PLoS Medicine Kicks Off Series on “Big Food,” Calls for Investigation

The journal PLoS Medicine has published two articles and an editorial in a
“major new series” on “Big Food” in this week’s issue, and will publish five
additional related articles over the next two weeks. The editorial notes that
the articles, focusing on “the role in health of Big Food, which we define as
the multinational food and beverage industry with huge and concentrated
market power,” were selected under the guidance of guest editors Marion
Nestle of New York University and David Stuckler of Cambridge University.
Contending that Big Food has “an undeniably influential presence on the
global health stage,” the editorial introduces the other articles and observes,
“We decided not to provide a forum for the industry to offer a perspective
on their role in global health, since this point of view has been covered
many times before and fails to acknowledge their role in subverting the public health agenda, thus ignoring the deeper issues that this series aims to
uncover.”

An article co-authored by Mark Gottlieb with the Public Health Advocacy
Institute, which was founded by anti-tobacco advocate Richard Daynard,
compares the “soda and tobacco industry corporate social responsibility
campaigns.” The authors argue that the “elaborate, expensive, multinational
corporate social responsibility (CSR) campaigns” launched by major soft
drink manufacturers “echo the tobacco industry’s use of CSR as a means to
focus responsibility on consumers rather than on the corporation, bolster the
companies’ and their products’ popularity, and to prevent regulation.” The
article discusses, among others, PepsiCo’s Refresh Project and Change4Life,
and claims that such “CSR initiatives are explicitly and aggressively profitseeking.”

The article states, “Emerging science on the addictiveness and
toxicity of sugar, especially when combined with the known addictive properties
of caffeine found in many sugary beverages, should further heighten
awareness of the product’s public health threat similar to the understanding
about the addictiveness of tobacco products.” Calling for public health
advocates to monitor soda company CSR campaigns, the authors conclude by
suggesting that advocates may be able to vilify the Refresh Project by arguing
that, with its $20 million price tag, “this is marketing, not philanthropy.”

Nestle and Stuckler co-authored the second article, titled “Big Food, Food
Systems, and Global Health.” They open the piece with the following: “Global
food systems are not meeting the world’s dietary needs. About one billion
people are hungry, while two billion people are overweight.” Underlying
this paradoxical coexistence of food insecurity and obesity, they write, “is
a common factor: food systems are not driven to deliver optimal human
diets but to maximize profits.” The article discusses the concentration of
market power in a relatively few companies and notes that virtually all of
the industry’s sales growth is occurring in developing countries, “the main
reason why the ‘nutrition transition’ from traditional, simple diets to highly
processed foods is accelerating.” According to the authors, evidence shows
that the industry is using tactics similar to those used by the tobacco industry
to “undermine public health responses such as taxation and regulation, an
unsurprising observation given the flows of people, funds, and activities
between Big Tobacco and Big Food.”

These authors criticize public health advocacy approaches that either favor voluntary self-regulation or partnerships with industry. They call for “public regulation as the only meaningful approach” to curb obesity, calling this “critical approach . . . a model of dynamic and dialectic engagement.” They state, “Public health professionals must recognize that Big Food’s influence on global food systems is a problem, and do what is needed to reach a consensus about how to engage critically,” and they call for nutrition to become as high a priority as “HIV, infectious diseases, and other disease threats.” The article concludes by urging support for “restrictions on marketing to children, better nutrition standards for school meals, and taxes on SSBs [sugar-sweetened beverages]. The central aim of public health must be to bring into alignment Big Food’s profit motives with public health goals.”

The American Council on Science and Health responded to the PLoS series by
dubbing it “big propaganda.” The group, which was formed by scientists “to
add reason and balance to debates about public health issues and to bring
common sense views to the public,” contends that the articles’ focus on soda
is misplaced because the proposed strategies and policies are not “founded
on solid evidence.” According to the council’s Gilbert Ross, “Frankly, the focus
should be on physical activity.” See PLoS Medicine, June 19, 2012; American
Council on Science and Health News Release, June 20, 2012.