FNV: Settling the Debate

by Daniel Taber on March 18, 2015

That was so much better than a Presidential debate! Last week’s Beyond Chron duel between Casey Hinds and Bettina Elias Siegel didn’t have the global implications of “Barack Obama vs. Mitt Romney” or the pure comedy potential of “Anybody vs. Sarah Palin.” But it was far more compelling.

Why? Two simple reasons: 1) they completely dissected Partnership for a Healthier America’s “FNV,” a campaign with enormous public health implications, and 2) debates like this are so rare.

I study food policies for a living and I blog and tweet about food policies constantly. I love it, but it can feel like an echo chamber because advocates usually agree. It’s rare to see two well-spoken, passionate food policy advocates, both of whom I greatly respect, in disagreement.

The debate was also compelling because I wasn’t sure whose side I was on. I’m an opinionated guy with thoughts on everything from food policy to March Madness to The Bachelor, but I couldn’t settle on a simple question: “Should fruits and vegetables be marketed to children?”

When I finished reading both perspectives, I instantly tweeted that my next blog should be, “Why Hinds and Siegel are both right.”

I changed my mind. Instead, I’m going to write, “Why Hinds is right … and I’m siding with Siegel anyway.”

Why Casey Hinds is right

Many of Hinds’ concerns related to how FNV will be leveraged by food corporations to suit their interests. It could be leveraged either directly or indirectly – that is, by promoting healthy-sounding-but-unhealthy products such as fruit juices, or by improving corporations’ public image to fight off industry critics.

Hinds wasn’t pulling conspiracy theories out of thin air. I’ve observed the same thing over years of studying food policy effects. The best way to illustrate Hinds’ doubts is to reflect on another initiative that sounded healthy on paper but had industry fingerprints and sugar stains all over it: the Alliance School Beverage Guidelines.

In 2006, the Alliance for a Healthier Generation partnered with the American Beverage Association to set guidelines on what beverages could be sold in schools. The exact guidelines can be found here, but in a nutshell, the ABA pledged to stop selling regular soda in school but still sold other sweetened beverages such as fruit juices, particularly in high schools.

“Stop selling soda in school” – it sounded like a great idea. An ABA-sponsored study even reported that the number of beverage calories shipped to schools declined by 90%. So why do I consider the Guidelines a failure?

First, there is absolutely zero evidence the Guidelines improved children’s health. The ABA-sponsored study did not even measure beverage consumption or any health outcome.

Second, the ABA essentially used the Guidelines to diversify its portfolio. Other high-sugar, high-calorie beverages were sold in schools and marketed as “healthy” alternatives to soda. A study from the University of Michigan found that, from 2006-07 to 2010-11, soda availability in schools was cut in half but total sweetened beverage availability in schools barely budged. Overall trends suggest adolescents, in particular, have shifted from soda to other sweetened beverages.

Finally, the Guidelines became ammunition against more ambitious food policies. When leaders pursue a policy that companies are genuinely terrified of, such as sweetened beverage taxes, the ABA is quick to point to the Guidelines as a reason to oppose it. Their basic argument: Look at all this good we’re doing – now leave us alone.

There is a steady stream of evidence that the “health halo” strategy worked. Just last week, the Rudd Center for Food Policy & Obesity published a study on parents’ confusion about what beverages are “healthy.”

It doesn’t take much imagination to foresee FNV unfolding the same way. Previous industry-led marketing pledges failed, and the overall evidence to support industry-led initiatives is remarkably scant. Furthermore, as I blogged about last month, food industry groups have a hypocritical double standard when it comes to evaluating their evidence base.

In short, when it comes to leading the charge to improve children’s health, food corporations have not exactly earned the benefit of the doubt. Hinds has every reason to keep a skeptical eye on FNV.

Why I’m siding with Bettina Elias Siegel anyway

Siegel did an excellent job addressing concerns that Hinds and I share, so I won’t repeat her rebuttal. Instead, I want to add the two reasons why I think food policy advocates should be open to fruit and vegetable marketing.

First, if I opposed every policy and program food corporations might undermine, then I’d be really bored. Because I’d have nothing to support! Industry giants try to undermine everything.

That said, we learn the most about industry in their moments of crisis. Scientists and anti-tobacco activists learned the most about Big Tobacco tactics when tobacco companies tried to undermine anti-tobacco policies. By documenting unethical and deceptive industry practices, leaders were able to generate more public support for policies.

Likewise, we learn the most about food corporations when they undermine food policies. Berkeley leaders learned from beverage companies’ tactics in previous soda tax campaigns, and it helped them pass Berkeley’s sweetened beverage tax. Mexico implemented a similar tax and is already learning how companies fight back.

Dr. Simon Barquera, Director of Nutrition Policy and Programs Research at the Mexican National Institute of Public Health, has reported subtle shifts since the tax was implemented, such as soda being placed near fruits and vegetables in grocery stores to imply that it is healthy. I think Mexico’s tax is far more likely to succeed because leaders are actively studying such adaptive tactics.

The bottom line: Drawing attention to industry deception, as advocates like Hinds do, is more effective than trying to control it.

My second reason for supporting FNV is that, as odd as it sounds, health organizations are not that different from food companies. Both parties want to change people’s behavior. The big difference between the two – and I don’t know how to say this delicately – is that food companies are good at it.

I’ve worked in a variety of health organizations for 15 years and I’m now an Assistant Professor in Health Promotion & Behavioral Sciences. I might upset some colleagues by saying this, but as a profession, public health isn’t very good at changing behavior. Actually, we stink at it. A skilled dietitian can help individuals make healthy dietary changes, but education alone almost never produces behavior change on a national scale.

Public health education is stocked with facts, data, science, and logic. Our strategy would be flawless if people were robots.

Successful food marketers are exponentially more clever. As Partnership for a Healthier America’s CEO, Lawrence A. Soler, said in a statement, industry tactics are “relentless” but also “catchy, compelling, and drive an emotional connection with their products,” which is fundamentally different from public health models that are maddeningly logical and unemotional.

I get paid to analyze data and I’ll be the first to tell you – data and statistics do not emotionally connect with anyone.

I like the idea of marketing fruits and vegetables if only to get public health scientists and leaders to think differently. Kids don’t listen to a PhD like me; celebrities and cartoon characters have far more influence. I don’t remember a dentist or my parents saying to brush my teeth, but I remember cartoon characters saying it. It’s been 25 years since I watched G.I. Joe and I still remember the health messages at the end of each episode. (Just kidding. It’s been way less than 25 years.)

I disagree with Hinds that marketing fruits and vegetables is “defeatist.” I think it’s simply smarter. Public health leaders and advocates need to recognize what we’re good at – monitoring the effects of industry-led initiatives with a critical eye – and what we stink at – changing the nation’s eating behavior with our data-saturated approach.

Food companies can be deceptive, unethical, and manipulative. However, they’re also smart and know a lot about changing behavior. I think we’d be wise to learn something from them.

Just don’t hesitate to call them out if FNV goes awry. Nancy Huernergarth put it best during a recent tweetchat about beverage marketing, “Industry LOVES to silence potential community critics with charitable contributions. Don’t let it happen!”

Dr. Daniel Taber, PhD, MPH, is an Assistant Professor at the University of Texas School of Public Health and the Michael & Susan Dell Center for Healthy Living, where he specializes in childhood obesity policy research. His research has been featured in The New York Times, NPR, CNN, Wall Street Journal, and several other media outlets. You can follow him on Twitter @DanTaber47 or read his blog where he offers jargon-free thoughts on policy and science related to childhood nutrition and obesity. His views or opinions in this article do not represent the University of Texas or the Michael & Susan Dell Foundation.

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Filed under: Soda Tax/Food Politics

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