Because I tend to focus my attention on news being generated by the major food companies, I don't always pay close attention to the latest scary reports on obesity data. So when the annual report called F as in Fat: How Obesity Policies are Failing America came out this week, I just thought, Oh there's that report again with the awful name, with the same gloomy numbers as last year.
But then I got an interesting email message forwarded from New York University professor and food politics maven Marion Nestle that made me realize I should pay closer attention to this year's report. The email was from Harold Goldstein, executive director of the highly effective non-profit, California Center for Public Health Advocacy. He was questioning how the CEO of PepsiCo was given 2 pages of airtime in the report. What was that? The CEO of a major company contributing to the very facts and figures contained within the 124-page document was offered space to make her case?
Under the heading, "A Personal Perspective," here is just a sampling of what PepsiCo CEO Indra Nooyi had to say: (her entire missive is on pages 44-5 of the report)
At the heart of America's obesity epidemic us achieving a balance between the calories we put into our bodies and the calories we burn. It's a simple equation but a complex challenge that companies must help their employees and consumers to overcome....
We firmly believe companies have a responsibility to provide consumers with more information and more choices so they can make better decisions... I believe the food industry can play a leading role in this area. In fact, we must play a leading role... It’s a challenge, but increasingly PepsiCo and other companies recognize and accept our responsibility to help our associates and consumers succeed.
OK, so this rhetoric is certainly nothing new and on its own reads like the usual PR-speak that we've come to expect from the likes of the maker of Cheetos and Mountain Dew. But let's place these remarks into context. This report, which has been published annually for the past seven years, is put out by the organization, Trust for America's Health (TFAH) a fairly well-known public health nonprofit based in Washington, DC. Obesity is one of TFAH's several issue areas and they describe themselves as a "non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority." Noble enough.
This report gets a lot of press each year and is especially popular for how it ranks each state according to its obesity statistics. It also provides federal and state policy progress in a variety of areas, is fairly comprehensive, and relies heavily on government sources. In other words, the document makes a major contribution to the national conversation regarding obesity prevention and public policy.
Moreover, the report is co-published by its funder, the Robert Wood Johnson Foundation (RWJF) the nation's largest healthcare foundation. One of RWJF's most ambitious goals is to "reverse the childhood obesity epidemic by 2015." Since 2007, the foundation has backed that up with an impressive $500 million in grants to myriad programs around the nation. These days, it's hard to run into a childhood obesity prevention program that isn't funded by RWJF.
So how did the nation's largest healthcare funder and a prominent public health organization let the nation's largest food company get airtime in their annual obesity report? Good question.
In the introduction to the report is this attempted explanation: "TFAH asked the following policy-makers and experts in the field of obesity to offer their perspectives on what needs to be done to address the obesity crisis in the United States." And then PepsiCo CEO Indra Nooyi is listed among other contributors including Senator Tom Harkin and Kelly Brownell, director of Yale's Rudd Center on Food Policy and Obesity. That's quite a coup, for CEO Nooyi to be listed among the very same experts who are fighting PepsiCo's lobbying efforts.
Reporter Melanie Warner, who just published an excellent piece about this at BNET, (Obesity Report Chronicles the Sad State of America -- and Tells Us How Great PepsiCo Is) asked TFAH to explain itself. Here is what she learned:
Laura Segal, spokesperson for the Trust for America’s Health, says that having Nooyi’s comments in the report was an innocent attempt to have the “industry perspective” and not the result of any shady financial relationship. “We reached out to a number of companies and Pepsi was the first one to respond. We want to represent a range of opinions and the industry segment is a significant component of dealing with obesity,” says Segal.
Harold Goldstein (who gets the credit for first sounding the alarm) sees this incident as part of a troubling trend:
There seems to be a growing interest among public health organizations to appear "unbiased" when discussing obesity prevention by providing a forum for industry. It would be the equivalent of providing a forum for the tobacco industry to espouse their "personal responsibility" message in reports on smoking-related deaths.
As a national public health organization, I would have hoped TFAH would provide a clear and scientifically based public health perspective on issues like personal responsibility, rather than simply providing a forum for dissenting perspectives.
Also, the placement of the PepsiCo text is either suspect or ironic. It comes right after two pages describing recent efforts by various states to enact soda taxes, a contentious issue that PepsiCo lobbies hard against, despite mounting evidence that it may be one of the most effective policies available. Recognizing the connection, Harold Goldstein describes what Nooyi left out of her statement:
She doesn’t mention the highly sophisticated multimillion dollar national marketing and lobbying campaign they have undertaken to promote themselves as good corporate citizens and undermine efforts to establish state and local policies to reduce consumption of sugar sweetened beverages, which have been the single leading contributor to the obesity epidemic.
It's bad enough when the government invites industry executives to "workshops" on food marketing, and for years we have seen corporate sponsorships of nonprofits such as the American Heart Association and the American Dietetic Association. But this hurts even more, because it was unexpected. If we can't even read a major public health report on obesity data and policy solutions without running into a PR statement by Big Food, then no place is safe.
As Melanie Warner points out: "the inclusion of Nooyi’s remarks in a public health report feels a bit like if Congress were to suddenly decide to give BP several pages with which to defend itself in forthcoming congressional reports on the oil spill."
While most of the information contained within the report may still be reliable, the fact that PepsiCo was allowed to participate also raises the question, what other editorial decisions were made that might have been favorable to the food industry? We'll never know, and that's the heart of the problem: Once the door is open to providing industry a forum in a public health context, no longer can we trust that we are getting the best information available from those sources.
Finally, I asked Marion Nestle for her reaction:
By this time, research has clearly demonstrated that partnerships and alliances of health organizations with food companies benefits the food companies far more than the health organizations. The goals of public health and food companies differ. Food companies enter such alliances for public relations and to deflect public attention from the need to regulate their marketing practices. RWJF ought to be well aware of the risk of such alliances and to protect its integrity against them.
What do you think? It would be great to hear from RWJF grantees. You can make comments on this blog anonymously if you prefer. (Cross-posted from here.)