CHAPTER 11
HOW BIG FOOD BUYS PARTNERSHIPS AND HIDES BEHIND FRONT GROUPS
The food industry strategy for controlling science, public health groups, professional health care societies, public opinion, schools, community organizations, the flow of information, political institutions, and policy is calculated, clear, and effective. And it is well hidden. On purpose.
When New York mayor Michael Bloomberg introduced his controversial ban on large, sugary soft drinks back in 2012, the soda industry promptly sued. The industry, led by the American Beverage Association, ultimately won that battle when a New York State judge struck down the ban in 2013. But the industry did it with the help of some surprising allies: Dozens of minority groups came to Big Soda’s aid, filing “friend of the court” briefs in support of the soda industry’s lawsuit.1 These advocacy groups represent the very communities that have been hardest hit by the diabesity epidemic (the continuum from obesity to pre-diabetes to type 2 diabetes).
The NAACP and the Hispanic Federation were among the groups that came to Big Soda’s defense. These groups are supposed to fight for the best interests of the communities they represent, which are plagued by chronic disease. African Americans and Hispanics have the highest rates of obesity and diabetes in America—and it is precisely because the junk-food industry preys upon them. Fast-food restaurants are often concentrated in black and Hispanic neighborhoods. Companies disproportionately target them with predatory advertising. And they are more likely to market their worst foods to minority children than to whites, plying them with ads for products laden with salt, sugar, and unhealthy fat.2
Researchers at the University of Connecticut found that junk-food companies spend the most on ads that target African Americans and Spanish speakers. Guess which products were most heavily advertised toward minorities—Gatorade, Pop Tarts, Twix, Cinnamon Toast Crunch, and Tyson frozen entrees. The worse the nutritional profile, the more heavily the products were promoted through advertising. Where are the broccoli ads? These findings, the researchers noted, “highlight important disparities in the food and beverage industry’s heavy marketing of unhealthy foods to Hispanic and black youth, and the corresponding lack of promotion of healthier options.”3
So why would groups like the Hispanic Federation and the NAACP support the soda industry in its battle against anti-obesity measures? Could it have something to do with the fact that Coca-Cola gave the NAACP more than $1 million in donations between 2010 and 2015? Or that it gave the Hispanic Federation more than $600,000 in the same time period? In fact, many of the black and Hispanic civil rights, business, and health advocacy groups that joined the beverage industry in opposing soda regulation in recent years have been the recipients of millions of dollars in gifts and funding from the soda industry. Soda companies sponsored NAACP scholarships, financial literacy classes offered by the National Puerto Rican Coalition, and programs from the National Hispanic Medical Association.
While these prominent groups and others cozied up to Coca-Cola, the soda industry has run roughshod over black and Hispanic communities. Things came to a head when two prominent African American pastors filed a lawsuit against Coke and the American Beverage Association in 2017, saying that the soda industry deliberately deceived Americans about the link between soft drinks, obesity, and diabetes—a practice that contributed to the devastating disease epidemic in minority communities. The pastors told the Washington Post that they filed their lawsuit because they were sick and tired of attending funerals for their parishioners whose junk-food diets gave them heart disease, diabetes, and strokes. One of the men, Delman Coates, the pastor at Mount Ennon Baptist Church in Maryland, told the Post that it was not uncommon for members of his church to give their babies bottles filled with sugary drinks.4
“It’s become really clear to me that we’re losing more people to the sweets than to the streets,” he said. “There’s a great deal of misinformation in our communities, and I think that’s largely a function of these deceptive marketing campaigns.” Pastor Coates pointed out that he was well aware that minority groups had been co-opted as well. “This campaign of deception has also been bestowed on the leadership of our major Latino and black organizations,” he told the paper.5 This is a form of legal racism practiced by the food industry. And it is effective. The communities most affected are completely unaware of this invisible, insidious form of oppression.
BIG FOOD’S MAFIA TACTICS: CORPORATE CO-OPTING AND MANIPULATION
While establishing links to minority groups is particularly insidious, the food industry uses corporate sponsorships and financial gifts to buy loyalty from a wide range of prominent organizations. In a report by the Center for Science in the Public Interest, called Selfish Giving: How the Soda Industry Uses Philanthropy to Sweeten Its Profits,6 these nefarious tactics are extensively documented. Here’s their strategy:
Link their brands to health and wellness rather than illness and obesity
Create partnerships with respected health and minority groups to win allies, silence potential critics, and influence public health policy decisions
Garner public trust and goodwill to increase brand awareness and brand loyalty
Court growing minority populations to increase sales and profits
This strategy of investing in “corporate social responsibility” can generate support, as we saw with the NAACP and the Hispanic Federation, and it can buy silence from groups that might otherwise criticize junk-food companies for their most shameful behaviors.
The seduction of soda money has created chilling conflicts for many influential organizations. We already saw in Chapter 4 how Big Food fights back against soda taxes; their tactics also include corrupting health groups. Save the Children, an international nonprofit that has long fought for children’s rights, was once an outspoken proponent of soda taxes. The nonprofit group threw its endorsement behind soda tax campaigns in New Mexico, Philadelphia, Washington State, Mississippi, and Washington, DC. But in 2010, to the surprise of many in the public health world, Save the Children suddenly withdrew its support for soda taxes. It was perhaps no coincidence that around the same time the organization accepted a $5 million grant from Pepsi.7 The following year it received $50,000 from Coke.
Sadly, Save the Children was not alone. When Mayor Michael Nutter of Philadelphia proposed a soda tax in 2010, the soda industry offered to make a hefty donation to the city if it would agree to abandon the measure. Eager to receive a windfall, the city council voted down the tax, and the American Beverage Association followed through with a $10 million donation—some might call it a bribe—to the Children’s Hospital of Philadelphia for an obesity program.8 Fortunately, years later, the tax passed on both diet and regular sugar-sweetened beverages. The reason the soda companies so aggressively opposed it is because taxes work. In Philadelphia after the tax, the rate of daily consumption of regular soda was 40 percent lower, energy drinks 64 percent lower, and bottled water 58 percent higher, and the thirty-day regular soda consumption frequency was 38 percent lower.9 In a follow-up study of the 1.5 cents-per-ounce tax there was a 51 percent reduction in sugar-sweetened-beverage consumption, or 1.3 billion ounces less, over two years.10 However, the American Beverage Association has spent millions fighting back against this tax, trying to get it repealed, and has even taken the city to court. The judge ruled in favor of the city, upholding the tax, and the revenue from the soda tax went to creating 4,000 pre-K slots and twelve new community schools and to rebuilding crumbling parks and libraries.11
These tactics are used across the country. In 2012, the Chicago City Council proposed a soda tax to help reduce the city’s growing obesity rates—and you’ll never guess what happened next. Coca-Cola donated $3 million to launch fitness programs in Chicago community centers—and the soda tax that had been proposed magically disappeared.12 In the 2016 election, four cities in California had a soda tax on the ballot measure. The food industry spent $38 million in a campaign to defeat the measures. Former New York mayor Michael Bloomberg and the Arnold Foundation spent $20 million to pass it. It passed. But there are not that many billionaires who are willing to engage in heroic measures to defeat Big Food.
Thirty-three countries have enacted soda taxes, and seven cities in the United States. Studies show taxes work. If the United States passed a national penny-per-ounce tax it would save $25.6 billion in health care costs and produce $12.5 billion in revenue for community-based programs or programs to address obesity.13 The beverage industry has not taken this lightly and is fighting back. Taking a page from the tobacco industry’s playbook, they have launched a stealth strategy of preempting taxes. When tobacco was under the gun it launched a campaign to create state laws that would prohibit cities or municipalities from creating their own taxes. In effect, the state laws could preempt any city from passing a law restricting tobacco use, for example, in public places. It worked for tobacco.
The beverage industry launched two ballots to preempt taxes in the 2018 election. The one in Oregon was called “Yes on Measure 103, Keep Our Groceries Tax Free,” supported by the Parents Education Association PAC (an industry front group). The American Beverage Association (Coca-Cola, PepsiCo, etc.) spent $7.63 million and public health groups spent $6.95 million, funded mostly by Michael Bloomberg. The measure did not pass. However, in Washington State, “Initiative 1634, Prohibit Local Taxes on Grocery Measure” did pass. Why? The beverage industry spent $20.7 million to pass the preemptive measure, preventing any future soda taxes, while opposition groups were able to spend only $100,000.
In the face of a growing soda tax movement, the soda industry is making states an “offer they can’t refuse.” In California, the most liberal state in the country, where four out of the seven cities with soda taxes are, Big Food played dirty. They spent $7 million pushing a ballot measure that has nothing to do with soda taxes. It would force local governments to require a two-thirds majority to pass any local taxes. This would have effectively paralyzed local governments and limited their ability to fund public services such as schools, fire and police departments, and public libraries. In five days, before anyone knew what was happening, behind closed doors, the beverage industry told Governor Jerry Brown (formerly known as Governor Moonbeam for his liberal views) that if he signed a law prohibiting soda taxes for 12 years, they would withdraw the ballot measure that would cripple local governments.14 He buckled and signed it. They have done the same in Arizona, Michigan, and Washington.15
INFILTRATING PROFESSIONAL MEDICAL AND NUTRITION ASSOCIATIONS
It is painful to see so many nonprofit groups and lawmakers neglect their principles and fall under the spell of soda industry money. But what is most vexing is how Big Food has commandeered some of the most influential health and nutrition groups in the world. It is one thing to see a politician make policy changes that favor his or her corporate donors. It is another thing to see a vaunted public health organization do the bidding of Big Food.
If we can’t count on our leading health and nutrition professionals to do what is right for public health, then whom can we rely on? Public health groups are in many ways the last line of defense. We look to them for guidance and impartial advice. We count on their expertise. We expect them to do what is in the best interests of child, family, and societal health. And yet the evidence shows that many of these groups have far too often allowed themselves to end up in bed with Big Food. Take a look:
American Diabetes Association (ADA). With diabetes maiming and killing millions of Americans every year, you would think that the ADA would take a hard stance against companies that peddle diabetes-inducing junk foods. And yet over the years the ADA has signed a number of major deals with more than a dozen companies, including General Mills, Coke, and Campbell’s.16 In one instance, the group signed a $1 million deal with Kraft Foods that allowed the company to slap the ADA logo on products like SnackWell’s cookies, Post Raisin Bran cereal, Cream of Wheat, and sugar-free Jell-O. The diabetes group signed another megasponsorship deal with Cadbury Schweppes, the world’s largest candy maker, worth $1.5 million. In exchange, Cadbury was allowed to use the ADA logo on products that are terrible for diabetics, like Mott’s applesauce, Snapple, and Diet Rite soda. Yes, diet drinks have been linked to obesity and type 2 diabetes through their effects on appetite, hormones,17 and the gut microbiome.18
I once gave a talk at the ADA. As I walked through the exhibit hall, I saw a big booth with the banner “Cure for Diabetes.” It was a promotion for gastric bypass surgery. Yet the exhibit hall was a sea of processed food, junk food, and artificially sweetened products—things I would never let my diabetic patients near, ever.
American Academy of Pediatrics (AAP). When it needed funding to create a website to promote children’s health, the AAP turned to a company whose products have played a starring role in the childhood obesity epidemic: Coca-Cola. Between 2009 and 2015 the sugary-drink giant gave the academy roughly $3 million. The academy praised Coke for being a “gold” sponsor of its HealthyChildren.org website, calling it a “distinguished” company for its commitment to “better the health of children worldwide.” For a while parents and pediatricians who logged onto the academy’s website were treated to a picture of the Coke logo—a major coup for the world’s largest soft drink manufacturer.19
American College of Cardiology and the American Academy of Family Physicians (AAFP). Both have received millions of dollars in junk-food funding. The president of the American College of Cardiology carried the Olympic torch to help promote its CardioSmart initiative, which was funded by Coca-Cola.20 In 2010 Coca-Cola spent $102 million to support charities, which sounds generous. But at the same time, it spent $2 billion marketing sugary drinks. The good news is that many leading family doctors resigned from the academy in protest over the AAFP getting into bed with Coca-Cola.
American Heart Association (AHA). In 2017, the AHA received $182 million in industry funding from PepsiCo, Kraft, Monsanto, Cargill, Unilever, Mars, Kellogg’s, Domino’s, Subway, General Mills, and Nestlé, to mention a few.21 And they are in charge of protecting our hearts? Trade groups and authors of guidelines that promote the use of more bean and seed oils, like soybean or canola oil, are consultants and receive funds from and sit on the boards of these groups or companies such as the Canola Council of Canada or Unilever. That is why the AHA came out hard against coconut oil despite the lack of evidence that saturated fat causes heart disease. One large review of seventy-two studies on 600,000 people in nineteen countries including randomized trials and observational studies found no basis for our current government recommendations to reduce saturated fat intake.22 More than seventeen reviews of all the data on saturated fat and heart disease found no link.23
It is totally incongruous and offensive. Like a magic trick—look at the right hand doing something good, while the left hand does something destructive.
NUTRITION ASSOCIATIONS OR PUPPETS OF THE FOOD INDUSTRY?
Our most revered and respected nutrition societies are often in bed with Big Food. A prime example of the problems this can cause for both consumers and the public health community is the actions and policies of the Academy of Nutrition and Dietetics, also known as AND, the largest organization of registered dietitians in the world. Founded in 1917, the academy is considered one of the nation’s preeminent nutrition groups, with more than 100,000 registered dietitians who work in hospitals, schools, universities, the food industry, and private practice. Its stated purpose is “empowering members to be the nation’s food and nutrition leaders.” It describes its mission as “optimizing the nation’s health through food and nutrition.”
The academy has annual revenues exceeding $34 million, much of it from membership fees and sponsorships. But 40 percent of its funding comes from the food industry.
Public health expert Michele Simon published an exhaustive and disturbing exposé on the academy entitled And Now a Word from Our Sponsors: Are America’s Nutrition Professionals in the Pocket of Big Food? She found that in recent years AND underwent a radical transformation. In 2001 it had just ten food industry sponsors. But by 2011 that number had risen to thirty-eight. Among its most generous sponsors was a cast of characters that included some familiar names: PepsiCo, Mars, Kellogg’s, General Mills, Conagra, Unilever, the National Dairy Council, and Coca-Cola.24
So what are the perks that companies get in exchange for their generous academy sponsorships? Mostly it is a way for them to buy access to nutrition professionals so they can indoctrinate them on how to get people to purchase their products. As Simon explains in her report:
For example, partners can co-sponsor “all Academy Premier Events,” conduct a 90-minute educational presentation at AND’s annual meeting, and host either a culinary demo or media briefing also at the annual meeting. Partner status also confers this benefit: “The right to co-create, co-brand an Academy-themed informational consumer campaign.” Examples include the Coca-Cola “Heart Truth Campaign,” which involves fashion shows of women wearing red dresses (also promoted by the federal government). Another instance of partner/sponsor co-branding is the National Dairy Council’s “3-Every-Day of Dairy Campaign,” which is a marketing vehicle for the dairy industry disguised as a nutrition program. The partnership consists of several fact sheets that bear the AND logo, demonstrating the value of the group’s seal of approval. The National Dairy Council does not disclose that they paid for the right to use the AND logo.25
The thing is that AND’s and the government’s recommendations represent at best questionable science.26 Turns out skim milk can cause weight gain, and milk can cause osteoporosis, cancer, allergies, digestive problems, and autoimmune disease. Oops.
Another practice the academy has engaged in is allowing food corporations to teach dietitians. The academy oversees the credentialing process for registered dietitians and requires them to obtain continuing education credits. The list of accredited continuing education providers includes industry outfits like the Coca-Cola Beverage Institute for Health and Wellness, Kraft Foods Global, PepsiCo Nutrition, Nestlé Healthcare Nutrition, and the General Mills Bell Institute of Health and Nutrition. The “education” sessions they provide to dietitians teach them, for example, that obesity is all about calories; that artificial sweeteners are safe for small children; and that health concerns about sugar are an “urban myth” and “a misconception.”27 All of it is unscientific nonsense and food industry propaganda that is passed off as fact.
The companies are also granted prime real estate at the academy’s annual food and nutrition trade show. At one recent expo, the Sugar Association sponsored a booth where its representatives handed out flyers stating that mothers could placate kids who are picky eaters by sprinkling sugar on their vegetables. In her report, Michele Simon found that at one of these annual expos, many of the largest booths were occupied by processed-food companies. Among the largest expo vendors were:
Organization: Nestlé
Booth Fee: $47,200
Organization: Abbott Nutrition
Booth Fee: $47,200
Organization: PepsiCo
Booth Fee: $38,000
Organization: Unilever
Booth Fee: $28,800
Organization: General Mills
Booth Fee: $21,900
Organization: Cargill
Booth Fee: $19,600
Organization: Kraft Foods
Booth Fee: $19,600
Organization: Campbell Soup
Booth Fee: $15,800
Organization: Coca-Cola
Booth Fee: $15,800
Organization: Conagra
Booth Fee: $15,800
These industry partnerships and financial arrangements hurt the academy’s credibility and ultimately influence its policies. In 2015, the academy granted Kraft Foods permission to slap its “Kids Eat Right” logo on the company’s infamous “Kraft Singles”—a product that is so ultraprocessed that Kraft by law cannot even call it cheese because it doesn’t contain more than 50 percent cheese.28 What’s the rest of it? Instead, the label for Kraft Singles describes it as a “pasteurized prepared cheese product.” Getting the academy to provide its seal of approval was a major coup for Kraft, which boasted to news outlets that the arrangement marked the first time the academy had ever endorsed a product. Health advocates across the country were understandably in disbelief. After a fierce public backlash, Kraft and the academy decided to terminate their deal to slap the logo on the product.29
“I am really shocked that this would be the first thing that the academy would choose to endorse,” Casey Hinds, a mother of two who runs the blog USHealthyKids.org, told the New York Times. “It’s confusing and just one more way that feels like as parents, there are so many forces working against us as we’re trying to raise healthy kids.”30 The academy’s behavior even drew the attention of comedian Jon Stewart, who lambasted the organization on The Daily Show for selling out to a food company that “wants the positive PR of going healthy but doesn’t want the hassle of actually improving their product.”
“Here’s how you know Kraft has not changed their ingredients: Kraft is still not legally allowed to call their product cheese,” Stewart scoffed. “It turns out the Academy of Nutrition and Dietetics is an academy in the same way that Kraft Singles is cheese.”
Over the years AND and the soda industry became so entwined that it was hard to tell them apart. Coke and the American Beverage Association recruited some of the academy’s most high-profile dietitians to act essentially as their public relations machine. The company paid them to:
Promote mini-cans of Coca-Cola as a healthy snack.
Write articles disputing the notion that sugary drinks play a role in the obesity epidemic.31
Criticize soda taxes on social media. They paid more than $2.1 million to “independent nutritionists” to oppose soda taxes on social media.32
In 2017, the soda industry nearly took over the academy altogether, staging what many health advocates considered an attempted coup. That year, the academy held an election to select its next president. Two prominent dietitians ran for the position. But one of the two candidates, Neva Cochran, left some critical details out of her official bio that was circulated to voters: She failed to disclose that she had spent 27 years working as a consultant for Coke, McDonald’s, Monsanto, the Corn Refiners of America, the Calorie Control Council (which promotes artificial sweeteners), and the American Beverage Association. She was also one of the registered dietitians whom the soda industry had paid to write social media posts opposing soda taxes and promoting beverage industry products. “Plain water isn’t that appealing,” she wrote in one social media post. In another, she encouraged parents to give their “active teens” soft drinks, lemonade, sweet tea, and chocolate milk and accompanied her recommendation with a vintage advertisement of a young cheerleader with the caption “Jenny needs a sugarless energyless soft drink like a Beatle needs a hairpiece. Two-four-six-eight, what does she appreciate? Sugar.”
As Kyle Pfister, the founder of Ninjas for Health, a public health advocacy group, explained it: “Never before has an Academy’s presidential candidate been so compromised by corporate conflicts of interest.”33 Cochran could have very easily won the election and been installed as the academy’s new president, had it not been for Pfister and several courageous dietitians, who called attention to Cochran’s deep industry ties. They sounded the alarm on social media, igniting a firestorm of criticism and embarrassing the academy leadership. Many dietitians who were already uncomfortable with the academy’s cozy relationship with Big Food said that allowing an industry consultant to head the organization was simply beyond the pale. Cochran’s opponent, Mary Russell, ultimately won the election, and a crisis was narrowly averted. As one nutritionist and academy member explained it, the election outcome showed that dietitians “want change and professional integrity, not more food-industry insiders.”34
AMERICAN SOCIETY FOR NUTRITION: WHO PULLS THE STRINGS?
The other main nutrition association is the American Society for Nutrition (ASN), which publishes the world’s premier nutrition journal, The American Journal of Clinical Nutrition. This “respected” society actively opposed sugar taxes. Could it be that its donors and sponsors include Coca-Cola, PepsiCo, Kellogg’s, McDonald’s, and Monsanto? Could that have anything to do with why they published a “scientific” article entitled “Processed Foods: Contribution to Nutrition” that concludes, “There are no differences between the processing of foods at home or at a factory.”35 Yes, cooking at home is processing—bake, broil, sauté. But is it the same as a processed Pop-Tart with forty-seven ingredients, most of which you would never have in your home? Sauerkraut is a processed food, but it’s quite different from a Twinkie. Maybe the ASN didn’t see the research that found that for every 10 percent of your diet that is ultraprocessed foods, your increase for risk of death goes up 14 percent. They also launched a Smart Choices Program to place their seal of approval on “healthy food,” like Froot Loops. When questioned about this endorsement, their response was, “Well, Froot Loops are better than doughnuts.” (Fortunately, the program didn’t last; it shut down in 2010.) Is that really the advice we expect from the country’s leading nutrition society? They have a long and sullied history of being in bed with the food industry, compromising science, and placing the welfare of their sponsors above public health.36
ASTROTURFING, FRONT GROUPS, AND OTHER TOOLS OF INDUSTRY DECEPTION
Not only does the food industry infiltrate and influence existing groups; they also create “grassroots” groups that are largely, or even entirely, funded by them to manipulate public opinion. One of the most insidious ways that Big Food controls public opinion is through benevolently named front groups, like the Alliance for Safe and Affordable Food, funded by the GMA and Monsanto, that pretend to promote the interests of citizens and the science. They fight GMO labeling and attack organic food. Another is the Center for Food Integrity, also funded by Monsanto, as well as the National Restaurant Association and the United Soybean Board. All of these organizations discredit organic food production, defend pesticides and antibiotics in animal production, and promote the benefits of artificial sweeteners, trans fats, and GMO foods. Some of the worst groups funded by Big Food, Big Ag, and Big Pharma are documented in a report by Friends of the Earth entitled Spinning Food: How Food Industry Front Groups and Covert Communications Are Shaping the Story of Food.
These groups have spent hundreds of millions of dollars to manipulate public opinion, discredit legitimate science, and influence policy makers. In just four years, from 2009 to 2013, four of the biggest trade groups spent more than $600 million to promote the benefits of pesticide use, GMOs, and the interests of Big Food. Fourteen front groups spent $126 million using stealth tactics to corrupt the truth. They attack journalists and scientists, pay “independent sources” like the SciMoms blog on evidence-based parenting, create propaganda disguised as editorial content, and employ covert social media tactics.
There are many of these groups. The American Council on Science and Health (ACSH) has one of the most striking names of any industry front group. The first time I heard their name I had to look them up to see if they were a legitimate public health agency. But make no mistake: The ACSH is a mouthpiece for some of the world’s largest corporations. Over the years the ACSH has received millions in funding from the likes of Big Food, Big Pharma, Big Oil, Big Tobacco, and other industries. According to the Center for Media and Democracy, their donor list has included names like Monsanto, McDonald’s, Pfizer, Coke, Pepsi, ExxonMobil, and Dr Pepper Snapple.37
The ACSH portrays itself as an important defender of science. But it has proclaimed that smoking, pesticides, and sugar are not harmful. It routinely attacks people who raise concerns about drug side effects and toxic chemicals in food. It dismisses the benefits of organic produce and dietary supplements. And it defends things like GMO crops, high-fructose corn syrup, e-cigarettes, and artificial colors and sweeteners.
In 2015 a group from the ACSH wrote a letter requesting that Columbia University remove Dr. Mehmet Oz from the faculty after his show raised questions about GMOs. Dr. Gilbert Ross, one of the signatories on the letter, is the acting president and executive director of the ACSH. He is also an ex-convict who was sentenced to forty-six months in prison for defrauding Medicaid of $8 million and at one time had his medical license revoked for professional misconduct.38
There are literally dozens of similar groups. The innocuous or deceptive-sounding names mask their true intentions. Their aggressive tactics, blatant lies, and half-truths are an attempt to dupe the public. While food industry corporations create and pay for these front groups, they try to conceal that information to protect the public images of their funders. They do the dirty work of the food industry so that food companies can keep their hands clean. Don’t be deceived by their propaganda. When you’re tempted to believe the latest campaign ads or sensational headline, look at the tactics they use. A front group or astroturfing efforts could be behind it.
FOOD FIX: ETHICAL SPONSORSHIP OF PROFESSIONAL SOCIETIES AND ASSOCIATIONS
Professional medical and nutrition associations like the ADA, the AHA, the ASN, and the AND should never accept money from junk-food companies. The practice is completely unacceptable. Dr. Ioannidis from Stanford University wrote an important review of corruption in these professional associations and recommended that they abstain from authorship of guidelines and disease definition statements.39 In other words, they should not be in the business of giving “objective” advice or recommendations. Professional health organizations must face the reality that Big Food has a long history of lobbying against public health, influencing public policy to the detriment of society, and manipulating scientific research.
But much like researchers, health organizations cannot be expected to sever all ties with the food industry. Plenty of food companies have missions that align with professional health organizations. You don’t have to look too far to see that in many cities a growing number of restaurant chains, grocery stores, health start-ups, and other food establishments are providing healthy, sustainable, and delicious options to consumers. Relatively new and popular farm-to-table food chains like Sweetgreen, Tender Greens, and Dig Inn are competing with McDonald’s and Burger King. There are plant-based chains like Veggie Grill, Freshii, and Salad and Go (the drive-through salad chain). And stores like Whole Foods and Thrive Market make it easy to find wild, organic, and sustainable foods. Professional health organizations should be looking to promote, commend, and form partnerships with these food companies—not the ones that make all their profits from junk food.
To objectively determine what food companies are ethical to work with, there needs to be a set of guidelines that will help sort out worthy food companies from junk-food peddlers. In 2013, a group of registered dietitians who were frustrated with the AND and its ties to Big Food formed a splinter group called Dietitians for Professional Integrity. They have been speaking out against Big Food’s infiltration of the academy and demanding change. To a large extent, they’ve been successful: The academy has severed ties with Coca-Cola and reduced the amount of funding it takes from junk-food companies. The splinter group has also devised a set of guidelines to help ensure ethical and responsible industry sponsorships. The recommendations are so simple and sensible that there’s no reason all professional health organizations shouldn’t abide by them. Companies that sell alcohol, soft drinks, and confectionery are automatically disqualified from consideration, but beyond that, the guidelines work in part through a scoring system. Companies are awarded points based on how they do on the following criteria, with zero points awarded if they perform badly and 1 to 2 points awarded if their performance is good or excellent.40
The extent to which they market their products to children
Whether their products contain artificial colors and sweeteners
How they rank on animal welfare and the use of hormones
Their use of fair-trade ingredients
Their organic production practices
Whether they use trans fats
Whether their meat and dairy products are grass-fed, organic, or conventionally raised
Their fishing and aquaculture practices
LEED Certification (a green building rating system)
Companies are scored in all applicable categories. In the event that a larger company owns a prospective sponsor, the parent company should be scored as well—which is important because most smaller good-for-you brands are owned by about nine Big Food companies. A company that attains a final average score of 1.5 or higher is considered an ethical and responsible sponsor.41
FOOD FIX: ETHICAL POLICIES IN MEDICINE
One of the reasons major conflicts of interest are so rife in the public health world is that many universities and medical centers do not have rigorous conflict-of-interest policies, nor do they impress upon future doctors and health professionals the importance of navigating potential conflicts. This is such a critical issue that the prestigious Pew Charitable Trusts convened an expert task force and published a report on conflicts-of-interest policies for academic medical centers.42 If you work in a university or medical center, take these recommendations to your leadership team:
Faculty members, staff, students, residents, trainees, and fellows should not accept any gifts or meals from industry.
Faculty should be required to disclose to their institutions any industry relationships.
Faculty should not accept industry funding for speaking engagements.
Continuing medical education courses should not be supported by an industry.
Faculty, students, and trainees should not attend promotional or educational events that are paid for by an industry.
Pharmaceutical sales representatives should not be allowed access to any faculty, students, or trainees in academic medical centers or affiliated entities.
Conflict-of-interest education should be required for all medical students, residents, clinical fellows, and teaching faculty.
It is a bit harder to ferret out the truth from fiction when professional associations, public health groups, and top scientists are co-opted by Big Food, Big Ag, and Big Pharma. Be a healthy skeptic. Get your information from independent nonprofits and public advocacy groups such as the Union of Concerned Scientists, the Environmental Working Group, and the Sustainable Food Trust, as well as academic institutions. Remember to follow the money and ask yourself when something fishy appears in the marketplace or media: Does it pass the sniff test? Is Froot Loops really a “Smart Choice” as our esteemed nutrition experts advise?