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The Rudd Center Health Digest

June 2012

New York City Proposes Ban on Large Sugary Drinks

SodaNew York City Mayor Michael Bloomberg recently proposed a citywide ban on sweetened beverages over 16 ounces, according to CBS News. Under the proposal consumers would no longer be able to purchase sugary drinks over 16 ounces from restaurants, movie theaters, and sports venues, among other establishments.

The CDC recently reported that the average soda is six times larger today than it was in the 1950s, and that Americans are on average 26 pounds heavier than they were in the ‘50s. The Rudd Center's Sugary Drink FACTS report notes consumption data of sugary drinks, including that they are the greatest source of added sugars in the American diet and the number one source of calories in teens' diets.

The proposed ban is meant to address rising obesity rates in New York City and is open for a three-month public comment period before a vote by the city's Board of Health.

The move by Mayor Bloomberg may have far-reaching consequences, as other cities have used New York as a model for similar bans on trans fats and smoking in public areas. "The portion size initiative is another example of strong leadership," said Kelly Brownell, PhD, Rudd Center Director, in The Atlantic.

Diet sodas, dairy-based drinks, alcoholic beverages, and drinks with fewer than 25 calories per 8-ounce serving would not be affected by the ban.

Disney to Reduce Food Marketing to Children

Disney recently announced that food advertised to children on its many media platforms will have to meet healthier standards. The new guidelines, set to go into effect by 2015, are designed to promote the consumption of fruits and vegetables and reduce the intake of sodium, sugar, and saturated fat.

"This is a significant advance by Disney," said Kelly Brownell, PhD, Rudd Center Director, in an interview with USA Today. "With their reach and credibility, the tight nutrition standards they have set for specially designated foods will touch millions of children."

The most common food advertisements viewed by children in 2011 were for fast-food restaurants, cereals, casual sit-down restaurants, and candy, according to a recent Rudd Report. The new standards would prohibit many of these types of food advertisements from being used on Disney-owned networks.

Rudd Report Responds to Recent Trends in Food Advertising to Youth

A recently released Rudd Report, “Trends in Television Food Advertising to Young People: 2011 Update,” documents a 5 percent decline in total food and beverage advertising seen by children in 2011 compared with 2010. Adolescent exposure remained the same. While exposure is down, children continue to view approximately 13 ads per day that almost exclusively promote unhealthy foods.

Rudd Center researchers examined children’s exposure to food advertising on all television programming and found slight improvements, while also documenting troublesome trends.

  • The average 2-to-11 year old saw 12.8 food and beverage ads per day in 2011 compared with 13.4 ads in 2010. While the reduction in 2011 somewhat reverses the upward trend in 2010, it still exceeds children’s average annual ad exposure from 2006 to 2009.

  • Adolescents viewed 16.2 food and beverage ads per day in 2011 and 2010. Although 2011 was the first year since 2007 that the rate did not increase, adolescents viewed 27 percent more ads in 2011 than in 2007.

  • Advertising for the least nutritious categories of food, including fast food, cereal, carbonated beverages, and juice, fruit drinks, and sports drinks, declined in 2011, but youth exposure to candy advertising from 2009 to 2011 increased by 55 to 70 percent.

This analysis reveals a mixed impact of the Better Business Bureau’s Children's Food and Beverage Advertising Initiative (CFBAI), a self-regulatory program working to reduce ads aimed at children. Compared with 2004, the year with the highest child exposure to food ads in the analysis, children now view 8 percent fewer food and beverage ads overall. However, compared with 2007, the year prior to the implementation of the CFBAI, children are now viewing 5 percent more food and beverage ads in total.

Just Published by the Rudd Center

Strong Wellness Policies Improve Connecticut School Environments

Strong written school wellness policies lead to healthier food and more physical activity in schools, according to a study just published by the Rudd Center. The study, published in the Journal of School Health, found that districts with strong and clearly written school wellness policies are more likely to implement better nutrition education, higher nutrition standards for school meals and other food at school, and more opportunities for physical activity.

The Healthy, Hunger-Free Kids Act of 2010 requires that all school districts inform and update the public about the content and implementation of their local wellness policies during the 2011-2012 school year.

Rudd Center researchers collaborated with the Connecticut State Department of Education to collect and analyze the written wellness policies from 151 Connecticut school districts, and compared them to school principal reports of how well nutrition and physical activity policies were being implemented in their schools.

Statewide, school nutrition and physical activity practices improved in the first year of school wellness policy implementation. The districts that had stronger, more comprehensive policies were more successful in implementation than those with weaker policies.

The researchers found that urban districts with higher rates of free and reduced-price lunch eligibility developed significantly stronger written policies than other districts. Researchers asserted that urban districts may have taken the task more seriously due to concerns over elevated rates of obesity and other health issues among their students.

The paper was coauthored by the Rudd Center’s Marlene Schwartz, PhD, Deputy Director, Kathryn Henderson, PhD, Director of School and Community Initiatives, Meghan O’Connell, MPH, Research Associate, and Sarah Novak, PhD, former Rudd Center Research Associate; Jennifer Falbe, MPH, and Michael Long, MPH, Harvard School of Public Health; Christopher Wharton, PhD, ASU School of Nutrition & Health Promotion; and Susan Fiore, MS, RD, Connecticut State Department of Education.

Government Intervention in Unhealthy Food Marketing

The government can play a role in addressing the toxic food retail environment based on its interests in advancing public health, protecting children from manipulation and commercial exploitation, and supporting parents’ role in child-rearing, according to a paper published by the Rudd Center in the Indiana Health Law Review.

The paper, authored by Jennifer Pomeranz, JD, MPH, Rudd Center Director of Legal Initiatives, describes two viable methods, based on the best scientific evidence and within the constraints of the First Amendment, to address this environment.

“The government can argue that the use of characters on unhealthy food is deceptive and misleading as directed at children and thus not protected under the First Amendment,” according to Pomeranz. She continued that “in the absence of federal regulation, state and local governments could regulate the location of such products within retail establishments that do not meet certain nutrition profiles or regulate the location of the same unhealthy products that also bear characters on the packaging.”

National Food Policy Programs Improve Access to Healthy Foods

Access to healthy food in underserved communities has improved significantly after changes in federal nutrition and food assistance programs, according to a study just published by the Rudd Center in the Journal of the Academy of Nutrition and Dietetics. The study shows that the revisions in food packages for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) have increased the availability and variety of healthy foods in WIC-authorized, as well as non-WIC, convenience and grocery stores.

The WIC program is designed to help meet the needs of pregnant women and mothers of infants and young children who are at nutritional risk. The program’s food packages were revised in 2009 to offer foods that better reflect dietary recommendations for Americans. Researchers looked at inventories of 252 convenience stores and non-chain grocery stores in Connecticut to assess the variety, quality, and prices of WIC-approved foods before and after the new WIC food package implementation.

They found that within six to eight months of the WIC revisions, the provision of healthy foods, such as whole-grain products and produce, improved significantly in convenience and grocery stores participating in the WIC program. Non-WIC convenience and grocery stores, especially in low-income neighborhoods, also showed some improvement.

The researchers asserted that the WIC food package revisions have improved access to healthy foods not only for WIC participants but for communities at large.

The paper was coauthored by the Rudd Center’s Tatiana Andreyeva, PhD, Director of Economic Initiatives, Joerg Luedicke, MS, Biostatistician, Marlene Schwartz, PhD, Deputy Director, and Ann Middleton, MPH, former Research Associate; and Michael Long, MPH, Harvard School of Public Health.

Revising Sugar Labeling Requirements to Inform and Protect Consumers

Putting more information about sugar on food packages is necessary, achievable, and overdue, according to a recent Rudd Center paper published in the American Journal of Public Health. Author Jennifer Pomeranz, JD, MPH, Director of Legal Initiatives, cited evidence showing that consumers have little guidance to help them make informed choices about added sugar.

Pomeranz noted that the Food and Drug Administration’s sugar labeling regulations are outdated and need to be reanalyzed given several important developments. These include strong recommendations by the United States Department of Agriculture and the American Heart Association to limit added sugar consumption, robust science indicating that high intake of added sugar has a negative impact on health and overall diet quality, and the Institute of Medicine’s recommendation that the FDA consider added sugar in a front-of-package labeling system.

Pomeranz argued that the FDA’s previous reluctance requiring manufacturers to disclose sugar and added sugar on their products’ packaging is based on outdated science and obsolete concerns. Regulations on food allergens and tobacco labeling have been successfully enacted amid these same concerns. Further, added sugar detection has a rich scientific history that is evolving to enable the FDA to test sugar-related claims on packaging. There should also be a disqualifying level of added sugar in products for manufacturers to be able to make health claims. Currently, many products high in added sugar have cartoon characters on the packaging to entice children, and health claims to appease parents.

Increased labeling requirements can also lead to innovation and would likely encourage positive reformulation due to increased competition among companies trying to create and market products with less added sugar.

“The American Heart Association, the USDA, and the World Health Organization have issued strong standards that can guide the government. There are no longer any viable reasons to maintain outdated nutrition labeling standards for sugar,” stated Pomeranz.

Rudd Center Spotlight: William H. Dietz, MD, PhD

DietzWilliam H. Dietz, MD, PhD, Director of the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention (CDC) presented Adventures in Food Marketing to Children during the Rudd Center’s Spring Seminar Series.

Prior to his appointment at the CDC, Dr. Dietz was a Professor of Pediatrics at Tufts University School of Medicine, and Director of Clinical Nutrition at the Floating Hospital for Children at Tufts Medical Center.

He is the author of over 200 publications in scientific literature; editor of five books including Clinical Obesity in Adults and Children and Nutrition: What Every Parent Needs to Know; a member of the Institute of Medicine; and recipient of several awards for his contribution to the field of children and media and for outstanding research in nutrition.

HBO Raises Awareness of the Stigma of Obesity

HBO’s recently released documentary series The Weight of the Nation addresses the complex causes of and solutions to obesity. Along with four main films, HBO produced ten short films, including Stigma: The Human Cost of Obesity, which features the Rudd Center’s Rebecca Puhl, PhD, Director of Research and Weight Stigma Initiatives.

The devastating and damaging experience of being stigmatized and discriminated against because of one’s obesity is rarely on the radar, according to a recent blog by Dr. Puhl on Medscape. HBO gives voice to these individuals, who recount their frequent experiences of weight bias in all aspects of society, and who are ostracized and treated unfairly by employers, health care providers, strangers, and even family members.

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).

Best and Worst Marketing Practice

Best: Birds Eye Markets Vegetables
Birds Eye will join Partnership for a Healthier America to market vegetables to children. From 2012 to 2014, the company will spend a minimum of $2 million per year on advertising campaigns and other marketing outreach to encourage increased vegetable consumption among children. Read more.

Worst: Baby Ruth Candy Bar Touts Protein
The packaging for select varieties of Nestlé’s Baby Ruth candy bars now boasts “4 grams of protein per bar.” Although peanuts provide some protein in Baby Ruth bars, the first and largest ingredient is sugar. Each regular-sized Baby Ruth bar contains 33 grams of sugar, 230 calories, and 14 grams of fat. Read more.

Employment Opportunity at the Rudd Center

Research Assistant
Provide a high level of assistance to the Director of Marketing Initiatives. Duties include, but are not limited to, data collection (administering surveys, questionnaires, TV and internet ads); conducting structured interviews on food policy, food marketing, nutrition, and obesity; data entry; and analysis.

Legislation Update

As the summer approaches, many state legislatures are wrapping up their sessions. The Rudd Center’s Legislation Database tracks bills that address obesity and food policy. Users can search for bills according to topic or by state, track legislative trends, and generate reports of bills filed, passed, and failed.

Bills to Watch: North Carolina’s House Bill 1003 and its companion, Senate Bill 842, would prohibit school districts from charging “indirect costs” (e.g. the costs of custodians to clean the cafeteria and utilities to run it) to a school lunch program unless it is financially solvent. This legislation would protect struggling school meals programs from the additional burden of reimbursing their school districts for these services and could provide a model for use in other states.

Good News: Connecticut and Mississippi passed bills that will have a positive impact on the health of school children. CT SB 458 will require 20 minutes of daily physical exercise for grades kindergarten through fifth. MS SB 2752 establishes a Coordinated School Health pilot program that would bring together school administrators, teachers, other staff, students, families, and community members to assess health needs, set priorities, and plan, implement, and evaluate school health activities.

Bad News: Alabama passed HB 242, which prohibits lawsuits based on claims arising out of weight gain, obesity, or a health condition associated with weight gain or obesity. The bill gives little recourse for consumers to hold food manufacturers accountable for serving and promoting unhealthy products. Twenty-four other states have passed similar legislation.

The Latest Rudd Center Podcasts

Peter Kaminsky
Author
Culinary Intelligence

Jeannette R. Ickovics, PhD, Director, CARE: Community Alliance for Research & Engagement, Yale University
Marlene B. Schwartz, PhD
, Deputy Director, Rudd Center for Food Policy & Obesity
Big Food: Health, Culture and the Evolution of Eating

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

Front Burner News

Going Sour on Sugar

Many health experts are placing the blame for America’s obesity epidemic on added sugar. Is sugar really that harmful to our health? Read more.

Stigma Hurts Fight Against Obesity

Weight stigma threatens to impede efforts to fight the obesity epidemic. "As long as we have this belief that obese people are lazy and lacking in discipline, it will be hard to get support for policies that change the environment, which are likely to have a much larger impact than trying to change individuals, " according to Rebecca Puhl, PhD, Rudd Center Director of Research and Weight Stigma Initiatives. Read more.

Tax to Reduce Obesity

A tax to effectively reduce obesity should be at least 20 percent, apply to a wide range of unhealthy foods (not just sugared soda, for example), and the government must simultaneously offer subsidies for vegetables and other healthy foods, according to a study published in the British Medical Journal. Read more.

Jamie Oliver’s Food Revolution Day

Celebrity chef Jamie Oliver challenged chefs, parents, educators, companies, activists, and celebrities to make healthier food choices during his Food Revolution Day in May. Read more.

Healthy Food is a Better Deal than Junk Food

Healthy_Food

Healthy food is no more expensive than junk food, according to a study by the U.S. Department of Agriculture. The study states that there’s better value in fruits, vegetables, lean meat, and low-fat milk. Read more.

WHO Focuses on Improving Diets

The World Health Organization is developing a set of voluntary guidelines to reduce tobacco and alcohol use and improve diets, in an effort to reduce non-communicable diseases. Read more.

McDonald’s Rejects Anti-Obesity Proposal

McDonald’s investors have rejected a proposal by shareholders that would require the fast-food chain to assess its impact on childhood obesity. Read more.

Schools Reject Pink Slime

The majority of states participating in the National School Lunch Program have opted to order ground beef that does not contain “pink slime,” according to the U.S. Department of Agriculture. Read more.

Obese Women Never Escape Weight Stigma

Obese women may still suffer from weight stigma even after losing weight, according to a study by the University of Hawaii, the University of Manchester, and Monash University. Read more.

SUGAR-SWEETENED BEVERAGES/TAXES


Soda Summit

Doctors, politicians, advocates, researchers, and public health experts recently discussed ideas on how to cut down consumption of sugary drinks during the National Soda Summit. Read more.

Changing the Environment is More Effective than Education

Critics of New York City’s proposed ban on large sodas have described the proposed rule as interfering with a matter of personal choice and would like more education and access to healthy foods instead. However, according to Kelly Brownell, PhD, Rudd Center Director, while education incentives are popular with the public, they only reach small numbers of people due to limited funds. Changing the environment, as the proposed ban would do, is much more effective. Read more.

Beverage Industry Sponsors Ad Campaign on Subways

The beverage industry is fighting back against the New York City Health Department’s campaign to reduce sugary drink consumption by sponsoring ads on subway cars. Read more.

New York City’s Anti-Sugar Ad Goes National

The Centers for Disease Control and Prevention will use New York City’s anti-sugar ad of the “Man Eating Sugar” in a nationwide campaign to encourage people to stop drinking sugary drinks. Read more.

Richmond Soda Tax on November Ballot

Voters in Richmond, California will decide whether to make the city the nation's first municipality to tax soda and other sugary beverages, during a November ballot vote. Read more.

Fruit Juice Targeted

Fruit juice is not a better alternative to soda, according to health experts in the HBO documentary The Weight of the Nation. Read more.

VOICES


Industry Attacks Proposed Soda Ban

Mayor Bloomberg's proposal to limit sugary soft drinks to 16 ounces in New York City has elicited attacks from the soda industry. The industry has created a new organization called "Let's Clear It Up," which includes a website to counter scientific evidence that links sugary drinks to obesity. Read more.

Howard County Cuts Sugary Drinks

In Howard County, Maryland, The Horizon Foundation is partnering with the health department, county government, the school system, health care institutions, faith communities, and other community groups to change the way the community thinks about sugary drinks. Read more.

Effects of Weight Stigma

Obesity rates are rising worldwide, but thinness continues to be the standard for physical beauty and attractiveness. Conversely, obesity is often linked with poor body image and low self-esteem, which only adds to the struggle with weight and weight-related health problems. Read more.

Sugar Sweetened Beverages and SNAP

It is time for the federal government to take a second look at the issue of excluding sugar-sweetened beverages from the SNAP program and stop ignoring one of the primary causes of an epidemic that is plaguing more and more people. Read more.

Need for Government Regulation

The federal government needs to do more than use voluntary standards to regulate food to improve the health of Americans. Read more.

Real Food

People should be encouraged to eat real food, and discouraged from eating non-foods, such as sugary drinks. Pretending there’s no difference is siding with an industry that cares more about pushing its products than our health. Read more.

FOOD MARKETING


General Mills Sued for Deceptive Marketing of Fruit Snacks

A federal judge in California has denied a request by General Mills to dismiss a lawsuit alleging that its Fruit Roll-Up and Fruit by the Foot snacks are deceptively marketed, saying a "reasonable consumer" might be confused by the products' actual fruit content. Read more.

PBS Markets Fast Food to Children

The Campaign for a Commercial-Free Childhood, Public Citizen, and Corporate Accountability International recently launched a campaign asking PBS to terminate a four-year marketing agreement between Martha Speaks, a popular animated kids’ show, and Chick-fil-A. Read more.

TV Ads Play Role in Obesity

Children who recognize fast-food advertisements on TV are more likely to be overweight, according to research from the Children's Hospital at Dartmouth. Read more.

Lawsuit Against Happy Meal Toys Dismissed

A California judge has dismissed a lawsuit that would ban toys from being included in Happy Meals. The suit claimed that Happy Meal toys coerced children into eating unhealthy food, contributing to childhood obesity. Read more.

Coca-Cola’s Marketing Plan

Internet_Advertising

Alison Lewis, senior VP of marketing for Coca-Cola, describes the company’s new marketing plan, which includes "networks, connectivity, and conversations." As an example, she discusses the company’s "Polar Bowl" promotion, which links TV advertising to a live internet stream. Read more.