Should public health advocates engage with the food industry in efforts to tackle poor nutrition, over-consumption and obesity?

And if they do, how can they ensure that they remain effective champions for public health and are not simply recruited to industry PR and marketing efforts designed to block or at least delay public health action?

These are timely questions, given a few recent publications. The journal Globalization and Health has recently published this article by several PepsiCo executives, titled “The role and challenges of the food industry in addressing chronic disease”. The lead author is one Dr Derek Yach, whose presentation at the University of Sydney last year caused a bit of a splash in Croakey at the time.

The new article encourages public health experts to work with the food industry.

It does note, however, that: “Potentially some of the greater challenges facing food companies are the levels of mistrust aimed at corporate entities.” (Funny that, given the outstanding history of corporate concerns for public health, let me see – tobacco, asbestos, alcohol etc)

The article has prompted some cynicism around the public health traps, including this response from Associate Professor Tim Gill, of the Institute of Obesity, Nutrition and Exercise at the University of Sydney: “It is surprising that journals will publish PR pieces like this but it is also surprising how many opportunities and time Derek is given to promote this message in different fora. Big food have been much more successful and subtle than big pharma in avoiding scrutiny and criticism of their influence on public policy.  Indeed some of their biggest supporters are academics. It would be good to consider a more united and sophisticated response to these PR pushes.”

Meanwhile, on a related theme, this blog with the catchy title of Appetite for Profit, run by a public health lawyer in the US called Michele Simon, has been investigating the implications of the PepsiCo CEO, Indra Nooyi, getting significant airplay in a major new report on obesity.

The report is published by the Robert Wood Johnson Foundation, a major funder of childhood obesity prevention programs in the US.

Simon writes: “If we can’t even read a major public health report on obesity data and policy solutions without running into a PR statement by Big Food, then no place is safe.”

She also quotes the public health nutritionist, Professor Marion Nestle (who has also been tweeting and blogging on this issue). Nestle said: “….research has clearly demonstrated that partnerships and alliances of health organizations with food companies benefits the food companies far more than the health organizations. The goals of public health and food companies differ. Food companies enter such alliances for public relations and to deflect public attention from the need to regulate their marketing practices. RWJF ought to be well aware of the risk of such alliances and to protect its integrity against them.”

Dr Catriona Bonfiglioli, a lecturer in media studies at the University of Technology, Sydney, said that the case was another “salvo in the debate about whether public health professionals should work with industry or against it.”

She said: “On a recent visit to Australia, Professor Philip James (chairman of the International Obesity Taskforce) advised working with industry (or at least that’s how I understood his advice).  However, from a strategic communications point of view it looks like another win for PepsiCo  – to have PepsiCo CEO Indra Nooyi included in a list of  “policy-makers and experts in the field of obesity” is a priceless endorsement. The more we learn about soft drinks, the more we can interpret soft drink manufacturers as experts in obesity. The more influence they have on policy the more they can be seen as policymakers. I’m not sure this counts as progress but it is very interesting.”

Meanwhile, Croakey is pleased to report on some good news about progress on healthy food policy. This is an article, published by Crikey today, by Jane Martin, Senior Policy Adviser, Obesity Policy Coalition. She writes:

“The Victorian State Government’s fast food menu labelling announcement is a step in the right direction for obesity prevention. Sure, it’s the not the magic bullet that alone will turn the tide on one of Australia’s biggest health crises, but it’s the first serious step we’ve seen a Government take on prevention, and it’s been shown to have an impact on what people consume.

In New York, where fast food outlet menus must display calorie counts, people have been choosing products with lower energy.

Now Premier Brumby has announced the introduction of a similar scheme in Victoria: fast food chains (with more than 50 stores in Victoria or more than 200 nationally) will be required to display kilojoules on menus by 2012.

Menu disclosure makes sense on a number of levels.

People are increasingly eating outside of the home, with a large proportion of these meals (44%) being fast food.

To put this in context, KFC have two million visits per week Australia-wide – that’s more than 100 million per year.

Fast food is usually energy dense and sold in large serving sizes. We also know that people substantially underestimate the energy content of this food. If you do want to find out more about what is in the food, this is often hard to find, hard to interpret and in many cases tucked away on company websites, or only available to view in stores on request.

If the onus is on the individual to make better choices, then information is needed to empower them to do this. We know that 87% of Australian consumers are in favour of chains listing nutritional information on menu boards.

For example, at present you would have little idea that the low fat smoothie you just ordered as a snack is a nearly a quarter of your daily kilojoule intake. Nor can you make an informed choice between a burger and salad. Some of the highest kilojoule products have names such as Blueberry Blast, Garden Goodness and Green Tea Venti. While some of these products contain valuable nutrients, few people would realise there’s less than 100 kilojoules difference between a Big Mac and the McDonald’s Crispy Chicken Caesar Salad.

Research has also found that providing this information can result in people ordering lower energy foods and can have a positive effect on what they eat for the rest of the day. There is also evidence that parents shown this information order fast food with fewer calories for their children.

The next logical step in menu labelling reform is traffic light labelling, which would colour code foods as red, orange or green based on whether levels of fat, saturated fat, sugar and salt are high, medium or low, enabling consumers to sort the fat from the fiction at a glance.  There is also high public support for this type of disclosure.

The Victorian example is now being considered by other states. While the Brumby Government should be congratulated on taking the lead, a national approach is needed. We hope that the COAG national labelling review will go further and recommended traffic light labelling on fast food menus so that all Australians will be empowered to make healthier choices.”

Update, July 4: This New York Times story investigates why plans for a “soda tax” for New York have gone down the gurgler. One part of the explanation: The American Beverage Association spent $9.4 million in the first four months of the year to oppose New York’s soda tax, according to a search of public lobbying records by the New York State Healthy Eating and Physical Activity Alliance.

Update, July 7: Pepsico has joined the science bloggers. Jay Rosen, a US journalism academic, has tweeted:  Pepsi gets a blog at Science Blogs. This will: 1.) Last and damage SB’s rep; 2.) Last and prove harmless; 3.) Not last…?

And Pepsico is going gangbusters in India….

Update, July 8: John Rennie has provided a sharp analysis of the issues involved in the PepsicCo sponsored science blog. Rennie is a editor in chief of Scientific American and an adjunct professor in the graduate Science, Health and Environmental Reporting Program at the Arthur L. Carter Journalism Institute of New York University.

Update, July 9: After widespread criticism in the blogosphere and press, Science Blogs has canned the PepsiCo advertorial dressed as blog. The Appetite for Profit blog has links to many of the critiques if you want more info.


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