Tommy Thompson’s Keynote Address

Secretary of Health and Human Services Tommy Thompson gave the summit’s opening speech. He began by describing the enormity of the public health issue we are faced with: Obesity is on the verge of overtaking tobacco as the leading cause of preventable death; related illnesses cost the American economy $117 billion in 2000; 75 percent of our healthcare dollars are spent treating diseases caused by poor diet, such as heart disease, cancer, and diabetes. Preventable chronic illnesses cause 7 out of every 10 deaths; the number of overweight children has tripled in the last two decades. “America’s eating habits and lack of physical activity are literally killing us, and they’re killing us at records levels.”

Then he outlined his vision for the solutions. First, he stressed the role of individual action and personal responsibility: “We have to do it ourselves.” Next, he listed several federal programs designed to help promote physical activity, speaking about the importance of “small steps.” He then showed the series of four television commercials created by the Ad Council—the ones depicting “lost body parts,” thanks to engaging in healthy activities. Next he talked about how he has been meeting with leaders from the food industry to get them to make changes. While at first they resisted he said, in the past year, they have been responding. He cited several examples, including Kraft, Coca-Cola, and PepsiCo, as all making positive steps, because they want to be part of the solution. He highlighted McDonald’s new Balanced Lifestyles Platform and said he spent a day at Hamburger University, where McDonald’s trains management. He praised restaurants for serving more “low-carb” options. He said that Coke has stopped exclusive contracting in schools. He wants to give out awards to companies who are doing a good job.

Then he took a few questions. One was from Charlie Brown, a legislator from the state of Indiana, who tried to get a bill passed there to set nutrition guidelines on soda vending machines in school, but lobbyists from Coke and Pepsi opposed the legislation, and that killed it. Thompson responded that he didn’t know why they would oppose such legislation, suggesting that they were worried about lawsuits. He promised that “the next time that happens, you call me and I will come out and testify for you,” which was met with much applause. He also recommended “sitting down with them before introducing the legislation next time.”

Next was a question regarding the $34 billion that the food industry spends on marketing its products, and the connection between agriculture policy and nutrition. Thompson responded: “It’s impossible to be in balance—the government is not going to spend that kind of money. That’s why the Small Steps ads have to run at two in the morning. We are never going to be able to equal the advertising budgets of corporations. We have to scrape together every dollar.” As for agricultural policy: “That’s legislation. I am a farmer. I am not going to criticize my profession.” When Mark Fenton (host of PBS’ “America’s Walking”) asked about increasing federal dollars for walking and biking paths, Thompson replied: “That’s Congress. That’s not my department—that’s transportation” and went on to describe the great work he did as governor of Wisconsin on this issue. He ended by suggesting that Time host another summit again next year.

Overheard at the Summit

“I know that I was digging a grave with a knife and fork for myself. And like many other Americans, that’s exactly what we end up doing. We darn sure can’t afford the cost of obesity-related diseases in the next 10 to 20 to 30 years as a new generation of obese people comes into focus.” – Mike Huckabee, Governor of Arkansas

“I think we have to get rid of food chaos. We have the most unbelievably chaotic food system. Give me a million mad moms, and I’ll get some organization at school.”
– Susan Combs, Agricultural Commissioner, State of Texas

“It takes only five minutes to eat 500 calories, but two hours to burn it off, so the focus really does need to be on food. We need big solutions, not small steps.”
– Susan Roberts, Tufts University

Marketing to Kids Panel

Peter Jennings, who hosted an excellent ABC News special last fall that covered how the food industry markets excessively to children, did a good job at moderating this panel, which consisted of the following experts: Marion Nestle, author of Food Politics; Marva Smalls, Nickelodian; Tim Muris, Chairman of the Federal Trade Commission (FTC); Ann Fudge, Young and Rubicam; Michael Mudd, Kraft Foods; and Margo Wootan, Center for Science in the Public Interest.

The three industry representatives spoke at length about the responsible ways that they are marketing to kids, such as Nickelodian’s “Let’s Just Play,” which contains health and wellness messages. Margo Wootan countered that “If you looking at the balance of marketing, it’s totally out of whack, parents are completely outdone by the food industry.”

Marion Nestle concurred: “It’s really simple. These companies are in business. There are not sitting around a table saying, ‘Let’s see how we can make kids fat.’ They are saying, ‘How can we sell our product in a marketplace that is extremely competitive and in which there is too much food around? And they're trying to do three things: They're trying to establish brand loyalty as early in life as possible; they're trying to get kids to pester their parents to buy more food; and the most insidious of all is that they're trying to get kids to think that they're supposed to have their own special foods, like Lunchables and other things in packages. So kids are not supposed to eat the boring foods that their parents eat. And that, it seems to me, is the most important difficulty and the one that is greatly in need of addressing. And that's why the government has to be involved.”

Then the debate turned to the role of the government in regulating advertising. Industry favors self-regulation, through the Children’s Advertising Review Unit, which sets guidelines for how to market to children. But Wootan said self-regulation is ineffective and called for the government to at least set some limits that would have the force of law behind them. FTC Chairman Muris called banning advertising to children “a distraction” because it’s “impractical, ineffective, and illegal” and “to go down the road of eating up resources of my agency and others in a quixotic effort to ban marketing will be a real disservice.” And anyway, he observed: “Even our dogs and cats are fat, and it’s not because they are watching too much advertising,” to which a smiling Peter Jennings replied: “It’s a great line, no matter how many times you deliver it.”

Overheard at the Summit

“This is not an issue of personal responsibility, when people don’t have healthy choices in the supermarket. Obesity is a symptom of a problem, of not eating right. But many non-obese people are also eating unhealthfully.” – Andrew Weil, University of Arizona

“In my neighborhood, you can walk three blocks, find eight fast food places and one tiny little produce section. It’s also the world’s largest food distribution center.  Eighty percent of the region’s produce and 40 percent of its meats go right through my neighborhood, but the good stuff goes right past and the crap stays. And so, we’re trying to create our own mechanism to provide healthy and affordable produce for the community.” – Majora Carter, Sustainable South Bronx

Big Food, Healthy Profits Panel

This panel was moderated by Surgeon General Richard Carmona and consisted of four industry representatives: Niels Christensen, Nestle; Betsy Holden, Kraft Foods; Shelly Rosen, McDonald’s; and Dan Short, Coca-Cola.

Carmona began by asking the panel, “What is the responsibility of corporate America in addressing this obesity epidemic?” Nestle spoke of acting for the public good over the long term and said: “We see this as a business opportunity, to develop new value-added products.” Kraft said: “It’s part of our responsibility to be part of the solution” and that “We are trying to improve the nutritional value of our portfolio. We’ve impacted about 200 products and 30 billion calories.”

McDonald’s chimed in with: “Corporate citizenship is part of our DNA.” With their new Balanced Lifestyle Platform: “Our strategy is really to focus on personal responsibility and help our consumers achieve their personal balanced lifestyle goals.” And in response to the charge that they are trying to shift the focus away from eating and onto physical activity: “We believe this is all about energy balance, and: so we’re doing both equally.”

Coca-Cola spoke of their strict policy not to advertise to children under age 12. Regarding school vending machines, they have model programs and guidelines and work with individual teachers and districts to determine what to do. Coke has also just started a “Beverage Institute for Health and Wellness” to apply the same scientific rigor for food pyramids to beverages. Short explains: “Mom told us to drink eight glasses of water, but is it ok to give artificial sweeteners or non-nutritive sweeteners to kids? What are we going to say to mom? We’ve got to help her with some of that information, and so the idea of this Beverage Institute is to get some of that information out.”

Next, Carmona asked: “Do we need lawsuits? Are lawsuits necessary to force corporate America to do their job?” McDonald’s jumped in with: “The answer is clearly no. We believe the way to change behavior needs to be positive and collaborative and to work together with the right solutions.” Kraft agreed: “I don’t think nutrition policies should be decided in a courtroom and often we look for silver bullets when this is a very complex issue and there isn’t one sector or industry that’s fully to blame.”

To which Carmona responded: “I appreciate the comment about the silver bullet, because Americans want instant gratification. But it’s taken us decades to get here and… this is an intergenerational endeavor. I think we have to step back and really deal with this thing realistically to understand that it is going to take quite a long time to change the culture of an entire country.”

There was only time for a few questions, but the audience had many. The same legislator from Indiana who challenged Secretary Thompson took the opportunity to ask Short, from Coca-Cola whether he would make a public pledge to not lobby against the efforts of states to set a standard of 50 percent of products sold in school vending machines be of nutritional value, as they had in his state. Short replied: “We are leaving that decision to the schools and we are working with the schools to provide them with the choices they want.”

After only a few questions, Carmona wrapped up with the following: “This terror that is eating us from within, which is going to have catastrophic consequences if we don’t stop, is before us…. We really need to continue to move forward with this, but rather than creating adversarial situations, my approach is to try and keep all the stakeholders at the table, but keep their feet to the fire, and continue to make those changes that will result in a healthier America.”
 

Overheard at the Summit

“The early days of tobacco history involved everybody standing around the campfire holding hands and saying we need to collaborate, cooperate. We paid a huge price for that because it stalled public health efforts to control tobacco for decades, and who knows how many millions of people died as a consequence.” [Taking exception to food industry calls for collaboration.] – Kelly Brownell, Yale University

“The Unites States has spread its toxic food environment to the rest of the world. Agricultural and economic trade policies are the reasons we’ve got huge health problems. The U.S. orchestrated the opposition to the World Health Organization’s global strategy on diet and health. You are dominating the agenda of the world.”
– W. Philip T. James, International Obesity Task Force
 

Things Washington Can Do Differently Panel

 This panel consisted of Tom Stenzel, United Fresh Fruit and Vegetable Association; Sandy Beall, Ruby Tuesday; James Tillotson, Tufts University; and Michael Suk, Department of Interior.

Professor Tillotson was mostly concerned about the concentration of the food industry. He recently conducted a survey showing that 47 percent of retails sales in supermarkets comes from 10 companies. Also, the top six restaurant chains own 50,000 outlets and spend $1.6 billion on advertising. He is also concerned about the disconnect in Washington among all the various government agencies that have authority over some portion of food policy. He says this is due to agricultural policy originally formed during a period of food scarcity, but all that has changed. “While nutrition knowledge has developed slowly, no one was on first base. So what we have today is authority for nutritional policy scattered throughout the government, and we have a colossal nutrition problem.”

Stenzel had several interesting points. He began by criticizing the U.S. government for not doing enough. Apparently referring to Thompson’s speech, he said: “If you look at the magnitude of this problem, to stand here on this stage and say, ‘We’re tackling it,’ is absolutely absurd. The amount of resources that our federal government is putting into tackling this challenge is abysmal. We’re not going to tackle this with a few Ad Council PSAs, no matter how good they are.” He recommends increasing the amount of money devoted to the National Cancer Institute’s 5 a Day program (to promote eating at least 5 servings of fruits and vegetable per day) from $3 million to $3 billion. He also stressed the need to create a greater connection between agricultural and health policy. He praised a government–funded pilot program to bring free fruits and vegetables into schools. But in the end, he stressed that policy is not shaped in Washington DC, but rather at the local level: “Pubic health policy is being shaped today in local school districts and school boards around the country. People in Washington are quite often the last people to get it.”
 

What I found most striking at the summit was the utter lack of leadership from our federal government officials. Thompson’s speech had all the cheerleading you might expect, but none of the substance. He was long on showing off government programs ostensibly addressing the problem, but short on acknowledging how they could do better. The chilling call to go out and “spread the gospel of personal responsibility” is still ringing in my ears. Just as disturbing was the glowing praise for industry, including at least one mischaracterization of their promises. Contrary to Thompson’s statement, Coca-Cola has not vowed to end exclusive contracting in schools, and certainly has not done so. Moreover, the secretary’s glee over the increasing “low-carb” menu options in restaurants (he referenced this “good news” more than once) was especially startling for its nutritional dubiousness. In addition, his attitude while taking questions was quite revealing. If things got too challenging, he would cut the questioner off in a patronizing, jocular manner. When pressed further, he would dismiss the concern with the familiar refrain, “that’s Congress” or “that’s legislation,” like it was some sort of separation of powers problem. Call me crazy, but shouldn’t it be the top health official’s job to tell congress exactly what the national health priorities are and maybe make a few suggestions for how to increase funding, and/or make the necessary structural changes in government?

Next, FTC Chairman Timothy Muris showed his true colors with his flippant remark: “Even our dogs and cats are fat, and it’s not because they are watching too much advertising.” This apparently has become his favorite line. In the press room after the panel, he used it again and all the other reporters just soaked it up. When I tried to ask him why he is so opposed to regulating marketing of food to kids, when we do have restrictions for tobacco advertising, he just dismissed the idea, opining: “Oh it’s not the same thing. I think the analogy to tobacco is bogus.”

And just when I thought it couldn’t get any worse, along came Surgeon General Carmona as moderator of the industry panel. He wasted so much time prattling on about how we all need to work together on this challenging issue. After each set of answers he would thank the panelists, fawning all over them for showing such leadership. And Carmona wins the prize hands down for the most absurd question asked of industry, with: “Do we need lawsuits?” It seemed he was looking for the responses he wanted, and he sure got them. Thanks to Carmona blowing off so much hot air (not to mention the utterly self-serving and long-winded answers from the industry reps), there wasn’t nearly enough time for questions from the audience. The tension in the room was palpable as participants were obviously frustrated that their voices could not be heard. In the end, I couldn’t help wondering what exactly the point was of an all-industry panel with no opposing viewpoints and a “moderator” who asked no challenging questions.

The summit agenda was also notable for what was not covered. Other than Alice Waters (whose remarks were mostly limited to her innovative school garden program), there was no voice for any alternative to the multi-national, corporate-controlled, industrial food system represented so heavily by the likes of Kraft, et al. I don’t recall hearing the phrase “sustainable agriculture” uttered even once. In addition, while there was one break-out session on “Communities of Color,” the sobering fact that diet-related illnesses disproportionately strike those in lower income populations was hardly mentioned. Apparently, it was more important to give time to the big names in Big Food and watch the “Diet Warriors” battle it out.

With so many top experts gathered in one place, it seemed an opportunity was lost. While the event got some good press, bringing much-needed attention to the issues, no real tangible strategies or solutions resulted, which seems ironic, since this is what Time had hoped for: “To spend three days trying to thrash out an anti-obesity action plan.” That did not happen, not by a long shot. Nevertheless, the few highlighted community success stories did serve as strong reminders that, as with other public health challenges, our best hope for policy change lies at the local level, where dedicated individuals come together to make a real difference.

For more summit details directly from TIME and ABC News, including photos, video, conference wrap-up, and more, visit: http://www.time.com/time/health/article/0,8599,646304,00.html

Upcoming Lectures

If you’re at least 55 years old and live near San Jose, California, you can sign up for one of a series of upcoming lectures this summer on the politics of food. Taught by CIFC’s Michele Simon and hosted by San Jose State University’s Osher Lifelong Learning Institute, topics include the politics of nutrition advice and connecting the personal to the political. For details, see visit: http://iesweb.sjsu.edu/searchprofdev/searchCourse.java.jsp?command=1&courseId=18821 

Michele Simon is available for workshops in your community and can speak on a variety of food policy topics. For more information, visit: http://www.informedeating.org/lectures.html

Volunteers Needed

Have some spare time and want to offer it to a worthy cause? CIFC is in need of help in the following areas: 1) research on food industry tactics; 2) outreach for public speaking opportunities; 3) sporadic updates to the website. If you’re interested, contact Michele Simon at: Michele@informedeating.org or call 510-465-0322.

 
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