International Association for the Study of Obesity Tim Lobstein Director of Policy and Programmes tlobstein@iaso.org
Nutrition advocacy Identify the problem
Health messages Reduce fat, especially trans and saturated fats Reduce sugars especially added sugars Reduce salt Reduce energy density of foods Increase fruit + veg, wholegrain foods, lean meats and fish
Health messages Reduce sales of fatty foods, especially foods with trans and saturated fats Reduce sales of foods with added sugars Reduce sales of salty foods Reduce sales of energy dense foods Increase sales of fruit, veg, wholegrain foods, lean meats and fish
McDonald's stores 6000 5000 W Europe 4000 3000 2000 1000 0 E Europe 1970 1980 1990 2000 Western Europe Eastern Europe
Higher BMI = greater food consumption UK average adult now 8.4kg heavier than 1980 Value of food consumed = 8.6bn /year 1 Australia estimated value of obesity to the food industry AU $3.5bn / year 1. Lobstein Public Health Nutrition 2011
Nutrition advocacy Identify the problem Follow the money Develop the language
Language Consumers Primary producers farms, fisheries Importers and wholesalers Manufacturers Retailers Shoppers / eaters
Language The food industry Large, global companies dominate policy setting Must be consulted: we all have to eat part of the solution Big Snack not eat their products: branded, highly advertised, unhealthy, replace traditional healthy diets.
Language health promotion who, where, how Targets include parents, children Settings include schools and workplace Approaches include information and education
Health promotion plus! who, where, how Targets include parents, children, but also food producers, adv agencies, legislators Settings include schools and workplace, also retail and fast food outlets, media, Approaches include information and education, also marketing controls, labelling regulations, food prices, agricultural policy
Nutrition advocacy Identify the problem Follow the money Develop the language Local action needs national / upstream action too Learn the policy dance
CI (Malaysia) 2004 IACFO 2003
WHO 2003 some experts have suggested that the marketing of such [HFSS] foods contributes to an obesogenic environment that makes healthy food choices more difficult, especially for children.
WHO 2004 Governments should work with consumer groups and the private sector (including advertising) to develop appropriate multisectoral approaches to deal with the marketing of food to children
Institute of Medicine (USA) 2005: Marketing strongly influences children s food preferences, requests and consumption Food and drink advertising on TV is associated with obesity of children (strong evidence) and youth (weak evidence)
European Commission 2004: Commissioner gives industry one year to show reform or be regulated. 2005: extended further two years. 2006: Green Paper discussion on policy 2007: White Paper on nutrition and obesity policy
European Commission s Advertising to children: WHITE PAPER 2007 The Commission s preference is to keep the existing voluntary approach at EU level...
The IOTF Sydney Principles Launched ICO 2006 1. SUPPORT THE RIGHTS OF CHILDREN. Regulations need to align with and support the United Nations Convention on the Rights of the Child and the Rome Declaration on World Food Security which endorse the rights of children to adequate, safe and nutritious food. 2. AFFORD SUBSTANTIAL PROTECTION TO CHILDREN. Children are particularly vulnerable to commercial exploitation, and regulations need to be sufficiently powerful to provide them with a high level of protection. Child protection is the responsibility of every section of society - parents, governments, civil society, and the private sector. 3. BE STATUTORY IN NATURE. Only legally-enforceable regulations have sufficient authority to ensure a high level of protection for children from targeted marketing and the negative impact that this has on their diets. Industry selfregulation is not designed to achieve this goal. 4. TAKE A WIDE DEFINITION OF COMMERCIAL PROMOTIONS. Regulations need to encompass all types of commercial targeting of children (e.g. television advertising, print, sponsorships, competitions, loyalty schemes, product placements, relationship marketing, Internet) and be sufficiently flexible to include new marketing methods as they develop. 5. GUARANTEE COMMERCIAL-FREE CHILDHOOD SETTINGS. Regulations need to ensure that childhood settings such as schools, child care, and early childhood education facilities are free from commercial promotions that specifically target children. 6. INCLUDE CROSS BORDER MEDIA. International agreements need to regulate cross-border media such as Internet, satellite and cable television, and free to-air television broadcast from neighbouring countries. 7. BE EVALUATED, MONITORED AND ENFORCED. The regulations need to be evaluated to ensure the expected effects are achieved, independently monitored to ensure compliance, and fully enforced.
World Health Organization European Region 2006...substantially reduce the extent and impact of commercial promotion of energy-dense foods and beverages, particularly to children
No ads, unless the foods are Company Burger King per child s meal Kellogg per serving General Mills per serving without milk Energy (kcal) Total fat Saturated fat Trans fat Added sodium Added sugar 560 <30% <10% energy 0 g 660mg 10% energy energy Notes No artificial colourings, flavourings 200 2g 0 g 230mg 12g Exceptions for waffles. <175 1.7g 200mg 12g Whole grain 8g; vitamins & minerals 15% RDA per 100g PepsiCo per specified amount 150 (snacks) 35% energy 10% energy <0.5g 150mg 10% energy Cholesterol 30mg; exceptions for some products Unilever 13% energy and 33% of total fat 2% energy 1,6 mg/kcal 7g/100g Total sugars 25% energy; exceptions for some products Kraft Nestlé Specific criteria for different food groups. Specific criteria for different food groups.
Company s soft criteria Calippo (Wall s/unilever): 19g sugar per 100g Unilever limit for sugar: Maximum 20g per 100g Nesquik cereal: 24.7% sugar, company criteria 25%
We agree not to advertise to under 12s Company TV, radio Printed media Paid for ads on internet Product placement Interactive games Licensed characters Coca Cola Yes Yes Yes Yes Yes Yes Danone Yes Yes Yes No No Yes Ferrero Yes Yes Yes No No No PepsiCo Yes Yes Yes Yes No No Nestlé Yes Yes Yes No No No Kellogg Yes Yes Yes Yes Yes Yes Kraft Yes Yes Yes No No Yes Unilever Yes Yes Yes Yes Yes Yes Burger King Yes Yes Yes No No No Mars Yes Yes Yes Yes Yes Yes
Celebrity endorsements: e.g. PepsiCo Brand equity characters: e.g. Kellogg s, Mars Premiums: e.g. Burger King Company websites: e.g. Danone Advergames: e.g. Mars, Danone
Kelloggs publicity in 2007
WHO recommendations 2010
World Health Assembly, May 2010 Resolution Governments should set the policy components e.g. age, media, techniques, foods, monitoring Settings where children gather should be free of HFSS food marketing Member states should cooperate to reduce the impact of cross border marketing
StanMark Standards for Marketing food and beverages to children Co-funded by the European Union within the framework of the Pilot Project on Transatlantic Methods for Handling Global Challenges in the European Union and the United States.
Reviews of policy and research Development of advocacy tools Proposal: high standards for cross-border marketing Evidence and policy reviews Copenhagen, 29-30 May 2010 Washington DC, 22-23 October 2010 Brussels, 9-10 March 2011
Reviews of policy and research Development of advocacy tools Proposal: high standards for cross-border marketing Web-based policy maps Marketing news - weekly bulletin Library of research resources
Reviews of policy and research Development of advocacy tools Proposal: high standards for cross-border marketing Aims: to identify key issues needing standards to identify high standards already proposed in other public health fields
ISSUES: What is a child? Which media need to be included? Ads targeting children or seen by children? Which food products to include and exclude? How should standards be monitored and enforced? Who is accountable?
ISSUE: What is a child? In practice Risk reduction strategy: persons who have not reached an age when they are considered to be legally competent to protect their own welfare. UK Ofcom: TV advertising to children under 16 Alcohol: Facebook: not to persons under 25
ISSUE: Which foods and beverages? In practice Risk reduction strategy: promote only those products which conform to national and international dietary guidelines supporting WHO s Global Strategy to prevent obesity and chronic disease. UK Ofcom: FSA nutrient profiling system, reviewed and found fit for purpose, validated for UK dietary patterns US: Interagency Group proposals (?) Norway: Keyhole products (?)
Nutrition advocacy Identify the problem Follow the money Develop the language Local action needs national / upstream action too Learn the policy dance Anticipate and demand more Collaboration
Alliances with common interests Less processed meat... less imported processed foods... more fruit and veg... Environmental groups / campaigns Animal welfare campaigns Small producer/sustainable farming Fair trade campaigns Small retailers...
Nutrition advocacy Identify the problem Follow the money Develop the language Local action needs national / upstream action too Learn the policy dance Anticipate and demand more Collaboration Join the campaigns! Support the advocacy groups!
THANK YOU! tlobstein@iaso.org