to children worldwide lists and describes voluntary pledges from major global food and beverage companies, such as the CFBAI.

F as in Fat Recommends New Public Policy Initiatives to Fight Rising Obesity Rates

The recently released report, F as in Fat: How Obesity Threatens America’s Future 2011, encourages a national investment in policy initiatives that would help reverse obesity in the United States. The report was written by Trust for America's Health and the Robert Wood Johnson Foundation to raise awareness on and drive public policy actions.

The eighth annual report found that obesity rates rose in 16 states over the past year and declined in none. Rates have also increased over the last 20 years, when no state had a rate higher than 15 percent. Today in two-thirds of states, more than 25 percent of people are obese.

F as in Fat highlights the Rudd Center’s Fast Food FACTS report, which found that:

  • Eighty-four percent of parents reported taking their child to a fast food restaurant at least once a week.
  • Just 12 of 3,039 possible kids' meal combinations met nutrition criteria for preschoolers; 15 met nutrition criteria for older children.
  • African American children and teens saw at least 50 percent more fast food ads on TV in 2009 than their white peers.

Also discussed was the importance of menu labeling – 80 percent of consumers want nutrition information on menus and menu boards – and states and locales that have implemented menu labeling laws.

A main priority outlined to reverse childhood obesity is using taxes and other pricing strategies to discourage the consumption of calorie-rich, nutrient-dense foods and beverages. One such strategy is a penny-per-ounce tax on sugar-sweetened beverages, which could decrease consumption by 24% and generate significant revenue for cities, states, and the nation. 

Recommendations for policy initiatives include:

  • The USDA quickly issue strong standards on competitive foods and beverages.
  • The food and beverage industry implement standards on food marketing to youth consistent with those proposed by the federal Interagency Working Group.
  • Women, Infants, and Children (WIC) program be fully funded and carried out.

Institute of Medicine Recommendations on Reducing Childhood Obesity

The Institute of Medicine (IOM) recently released a report that outlines several key strategies for preventing obesity in children from birth to age 5. The report, Early Childhood Obesity Prevention Policies, stresses that obesity prevention measures should begin before a child enters school. Twenty percent of children between the ages of 2 and 5 are currently considered overweight or obese in the United States.

The IOM report recommends establishing dietary guidelines for children from birth to age 2, increasing participation in food assistance programs, and setting voluntary food marketing standards for the food and beverage industry. These recommendations are aimed at policymakers, healthcare professionals, and caregivers. The IOM also recommended that parents and caregivers provide meals for children that include vegetables, fruits, and whole grains, and avoid serving nutrient-poor foods.

Los Angeles Removes Flavored Milk from School Menus

Chocolate_Milk

As of July 1, the Los Angeles Unified School District (LAUSD) no longer serves flavored milk to students. The district's school board voted to eliminate chocolate and strawberry milk. British chef and TV personality Jamie Oliver is given much credit for pushing the LAUSD to remove flavored milk, a major source of added sugar in the diet of school children. A cup of strawberry milk contains 26 grams of sugar, which is nearly equivalent to a cup of Mountain Dew. The school district’s menu will include low-fat, nonfat, soy, and Lactaid milks.

The LAUSD is now the largest school district in the nation to make such a move, joining school districts in Washington, DC, Berkeley, Calif., and Boulder, Colo. With increasing rates of childhood obesity in the United States, cutting sugary drinks from schools is being praised by children's health advocates. Chef Ann Cooper of Colorado, a school food advocate, joined Oliver in supporting the LAUSD's action. Cooper recently said that flavored milk is simply “soda in drag.”

Rudd Center to Evaluate Wellness Polices of Nation's Second-Largest Child-Care Provider

The Rudd Center will create and carry out an evaluation of the wellness policies of Bright Horizons Family Solutions, the nation's second-largest child-care provider.

The evaluation will help Bright Horizons advance its nutritional, physical activity, and screen-time policies. The company goal is for all its child-care centers to meet wellness standards and serve as an example for other child-care centers nationwide.

Bright Horizons recently announced the initiative along with the Partnership for a Healthier America and First Lady Michelle Obama. It is part of Let's Move! Child Care, the newest phase of the First Lady’s Let's Move! campaign.

The Rudd Center's Marlene Schwartz, PhD, Deputy Director, and Kathryn Henderson, PhD, Director of School and Community Initiatives, will lead the evaluation. Results will be released to the public upon completion.

Food for Thought:

Decreased Life Expectancies of U.S. Women Linked to Obesity

In many regions of the United States, life expectancies for women have declined since 1997, according to a study recently released by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Between 1997 and 2007 life expectancies for women declined in more than 737 U.S. counties. By comparison, women's life expectancies declined in 227 counties between 1987 and 1997.

The study suggests that the backslide can be attributed to preventable risk factors such as tobacco use and obesity. According to the National Institutes of Health, two-thirds of U.S. adults are overweight or obese.

IHME compared life expectancy rates around the world and found that rates in many developed nations, such as Japan and Canada, are growing each year – a stark contrast to shrinking life spans in the United States.

Childhood Obesity and News Media Framing

Childhood obesity has increased dramatically in the United States during the past three decades. Rates among children ages 6 to 11 tripled since 1980. The news media’s framing of childhood obesity affects how citizens view the causes and possible solutions, according to a paper recently published in the journal Pediatrics.

The paper's authors analyzed a random sample of news stories on childhood obesity from 2000 to 2009 published in 18 national and regional news sources. Print and television news stories were equally as likely to say childhood obesity is caused by individual choices, such as overeating, as it is by system-level causes such as aggressive food marketing. Print and TV news stories consistently mentioned the need to change individual behaviors as the main solution rather than system-level solutions such as marketing regulations or sugar-sweetened beverage taxes.

Prevention Magazine Takes on Weight Bias in Health Care

Patients who experience discrimination from health care providers based on their weight can find solutions in a recent article in Prevention magazine, according to a recent blog by Rebecca Puhl, PhD, Rudd Center Director of Research and Weight Stigma Initiatives.

Providers and patients can also learn more about weight bias prevention by visiting the Rudd Center’s free toolkit, Preventing Weight Bias: Helping without Harming in Clinical Practice. The blog is the latest in a series about weight bias by Dr. Puhl on Medscape, a part of WebMD Health Professional Network (free online registration required).

Rudd Center Spotlight: Marie Bragg, MS, MPhil

Marie_BraggMarie Bragg, MS, MPhil, is a doctoral student at Yale University pursuing a degree in Clinical Psychology. Prior to starting her graduate studies, she earned a BA in psychology from the University of Florida, where she was the project coordinator for a study designed to prevent and reduce obesity among low-income culturally diverse families.

Ms. Bragg’s current research focuses on how professional athletes and sports organizations are used to promote unhealthy foods and beverages. She is conducting a series of studies to examine the prevalence of athlete endorsements, including LeBron James’ endorsement of McDonald’s, and sports sponsorships such as Coke’s sponsorship of the Olympics.

She will soon launch a study that examines whether these marketing tactics influence food consumption by making the products look cooler, healthier, or more appealing. Ms. Bragg said she hopes her research will play an integral role in what type of food products athletes and sports organizations consider endorsing.

Ms. Bragg will complete a clinical internship before graduating in May 2013 and then will pursue a postdoctoral research position at a university where she sees a potential for making an immediate impact on obesity interventions and prevention.

Gallery Shows Harmful and Helpful Media Images

A recent article by CBS News displayed images used by the media that show obese people in a negative light, which may harm a person’s psychological well-being and trigger unhealthy behaviors, according to the Rudd Center’s Rebecca Puhl, PhD, Director of Research and Weight Stigma Initiatives. The gallery also showed corresponding images depicting obese individuals favorably. The Rudd Center offers a free Image Gallery for the news media and researchers to promote positive portrayals of obese people.

Jack in the Box Cuts Toys from Kids' Meals

In a move that has been lauded by health advocates nationwide, fast-food chain Jack in the Box stopped including toys in its meals for children. Company spokesman Randy Carmical said the restaurant wants to focus on offering healthier options such as sliced apples instead of french fries and grilled chicken strips instead of breaded and fried chicken nuggets. Carmical said the company believes parents will find healthy options more appealing than unhealthier meals with a plastic toy.

San Francisco and Santa Clara County recently passed laws that create nutrition guidelines for kids’ meals with toys. Unlike many restaurants that lobbied against these laws, Jack in the Box voluntarily made the change.

Library of Podcasts

Eric Mar
Supervisor, San Francisco Board of Supervisors

Matthew L. Myers
President, Campaign for Tobacco-Free Kids

Brian Wansink, PhD
John Dyson Endowed Chair, Applied Economics and Management Department, Cornell University; Director, Cornell Food and Brand Lab

The Rudd Center’s extensive library of podcasts is available for download on iTunes U and through an RSS Feed.

Front Burner News

Big Food, Big Lies

In a recent commentary in the Journal of the American Medical Association, researchers assert that the food industry participates in "deceptive science and advocacy” by engaging scientists, funding their research, and offering them lucrative speaking and consulting deals in an effort to confuse consumers about the health effects of popular food products. Read more.

TV Time Linked to Diabetes and Heart Disease

Screen_Time

TV watchers are at greater risk of developing diabetes and heart disease, according to researchers at the Harvard School of Public Health. The combination of a sedentary lifestyle, unhealthy diet, and obesity contribute to the risk of developing these potentially fatal diseases. Read more.

Local Laws Fight Public Health Efforts

Several state legislatures are passing laws that prohibit municipalities and other local governments from adopting regulations targeted at curbing obesity and improving public health. Read more.

Celebration Food Banned in Some Massachusetts Schools

Schools in Mansfield, Mass., recently approved a no-food policy for classroom celebrations due to the rising number of illnesses among children. Read more.

Pros and Cons of MyPlate

While the USDA’s new food guide icon, MyPlate, is easier to understand than the food pyramid, some messages are lost, including the acceptable amount of fat and sugar, the distinction between refined grains and whole grains and fatty meats and nonmeat sources of protein, and portion sizes. Read more.

Overload of Food, Media, and Work Harms Health

The abundance of cheap and convenient foods, busy work and social lives, and the barrage of media sources are having a detrimental effect on the mental and physical health of Americans.
Read more.

Government Releases Plan for Healthier Lifestyles

The federal government recently released a plan that calls for preventing disease and injury. The plan emphasizes creating healthier homes, communities, foods, roads, and workplaces. Read more.

Schools to Serve Free Meals to All

Starting this fall as part of a pilot program offered by the U.S. Department of Agriculture, any school in Illinois, Kentucky, and Tennessee where at least 40% of students are needy is eligible to serve free meals to all children, regardless of family income. Read more.

Increased Weight Negatively Affects Women’s Quality of Life

Health-related quality of life declines as weight increases, and women’s quality of life is more negatively affected by weight than men’s, according to researchers at the Kaiser Permanente Center for Health Research. Read more.

Exhibit Explores History of U.S. Food

The National Archives has opened an exhibit called “What’s Cooking Uncle Sam?” that explores the history of U.S. food and the government's role on the nation's diet. Read more.

Schools Honored for Healthiness

The Alliance for a Healthier Generation, founded by the American Heart Association and the William J. Clinton Foundation, honored 275 schools for increasing physical activity and healthy eating. Read more.

Cost Concerns over Healthier School Lunches

Some school districts and conservative lawmakers are concerned that the government’s effort to make school lunches healthier will cost more than the nation can afford. Read more.

Washington State Still Seeks Childhood Obesity Strategy

Washington State has spent millions of dollars and hundreds of hours developing strategies to combat childhood obesity. Still, the number of overweight and obese children continues to climb. Read more.

Louisville Tries to Slim Down

With the help of the Robert Wood Johnson Foundation and planned exercise programs, Louisville, Ky., sees signs of progress in the fight against obesity. Read more.

FOOD MARKETING


Junk Food Ads Targeting Teens

One of the most contentious issues in the government’s voluntary food marketing guidelines is whether the marketing limits should be applied to older children, ages 12 to 17. The food industry says the overlap between teen and adult audiences makes restrictions impractical. Read more.

Children Still Battle Lure of Junk Food

Even though many states are trying to fight the obesity epidemic, reducing food marketing to children should be a main priority. Read more.

Pepsi’s Mid-Calorie Drink

Pepsi’s NEXT, a reduced-sugar and reduced-calorie cola, will launch in July. To distinguish NEXT from Diet Pepsi and Pepsi Max, advertising will focus on a reduced-sugar, rather than a reduced-calorie, message. Read more.

Fast Feeders Move Upscale with Café Concepts

Fast-food chains like McDonald’s, Burger King, and Subway are rolling out revamped, high-end locations in an effort to compete with Starbucks and other cafés. Read more.

VOICES


Stigmatized in School, Burdened for Life

Decreased education is a key factor in reduced career achievement among overweight women, yet no similar gap was found in educational attainment for overweight men, according to researchers at Utah State University and Arizona State University. One explanation may be that overweight girls are more stigmatized and isolated in high school compared with overweight boys. Read more.

Dietary Guidelines Contradict Subsidies

The U.S. Department of Agriculture recently released new dietary guidelines advising Americans to limit high-fat products such as meat and cheese, yet the federal government continues to subsidize these products with billions of tax dollars and gives almost no such support to fruits and vegetables. Read more.

Let’s Move! Is the Real Obamacare

The real Obamacare is not what the President has been focusing on but rather the modest steps that his wife, Michelle Obama, has been taking to counter the doubling of obesity rates among children in recent years. Read more.

School Buses No Place for Junk Food Ads

The Director of the New York State Healthy Eating and Physical Activity Alliance responded to a proposal that would allow New York school buses to carry advertising. She urged legislators to take a stand against these “predatory” marketing practices. Read more.

An Unhealthy Business Model

PepsiCo investors are unhappy that the company is pushing its "healthier-for-you" foods instead of pushing the more profitable "fun-for-you" products like Pepsi-Cola, Gatorade, and Cheetos, leaving food companies in a dilemma about what to market. Read more.

SUGAR-SWEETENED BEVERAGES


Philadelphia’s Soda Tax Time Will Come

Even though the mayor of Philadelphia’s proposed tax on sugary drinks was recently defeated, the idea will most likely resurface. Read more.

One Quarter of High Schoolers Drink Soda Every Day

The Centers for Disease Control and Prevention recently reported that one in four high school students drink a soda every day. The figure represents a decrease in consumption from the 1990s and early 2000s when more than three-quarters of teens consumed a sugary drink each day. Read more.

Consumption of Sugar-Sweetened Beverages Dulls Taste Buds

Sugar-Sweetened_Beverages

Researchers at two British universities found that consuming two sugary drinks a day can dull taste buds and cause cravings for high-calorie foods. Read more.