Friday, December 3, 2010

The Obesity Wars

This was open warfare, a battle between "good and evil," between Public Health and Big Food. It's time to call a truce

first American Public Health Association Annual Meeting, a gathering of nutritionists, researchers, and public health advocates most invested in improving the health of Americans that took place one month ago in Denver.

Of particular interest to me were the programs that unveiled new research related to food marketing and obesity. As expected, a number of speakers presented their take on the correlations between consumption of soft drinks, fast foods, and snacks with obesity; the problems surrounding advertising to children; and the impact of posting calorie counts on what fast food items customers select.

But what struck me the most was what wasn't emphasized (or picked up by the press). For instance:

• Posting calories on restaurant menu boards is not working. In the four metropolitan areas in which calorie information had been provided to customers (New York; Philadelphia; Seattle; Portland, Oregon), results demonstrated little or no reduction in the number of calories purchased.

• Some food marketers are making dramatic improvements in reducing advertising to children. While the number of fast food advertisements directed at children increased from 2003 to 2009, the number of ads earmarked to kids dropped for the major soft drink companies, with Coca-Cola recording the biggest decline at -56 percent.

• There is no evidence that taxing sweetened beverages lowers obesity rates. These taxes will surely reduce consumption of sugar-sweetened beverages, but studies to date have not dealt with the "substitution effect"—do consumers simply eat other unhealthy products instead?—which other researchers indicate would not help ameliorate the problem.

But there was more than these seemingly innocuous omissions. One session I attended delineated legal tactics on how to attack the food industry based on lessons from the tobacco wars, tactics eerily similar to what food marketers have been accused of employing.

In another presentation, I suggested that perhaps it would be worth creating incentives for food marketers to more aggressively lower the number of calories they sell. This was met with an irate response from the session's leader: That approach won't make a difference, industry will never change, and "good luck" trying.

With that I concluded that the campaign to reverse America's ever-expanding girth has reached an impasse. This was no silent undertone of discontentment. This was open warfare, a battle between "good and evil," between Public Health and Big Food.

It's time to call a truce.

Americans are continuing to get fatter and fatter, with obesity rates reaching 30 percent or more in nine states last year, as opposed to only
three states in 2007, health officials reported on Tuesday.

The increases mean that 2.4 million more people became obese from 2007 to 2009, bringing the total to 72.5 million, or 26.7 percent of the population. The numbers are part of a continuing and ominous trend.

But the rates are probably underestimates because they are based on a phone survey in which 400,000 participants were asked their weight and height instead of having it measured by someone else, and people have a notorious tendency to describe themselves as taller and lighter than they really are.

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