Welcome to the Obesogenic Environment

In his most recent post, Snowdon makes a far-reaching case to support the “slippery slope of food regulations,” arguing his “opinions” to counter the “truisms” that Saunders and I present.

However, closer examination of his opinions shows them to be just that – opinions. He supports this broad array of opinions with a scant six references, including references that do not support his opinions at all. For example, as support for the claim, “Contrary to some hyperbolic claims made in recent years, sugar is not addictive,” he presents an article from a neuroscience journal that argues, “The currently available evidence for a substance-based food addiction is poor, partly because systematic clinical and translational studies are still at an early stage. We do however view both animal and existing human data as consistent with the existence of addictive eating behavior.” In other words, the research on the addictive properties of individual nutrients (primarily sugar) is still in its early stages so scientists cannot yet conclude that sugar itself is addictive, but they can conclude that eating behaviors (e.g., consuming sugar-sweetened sodas) can become addictive.

But I will stick to my area of expertise – food marketing and the “so-called” obesogenic environment.

First, an accurate definition of the obesogenic food environment. Snowdon describes it as an environment where “consumers are unable to satisfy their latent desire to eat cabbage and broccoli.” In fact, humans are biologically programmed to desire sweet-tasting and high-fat foods – and to overconsume them so they can be stored as fat for use in lean times. Children can be taught to like the taste of cabbage and broccoli, but it takes numerous exposures. It also takes time and money, as fresh vegetables cost more and take more time to prepare than fast food and packaged processed foods. In the obesogenic food environment, high-calorie nutrient-poor foods (also the foods that humans innately prefer) are cheaper, faster and easy to overconsume.

Snowdon claims that store shelves “even in inner cities” are full of “fruits and vegetables from around the world.” Really? The USDA estimates that 23.5 million Americans live in food deserts, defined as “urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food. Instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants and convenience stores that offer few healthy, affordable food options.” I live in one of those food deserts. The closest supermarket is 2.7 miles away and on a different bus line. If I didn’t have a car, it would take me more than one hour each way to reach those “fruit and vegetables from around the world.”

My research team has spent a lot of time examining food marketing in the United States and documenting how it contributes to the obesogenic environment. We recently published a report on beverage marketing that paints a starkly different picture from the one presented by Snowdon.

According to Snowdon, “Nearly all soft drink companies produce similar low-calorie, zero-calorie and sugar-free varieties.” That is true, but at the same time beverage companies have introduced low- and zero-calorie beverages like Coke Life, they have also introduced similar numbers of sugary beverages. Take Mountain Dew Kickstart, for example. This product contains less sugar (60 calories per can) but more caffeine than a typical soda and 10% juice. The product is marketed to teens as a great way to “kickstart” their day. Soda for breakfast? Hardly a win for public health. In fact, from 2010 to 2013, median calories and sugar in sodas did not change.

Snowdon also claims that, “All [low-calorie and sugar-free options] are widely advertised and all are available on the same shelves, in the same stores, and for the same price as their more sugary cousins.” In fact, according to Nielsen – the same data used by companies to measure their own advertising campaigns and those of their competitors – in 2013 beverage companies spent almost $900 million to advertise sugary drinks, primarily sugar-sweetened sodas, energy drinks, sports drinks, and fruit drinks; $200 million to advertise diet (i.e., zero-calorie) sodas and other beverages; $140 million to advertise 100% juice; and approximately $50 million to advertise plain (unsweetened) water.

In other words, beverage brands invested 65% of their over $1 billion advertising budgets to promote sugar-sweetened beverages. In contrast, just 14% of their advertising encouraged consumption of water or 100% juice – the only products in their portfolios that provide any nutrients humans require to live. Contrary to Snowdon’s assertion, quitting sugar-sweetened beverages is an option. And as with tobacco, one that will greatly improve their health.

Of course, according to Snowdon, this advertising has no impact on consumers’ preferences for sugary drinks over other options – as his selection of two online references written by economists support. However, my own research – conducted with two economists and published in a peer-reviewed economics journal – documents the opposite. Exposure to advertising for carbonated soft drink advertising, including both sugar-sweetened and diet sodas, is a strong and significant predictor of sugary soda consumption in fifth graders.

But even if Snowdon dismisses this research as evidence of my “deeply held beliefs” about the effectiveness of advertising, his argument makes no sense. Bottled soft drinks did not exist until the early 20th century – fruit drinks, sports drinks, and energy drinks are even more recent inventions. Yet in 2013, U.S. households spent over $14 billion to purchase these sugary drinks. And whereas our ancestors survived drinking only water, milk, and the occasional alcoholic beverage, consumers today believe that drinking sugary drinks is “fun,” promotes “happiness,” is a necessity for athletes, and is “energizing” to boot. If not driven by marketing, how did these behaviors and beliefs develop? Surely beverage companies also must believe that advertising works or they wouldn’t invest over $1 billion per year on it.

In this fictional market that Snowdon describes, the only barrier to consumers’ purchase of healthy options is their desire for the unhealthy stuff. But again our research on sugary drink marketing presents another barrier. Marketing often misleads consumers into believing that drinks consisting of water, calories from sugar alone, and miscellaneous additives are healthy options.

For example, Sunny D, a children’s fruit drink, contains 14 grams of sugar (3.5 teaspoons totaling 60 calories) per 8-ounce serving, plus artificial sweeteners to make it even sweeter, and high amounts of sodium. Although the product consists of just 5% fruit juice - with no orange juice - artificial colors make it look like orange juice. It comes in a clear bottle that is often stocked in the refrigerator case of the supermarket near the orange juice, although the product does not need to be refrigerated. Its label even includes pictures of oranges and the claim 100% vitamin C. These marketing techniques have been very effective. Although one serving of Sunny D contains the maximum amount of sugar that nutritionists recommend children consume in an entire day, 56% of parents believe that this is a healthy drink to serve their child.

Especially egregious are marketing practices that target children and adolescents in companies’ drive to “capture the stomach” of young consumers. Companies know that brand preferences, taste preferences, and eating behaviors develop at an early age and are extremely difficult to change once established. A Coca-Cola marketing executive supports the company’s teen-targeted marketing practices, “We can’t afford not to talk to teens. You can’t think, ‘Teens already know us and skip a couple of years.’ Every six years there’s a new population of teens in the world.” According to PepsiCo’s website, they offer “good-for-you” beverages (including water and orange juice) and “fun-for -you” beverages (including sugar-sweetened soda). Which ones do you think they market to teens? Of note, over 90% of food marketing that targets children in their own schools promotes sugary drinks. And this marketing is much more prevalent in low-income schools.

I could go on, but I will finish with this observation. Snowdon believes that a rate of 17% of children who suffer from obesity is acceptable – that is almost one out of every five children in the United States. I don’t agree, and perhaps that is the main reason for my beliefs. In my opinion, it is unconscionable to doom any child to a lifetime of serious health challenges such as type 2 diabetes, hypertension, and stigma simply because they were born in an environment designed to make it so easy and cheap to overconsume great-tasting but nutritionally poor foods. You can blame the parents who don’t have the means, the time, or the knowledge to overcome this environment surrounding their children. Or you can try to improve the environment – including through public health policy – so that parents don’t have to do it on their own.    

Also from this issue

Lead Essay

  • Christopher Snowdon reviews the efficacy and fairness of sin taxes aimed at preventing obesity. He finds that at low levels of taxation, consumers don’t change their behavior appreciably, and when they do abandon the taxed foods, it will often be in favor of other high-calorie choices. Very high levels of taxation may be needed to bring about significant public health benefits, but here the evidence is sparse, because few jurisdictions have tried taxation at these levels. Moreover, all such sin taxes are regressive; they hurt the poor disproportionately and become justly politically unpopular. Snowdon concludes that sin taxes aimed at obesity are an ineffective public policy tool, even on their proponents’ own terms.

Response Essays

  • Baylen Linnekin largely agrees with Christopher Snowdon on the question of food and soda taxes: They appear to be ineffective. But he takes the argument further in two ways. First, even while taxes show little promise in shrinking waistlines, several government programs, including farm subsidies and sugar protection policies, seem to aim in the opposite direction. If anything, they make Americans fatter. We should abolish these policies immediately. Second, he suggests that taxes on sugar are antithetical to longstanding American traditions, which in the Revolutionary era included outright revolt against the British Sugar Act.

  • Russell Saunders argues that obesity is a complex problem. While sin taxes might not work all alone, they can be a part of the solution. While one can become obese owing to calories from any source, some sources make obesity a great deal more likely. Sodas are just such a source. Taxing them has been shown to cause substitution among teenagers - not in favor of still more empty calories, but in favor of while milk and other more nutritionally beneficial choices.

  • Jennifer Harris argues that advertising has created a dangerous food environment, one that is too strong for most parents to overcome. So while we might all agree that parents should be responsible for their children’s health, this simply isn’t possible anymore: Corporate profits come first for corporations, and they are winning the battle over what goes into our kids’ bodies. The result is an epidemic of childhood obesity. Further, the evidence shows that obese children tend to grow into obese adults, with all the associated health problems. Local governments know the costs of obesity, and they have responded with exercise and healthy eating initiatives, including soda taxes, but also exercise programs and education about the benefits of healthy eating.