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The Rudd Center Health Digest

August 2011

McDonald’s Alters Happy Meals

French_Fries

In response to pressure from parents, consumers, and health officials, McDonald’s recently announced that it will change the composition of its Happy Meals. The effort, which will be introduced in September and rolled out across the company’s 14,000 restaurants by April 2012, aims to improve the Happy Meal’s nutritional quality by reducing the amount of French fries, adding a fruit or vegetable, and reducing the calories, sodium, and fat in each meal.

The default Happy Meal will automatically include a quarter cup of seasonal produce, a smaller portion size (1.10 ounce) of French fries, and a reduction of sodium by 15 percent or more. The meal will come with a choice of either soda, low-fat chocolate milk, or 1-percent plain milk. A toy will still be included with the meal.

Rudd Center research has documented the need for change in the nutritional quality of kids' meals. In the Rudd Center's Fast Food FACTS report, released in 2010, researchers found that out of 3,039 possible kids' meal combinations examined, only 12 met nutrition criteria for preschoolers; 15 met nutrition criteria for older children. Researchers also found that families who visit McDonald's were aware of healthful choices, but chose them in only 11 percent of Happy Meal purchases.

In an interview with NPR, the Rudd Center’s Director, Kelly Brownell, PhD, said of the changes, “It’s a reasonable first step.” Even though progress is slowly being made, some public health officials believe McDonald’s has not gone far enough. In New York Times interview, Marion Nestle, a professor of nutrition at New York University, called the changes a “sham” because McDonald’s is not doing more to limit soda.

In addition, under the Children's Food and Beverage Advertising Initiative's (CFBAI) new set of nutrition criteria, McDonald's will be able to show the French fries in their advertising for Happy Meals, as long as the meal includes low-fat plain milk. Children see over 1,000 ads for fast food per year, according to the Rudd Center's Fast Food FACTS report.

Earlier in the month, the restaurant industry announced its Kids LiveWell campaign, where a group of 19 restaurant companies pledged to offer more-healthful menu options for children. McDonald’s did not participate in Kids LiveWell, but Burger King said it would stop automatically including French fries and soda in all of its kids' meals under the initiative. "Burger King's removal of French fries as the default is a much better way to encourage children to eat healthier options," according to Jennifer Harris, PhD, MBA, Rudd Center Director of Marketing Initiatives.

Just Published by the Rudd Center

Product Placements Market Unhealthy Food to Children

Children are being exposed to almost one advertisement every day for unhealthy food, beverage, and restaurant brands via product placements on prime-time TV, according to Rudd Center research recently published in the American Journal of Preventive Medicine.

By analyzing data from Nielsen, researchers found that nearly 35,000 food, beverage, and restaurant brands appeared in prime-time TV programming during 2008. Despite frequent brand appearances for products in several categories, the majority of exposure was for regular soft drinks from just one company, Coca-Cola, which accounted for 71 percent of product-placement appearances viewed by children and approximately 60 percent of adult and adolescent exposure. Children viewed five times as many product placements as they did traditional, paid television commercials for Coca-Cola products.

In 2006, the Council of Better Business Bureaus launched the voluntary Children’s Food and Beverage Advertising Initiative (CFBAI), which required participating companies to “cease paying for or actively seeking to place their food and beverage products in editorial and programming content that is primarily directed to children aged 12 and under for the purpose of promoting the sale of those products.” Coca-Cola was among the companies that pledged not to advertise any of their products to children. In spite of these pledges, the authors found that the products of companies participating in CFBAI made up 80 percent of the brand appearances viewed by children.

The study was coauthored by Sarah Speers, BA, formerly of the Rudd Center; and the Rudd Center's Jennifer Harris, PhD, MBA, and Marlene Schwartz, PhD.

Parents Often Misled by Health Claims on Children’s Cereal Packages

Nutrition-related health claims commonly used on children's cereals are often misinterpreted by parents, according to Rudd Center research just published in Public Health Nutrition.

Researchers asked parents with children between the ages of 2 and 11 to view images of children's cereal boxes. The cereals featured were of low nutritional quality, but contained various nutrition-related health claims including "supports your child's immunity," "whole grain," "fiber," "calcium and vitamin D," and "organic." Participants were provided with possible meanings for these claims, were asked to select any that applied with the option to write in additional meanings, and were asked to indicate how the claim would affect their willingness to buy the product.

The majority of parents surveyed believed that cereals with claims were more nutritious overall and might provide specific health-related benefits for their children. These beliefs predicted a greater willingness to buy the cereals.

“Promoting specific positive nutrients in products with other, less beneficial ingredients appears to be a highly effective and low-risk marketing strategy for food companies,” according to Jennifer Harris, PhD, lead author of the study and the Rudd Center’s Director of Marketing Initiatives. “These claims provide an opportunity to enhance product image and increase sales with limited potential for consumer skepticism or other negative reactions.”

The authors asserted that increased regulation from the Foodand Drug Administration to reduce confusion surrounding misleading nutrition claims is needed.

The paper was coauthored by the Rudd Center's Jennifer Harris, PhD, MBA; Marlene Schwartz, PhD; and Kelly Brownell, PhD; and Jacqueline Thompson, BA, formerly of the Rudd Center.

Childhood Obesity Is Not Child Abuse

The Journal of the American Medical Association recently published a commentary coauthored by Harvard researchers Lindsey Murtagh and David Ludwig that discussed the potential use of state intervention in extreme cases of childhood obesity.

While the authors wrote that state intervention would not be desirable or ethical for many obese children and removal from the home would not guarantee improved physical health, they proposed that "involvement of state protective services might be considered, including placement into foster care, in carefully selected situations."

The commentary triggered mass media attention along with backlash from terrified parents and concerned medical experts. In a recent interview, Dr. Ludwig asserted that the story was wildly exaggerated by the media and that the article was meant to promote a dialogue on childhood obesity. He clarified that state intervention could include financial support to families, social services, access to safe recreation areas, and parenting courses to help manage a child's uncontrolled eating habits. “The ultimate answer to the obesity epidemic is not to blame parents, it's to create a more healthful and supportive society,” he said.

Rebecca Puhl, PhD, Rudd Center Director of Research and Weight Stigma Initiatives, commented on Dr. Ludwig’s piece in her Medscape blog: “We cannot assume that childhood obesity is child abuse, and we need to ensure that the pervasive stigma that exists toward obese individuals does not color the judgments of authority figures who are making decisions about obese children and their families. Unless there is clear evidence that parents are truly incapable of caring for their child, a child should not be removed from their family on the basis of obesity alone."

CFBAI Announces New Nutrition Criteria for Foods Advertised to Children

The Children's Food and Beverage Advertising Initiative (CFBAI) recently announced new nutrition criteria meant to strengthen voluntary efforts in the food industry to regulate food products advertised to children. The CFBAI said the new criteria, which go into effect Dec. 31, 2013, will bring uniformity to advertised products. Currently, many companies follow their own self-created and self-regulated rules. Under CFBAI standards, advertised food products must meet limits on calories, sodium, saturated fat, and sugars.

The new criteria, developed by food-industry scientists and nutritionists, cover ten categories, including juices, dairy products, main dishes and entrees, and mixed dishes. Each category also has specific guidelines. For example, no juice with added sugars may be advertised; flavored milks must have under 24 grams of sugar per 8 ounces; and main dishes and entrees must have no more than 350 calories and 600 milligrams of sodium per serving. The CFBAI hopes its criteria will encourage companies to develop healthier products.

The Rudd Center offers a database with updated information on pledges and commitments from the CFBAI and others.

Rudd Center Launches Fall Seminar Series

Wansink

Brian Wansink, John Dyson Endowed Chair, Applied Economics and Management Department, Cornell University, and Director, Cornell Food and Brand Lab, was a speaker in the Spring 2011 Seminar Series.

The Rudd Center has hosted many renowned experts in academics, advocacy, and public policy to discuss their work and its implications for the study of obesity, food policy, and weight bias. The Fall 2011 Seminar Series will include Cheryl Healton, President and Chief Executive Officer of Legacy, and Michael Jacobson, Executive Director of Center for Science in the Public Interest.

Upcoming Seminar Speakers

September 7, 12:30 pm
Cheryl G. Healton, DrPH
President and Chief Executive Officer, Legacy
Lessons Learned from the Tobacco Wars for Products Which Adversely Impact Health

September 28, 12:30 pm
Tamara R. Piety, JD, LLM
Associate Dean of Faculty Development and Professor of Law, University of Tulsa College of Law
Marketing and the Commercial Speech Doctrine

Subscribe to our mailing list to receive reminders of upcoming seminars and schedule changes.

Unless otherwise noted, seminars are held at the Rudd Center. The seminars are free and open to the public. Seating is limited. The full schedule for our Fall Seminar Series is available online and for download.

Restaurant Chains Offering Healthier Menu Options to Children

Nineteen restaurant chains have pledged to offer healthier menu options to children through the restaurant industry’s Kids LiveWell campaign. Restaurants participating in the voluntary initiative, sponsored by the National Restaurant Association, must offer at least one full children's meal that contains fewer than 600 calories and has two or more servings of fruits or vegetables. They also must sell at least one item with fewer than 200 calories that has limits on fats, sugars, and sodium. In addition, participating restaurants must display the healthy item nutrition information and promote the healthful options.

Burger King also stopped automatically including fries and soda as default items in their kids' meals. Consumers will be asked if they prefer milk or apple slices while ordering the meal.

The Rudd Center's Fast Food FACTS report, released in 2010, examined twelve fast food restaurants. Just 12 of 3,039 possible kids' meal combinations met nutrition criteria for preschoolers; 15 met nutrition criteria for older children. The report recommended that restaurants do more to promote their lower calorie and more nutritious menu items inside the restaurants where young people and parents make their final purchase decisions.

With more than 15,000 locations, restaurants participating in Kids LiveWell include: Au Bon Pain, Bonefish Grill, Burger King, Burgerville, Carrabba’s Italian Grill, Chevys Fresh Mex, Chili’s Grill & Bar, Corner Bakery Cafe, Cracker Barrel, Denny’s, El Pollo Loco, Friendly’s, IHOP, Joe’s Crab Shack, Outback Steakhouse, Silver Diner, Sizzler, T-Bones Great American Eatery and zpizza. Additional restaurants and menu options will be announced in the coming months.

Healthy Dining, a campaign cosponsor, has created a website search function where parents can find healthy restaurants and program participants in their area.

Sugar-Sweetened Beverage Tax Supported by Mark Bittman

In a recent commentary in the New York Times, food columnist Mark Bittman asked what can be done to change the unhealthy eating habits of Americans. With chronic diseases such as obesity, diabetes, heart disease, and cancer caused in part by the standard American diet, and health care costs at an all-time high, he said a change is needed. Bittman proposed a controversial solution to this problem: taxing unhealthy food and using the revenue to subsidize the market for healthy foods.

Bittman described how the food industry appears incapable of marketing healthier foods and that “their mission is not public health but profit, so they’ll continue to sell the health-damaging food that’s most profitable, until the market or another force skews things otherwise. That ‘other force’ should be the federal government, fulfilling its role as an agent of the public good and establishing a bold national fix.”

“Though the reduced costs of healthy foods obviously benefit the poor most, lower prices across the board keep things simpler and all of us, especially children whose habits are just developing, could use help in eating differently,” he said.

According to Rudd Center research, a national penny-per-ounce tax on sugar-sweetened beverages would generate at least $13 billion a year in revenue while cutting consumption by 24 percent. Those numbers would increase dramatically if the tax were extended to additional products or doubled to two cents an ounce.

The Rudd Center's revenue calculator, developed in collaboration with Frank J. Chaloupka, PhD, produces expected federal, state, and city revenues by tax per ounce and type of beverage.

Food for Thought: Food Label Fix

The University of California, Berkeley School of Journalism recently held a contest for redesigns of the nutrition label on food packaging. The project brought in dozens of submissions from students, graphic artists, and web designers. Contest judges, including author Michael Pollan and pediatrician Robert Lustig, favored designs that were heavy on graphic elements and color. The contest winner was graphic designer Renee Walker, who created a color-coded system that breaks foods down by ingredients and nutrition facts.

The contest was not officially part of the government food package redesign effort, but it is likely that many of the labels will be considered by the U.S. Department of Agriculture.

Employment Opportunity at the Rudd Center

If you would like to work toward improving the world’s diet, preventing obesity, and reducing weight stigma, read about the open position at the Rudd Center: Biostatistician.

Rudd Center Spotlight: Cheryl G. Healton, DrPH

HealtonCheryl G. Healton, DrPH, founding President and CEO of Legacy, will lead off the Rudd Center's Fall Seminar Series on Sept. 7 with her talk, Lessons Learned from the Tobacco Wars for Products Which Adversely Impact Health. Legacy is dedicated to building a world where young people reject tobacco and anyone can quit.

At Legacy, Dr. Healton has guided truth®, the highly acclaimed, national youth tobacco prevention counter-marketing campaign. The campaign has been credited in part with reducing youth smoking prevalence to near record lows. Under her leadership, Legacy has undertaken numerous public education campaigns, research, technical assistance, and a broad grant program.

She holds a doctorate from Columbia University's School of Public Health and a master's degree in Public Administration from New York University. She joined Legacy from Columbia University's Joseph L. Mailman School of Public Health in New York, where she served as Chair of the Division of Socio-medical Sciences and Associate Dean for Program Development.

Dr. Healton is an author, researcher, professor, and public health administrator. She has served on a vast array of national, state, and local conferences, committees, and task forces for public health and policy issues.

Dr. Healton is a thought-provoking speaker and frequent commentator on national and local news coverage of tobacco control issues.

Front Burner News

CDC Data Show Sharp Rise in Obesity

Obesity is a problem in every state, according to data analyzed by the Centers for Disease Control and Prevention. Every state reported that at least 20 percent of adults were obese in 2010, which means no state achieved the national Healthy People 2010 goal to lower obesity prevalence to 15 percent within the past decade. Read more.

Weight Discrimination in the Workplace

Mistreatment of overweight employees by paying lower wages or failing to hire and promote is often presented by employers as a question of productivity. However, advocates say this argument is an excuse for outright discrimination. Read more.

European Union Adopts Uniform Food Labeling System

The European Union adopted uniform food labeling across its 27 member countries. Under the new rule, food labels must list calories, fat, saturated fat, carbohydrate, sugar, protein, and salt levels. Read more.

Plant-Based Diet May Reduce Childhood Obesity

The regular intake of certain plant foods may prevent weight gain in children and adolescents. Meanwhile, too much dairy consumption may increase childhood weight gain, according to a new study published in the Nutrition Journal. Read more.

Marijuana-Like Chemicals Trigger Fatty Food Cravings

The same chemical that triggers an irresistible desire to eat among marijuana smokers may help explain why people like fatty food, according to a study published in the Proceedings of the National Academy of Sciences. Read more.

Menu Labeling Makes a Difference if Consumers Notice

Menu

Calorie labeling in fast-food restaurants can make a difference in what consumers buy if they pay attention to the information, according to a study in the British Medical Journal. Read more.

Bias Causes Avoidance of Medical Care

According to Rudd Center research, many obese patients experience weight bias by doctors and will consequently delay follow-up appointments. Focusing less on weight and more on health is the best approach in addressing any patient's concerns. Read more.

Massachusetts Bans Sweets, Caffeine, Trans Fats in Schools

Massachusetts has banned sugary drinks (including soda and sugar-sweetened juice), potato chips, foods with artificial sweeteners, trans fats, and caffeine from school vending machines, a la carte lines, stores, and events. Read more.

Restaurant Calorie Counts May Be Inaccurate

About 20 percent of meals contain at least 100 more calories than indicated on the menu and some foods are off by as much as 225 calories, according to a study published in the Journal of the American Medical Association. 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.

Science of Sugar Addiction

The Rudd Center’s Ashley Gearhardt explored why certain foods are capable of triggering an addictive process during a conference at the University of California, Davis. Read more.

Bringing Fresh Produce to Food Deserts

Fruit_Vegetables

Wal-Mart, Walgreen Co., and Supervalu Inc., have joined the First Lady’s effort to bring fresh fruits and vegetables to food deserts. They plan to open or expand more than 1,500 of their stores in areas where access to fruits and vegetables is limited. Read more.

SUGAR-SWEETENED BEVERAGES


Tax on Sugary Drinks Should Be Considered

Massachusetts received a failing grade in the category of sugary beverages in a new report from the Healthy People/Healthy Economy Coalition because the state does not impose a tax on these drinks. Read more.

Beverage Industry Responds to Anti-Soft Drink Campaign

Beverage makers have sued the New York City health department over its public awareness campaign aimed to deter consumption of soft drinks. They have asked local governments to provide documents on the science behind the initiative, a similar tactic to one used by the tobacco industry. Read more.

Teenagers Prefer Caffeinated Drinks

Adding caffeine to a beverage increases its appeal to young people, even when they are unaware that the drink contains caffeine, according to researchers from the University of Buffalo. Read more.

Taxing Unhealthy Foods

Some public health advocates push to tax unhealthy foods, like sugary soda, French fries, and donuts, while opponents say Americans should have the right to eat what they want without being unfairly taxed for their choices. Read more.

VOICES


Similarities Between Obesity and Tobacco Smoking

The battle against obesity should be comparable to the battle public health officials have been waging against tobacco for the last five decades. Read more.

Overcoming Hard Weight Discussions

Good intentions of healthcare providers, relatives, or friends often go awry when they attempt to encourage their patients, family members, or friends to lose weight. How one starts and frames the conversation can make a real difference in successfully fostering change. 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.

Empowering Consumers Through Calorie Counts on Menus

Placing calorie counts on menus may not be the cure-all to the obesity epidemic, but critics who charge that the new menu-labeling rule is the height of “nannyism” are missing the point. Read more.

Food Industry Must Walk the Talk

Food companies that care about the health of children, and not just about financial gains, will see the value in the government’s voluntary guidelines that ensure foods marketed to children contain healthy ingredients. For those food companies who really want to be part of the solution, it is time to walk the talk. Read more.

Finding Solutions to the Obesity Epidemic

Jeffrey Levi, Executive Director of Trust for America’s Health, said the obesity epidemic can be reversed by protecting the Public and Prevention Fund; implementing the Healthy, Hunger-Free Kids Act; implementing the National Physical Activity Plan; restoring cuts to federal nutrition assistance programs; and ensuring that the food and beverage industry adopts strong, consistent food marketing standards. Read more.

Obesity Specialists Needed at GP Practices

General practitioners and their colleagues often struggle to offer effective solutions to obese patients. Obesity specialists are needed, according to British doctor Tony Leeds. Read more.

FOOD MARKETING


GOP Delays Effort to Limit Children’s Junk-Food Ads

House Republicans are attempting to delay the Obama administration’s efforts to reduce junk-food marketing to children by including a provision in next year's Federal Trade Commission budget that would require the government to study the potential costs and impacts of the guidelines before implementing them. Read more.

Marketing Junk Food to Children

Southern California Public Radio aired a segment to examine if the government has gone too far or not far enough in regulating junk-food marketing to children. Read more.

Industry Calls Food-Marketing Guidelines Unreasonable

Representatives from the food industry and advertisers have called the government's new guidelines for food marketing toward children a "reckless" maneuver in light of today's poor economy. Read more.

Marketers Create Smaller, Healthier Options

Some of America’s favorite food and drink marketers are introducing smaller, healthier, and cheaper options, such as Starbucks’ Bistro Boxes, which are under 500 calories and cost less than $7. Read more.

Food Industry Calls Voluntary Guidelines Unworkable and Unrealistic

When the government recently proposed voluntary guidelines for the types of food advertised to children, the industry decided to preempt these guidelines and create their own, claiming the guidelines are “unworkable and unrealistic." Read more.