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| Editorial: Fighting Obesity And The Food Lobby by Kelly D. Brownell and David S. Ludwig, Yale University and Harvard Medical School Obesity in children has tripled in the past 20 years. A staggering 50 percent of adolescents in some minority populations are overweight. There is an epidemic of type 2 (formerly "adult onset") diabetes in children. Heart attacks may become a disease of young adults. In response to this public health crisis, federal and state officials are seeking ways to protect children from the ravages of poor diet and physical inactivity. National legislation on the prevention and treatment of obesity is being considered. California and Texas are working to remove snack foods from schools. There are proposals for the regulation of food advertising to children. One big question facing those who deal with the problem is whether to fight the food industry or work with it. The industry, of course, favors the work-together approach. Currently, food industry lobbying groups are invited to Agriculture Department meetings, participate in professional nutrition conferences, and have testified before Congress on obesity legislation. A large and powerful lobby is at work. But before taking the cooperative approach in these matters some disturbing parallels with tobacco should be considered. In 1995 the American Academy of Pediatrics stated that advertising to young children is inherently deceptive and exploitative. Yet each year the food industry spends an estimated $10 billion to influence the eating behavior of children. The average child sees 10,000 food advertisements per year, 95 percent of them for fast food, soft drinks, candy and sugared cereals -- all high-profit and nutrition-poor products. Marketing campaigns link fast food and soft drinks to toys, games, collectibles, movies and popular personalities. Soft-drink companies have established lucrative contracts with cash-strapped school districts tying financial incentives to sales. By contrast, the entire federal budget for nutrition education is equal to one-fifth of the advertising costs for Altoids mints. Is it any wonder that children now consume about 15 percent of their total calories from fast food, 10 percent from sugar-sweetened soft drinks and only half the recommended amount of fruits and vegetables? The obesity epidemic has many causes, but deterioration in the diet almost certainly plays a central role. Fast food is served in massive portions, contains highly processed carbohydrate and the worst fats (especially "trans-fat"), and has little or no fiber. Each of these factors has been linked to increased risk for obesity, diabetes or heart disease. Excessive soft-drink consumption is related in scientific studies to increased calorie intake, weight gain and obesity. The food industry contends that more research is needed before action is taken on regulating advertising and sales; that physical inactivity and not specific foods should be the target for change; that parents must teach their children to act responsibly; that vending and soft-drink machines in schools provide freedom of choice; and that no food or company should be demonized. We agree on one count -- that more research on children's diets and their health would be helpful, but the research must be conducted in a rigorous and unbiased fashion by independent scientists. More insidiously, the food lobby uses money and power to influence national nutrition policy. Even the country's main professional dietetic association has succumbed; it has a Web page on beverage choices sponsored by a grant from the National Soft Drink Association. Legal Times reported that industry pressure led to weakening of USDA dietary guidelines aimed at reducing consumption of added sugar. Versions of these tactics have been used by the tobacco industry for years. Largely because of industry resistance, it took decades before the war on tobacco reduced rates of smoking significantly. The nation cannot afford stalling, diversion and policies with no teeth in the nutrition arena; the human toll is too great. There are voices of reason, or at least enlightened self-interest, within the food industry. But will they prevail? The time has come for the industry to demonstrate that it will be a trustworthy public health ally by adopting the following policies: (1) suspend all food advertising and marketing campaigns directed at children; (2) remove sugar-sweetened soft drinks and snack foods from vending machines in schools; (3) end sponsorship of scholastic activities and professional nutrition organizations linked to product promotion; and (4) refrain from political contributions that might influence national nutritional policy. Otherwise, profit prevails over public health and the nation loses. • |