Volume 3, Number 6, June 2012
Journal of the World Public Health Nutrition Association
Published monthly at www.wphna.org
The Association is an affiliated body of the International Union of Nutritional Sciences For membership and for other contributions, news, columns and services, go to: www.wphna.org
Editorial. Processing: The big issue
Q. What drives global obesity?
A. This is obvious
Access pdf of this month's WN commentary here
Access pdf of this editorial here
Does exposure to incessant advertising of energy-dense fatty, sugary or salty ultra-processed products have an impact on rates of childhood obesity?
The best response to the caption of the picture above: why is this a question that is still being asked? For the answer is obvious. The real questions are: how great is the impact, and when will governments finally do their duty of passing relevant laws to protect public health and public goods? There's another question, which is: just what exactly is so wrong with the products that are being advertised and marketed so relentlessly? And there is a further question, which is: what exactly is wrong with the corporations that make these products? This is where independent scholarship and investigation is needed, and where Carlos Monteiro comes in.
The issue is ultra-processing
'The most important factor now, when considering food, nutrition and public health, is not nutrients, and is not foods, so much as what is done to foodstuffs and the nutrients originally contained in them, before they are purchased and consumed. That is to say, the big issue is food processing – or, to be more precise, the nature, extent and purpose of processing, and what happens to food and to us as a result of processing. Specifically, the public health issue is 'ultra-processing'. This is how Carlos Monteiro introduced his grand theme in World Nutrition in November 2010, in a commentary that we reckon has now been accessed over 100,000 times. He returns to the theme this month, to answer a question often asked by colleagues, including at our Rio2012 conference. Why 'ultra-processed products'? What's the difference from 'processed food', or 'highly processed food', or 'fast food', or 'convenience food', or 'junk food'? Yes, there is a crucial difference, as summarised in Box 1.
Here is Carlos Monteiro's account. Ultra-processing is used to make products from combinations of ingredients extracted from whole foods, usually with little or even no whole foods. Typically, series of processes are used, in the creation of the ingredients and also in the creation of the products, which also usually contain some or many preservatives and cosmetic additives. They are formulated to be hyper-palatable, of long duration, and are usually packaged ready to consume. They are very profitable, and aggressively marketed. They are the end product of a chain of processes.
It is ultra-processed products that drive the profits of transnational food and drink product corporations. This is because of their characteristics. The transnationals could not make vast profits, or be able to penetrate deeply into the global South, if they shifted their priorities to fresh or minimally processed foods. There are other and broader issues involved here also, such as the undermining of meals, the family meal table, and family life itself, and of long established traditional food systems and culture, local economies, and national identity and independence.
One of the differences is not just the nature of the products themselves, but where they are coming from: which is to say, who makes and sells them. Immediately here, we come to another question of definition. There continues to be a lot of loose talk about 'industry', or 'the food industry', or 'the food and drink industry', as if any of these entities operate against the public interest. This is foolish nonsense. There is an analogy here with using the phrase 'processed food' as a term of abuse. This is also silly, because as people from industry rightly point out, almost all food is processed in some sense before it is consumed. Indeed, if crop and animal breeding are counted as types of processing, which is not much of a stretch, few people now ever consume unprocessed food. The issue here, is what type of processed food, – or rather, product – which is why Carlos Monteiro's careful definitions are vital. See also Reggie Annan's points made in Box 2.
Reggie Annan says: Most ultra-processed products are made with very cheap ingredients and are often preferred by impoverished people, making their negative health impact worse in lower-income countries. Public policies are needed to stop the dominance of ultra-processed products in food systems. These need to include marketing regulation, taxation and support for the production and supply of whole or minimally processed foods.
As an African, I have to say that while the negative health effects of these products are well known and commonly discussed in rich countries, in many poorer countries like my own country of Ghana, they are very prestigious. Fast food joints are springing up fast, and many people think it is modern and stylish to buy such products. No wonder that non-communicable diseases are increasing so fast.
It is also the transnationals
We all need to eat. There is nothing wrong with 'the food industry'. This includes farming co-operatives, family retail businesses, and indeed the whole human and physical machinery of long-established traditional food systems. Olive growers, greengrocers, and street market traders, are all part of 'the food industry'. At this point in any such discussion, the response may well be: 'that's not what I mean by "the food industry'.' Well, exactly: so what is meant? With many other commentators now, Carlos Monteiro states that above all now, what is meant is transnational corporations in the food and drink business. It is of course not true that all the products manufactured by transnationals are unhealthy. Nor even more obviously, is it true that all the products made by national or small manufacturers are healthy.
A jungle of transnational corporations and of their brands. Missing are the agribusiness, burger and booze conglomerates, who also call policy shots
But generally speaking, the big issue here is not industry. Of course it is not. It is the transnational corporations, who by analogy with Big Tobacco, Big Drink and Big Pharma, can be termed Big Food or, rather more precisely, Big Snack. Their interests are in direct conflict with those of public health, and of public goods.
The 'map' above, shows some of these: from top left, Coca-Cola, PepsiCo, General Mills, Kellogg's, Mars, Unilever, and then (after Johnson and Johnson and Proctor and Gamble, solely or mostly into inedible products), come Nestlé and Kraft. These corporations have annual sales the size of the gross national products of small or even middle-size countries. These are the corporations that buy large stands at nutrition conferences. The little gidgets, too small to read here, show some of their leading brands, which in the case of PepsiCo are mostly not soft drinks but snack products. Missing from the 'map' are manufacturers whose business is through licensing, such as McDonald's, Burger King, and Yum! Brands. Also missing are the vast agribusiness and agrichemical corporations such as Cargill, Conagra, Archer Daniels Midland, and Monsanto, whose branding and profile is less conspicuous.
It is executives of most of the corporations named here, together with Big Booze conglomerates like Diageo, that now help to supply the secretariats and resources and venues for summits on non-communicable diseases. It is they who sit round the table with UN and government officials, and with executives from supportive organisations such as the Gates Foundation, the Global Alliance for Improved Nutrition, the World Bank, and the World Economic Forum, when international policies on food, nutrition and public health are being determined.
Competition – with whom?
It is commonly supposed that industry is competitive. This is true, but often not in the ways advertised by those who advocate privatisation of public goods and deregulation of industry. First, once set free, big business in most if not all fields will tend to concentrate and become monopolistic.
The economist Adam Smith is supposed to be the original champion of 'the free market', which these days means enabling transnational corporations to act in any legal way they want, to increase their profits. But in his The Wealth of Nations he railed against monopoly, and in a well-known passage said: 'People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices'. He added: 'It is impossible indeed to prevent such meetings, by any law which either could be executed, or would be consistent with liberty and justice. But though the law cannot hinder people of the same trade from sometimes assembling together, it ought to do nothing to facilitate such assemblies; much less to render them necessary'.
The World Economic Forum, and now increasingly UN agencies following the UN 2000 Global Compact, are constantly providing such facilities. In her 'I get around' column this month, quoted in Box 3 below, Vivica Kraak points out that ways to make the transnationals accountable are not effective.
Weak or absent accountability
Vivica Kraak says: There are weak or absent corporate accountability mechanisms for industry within two existing, voluntary, global corporate governance systems. One is the United Nations Global Compact, launched in 2000, which offers corporations ten guiding principles to demonstrate best practices to support social outcomes. These principles lack explicit language to promote consumer health, nutrition and well-being goals. The other voluntary system is the Global Reporting Initiative, which lacks clear indicators for companies voluntarily to disclose their collective actions to protect public health nutrition, healthy lifestyles and well-being.
It gets worse. While any burger or cola drink transnational is in competition with the other leading corporations in the same business, the competitive products are practically identical, apart from their 'sizzle' – their branding, advertising and marketing. Characteristically, they are energy-dense, fatty, sugary or salty, and often formulated with the use of cosmetic and other additives to be ultra-palatable. Besides this, and most important, the food and drink product manufacturers are only notionally in competition with one another. Their common adversaries, in what is now a return to red in tooth and claw jungle capitalism, are the smaller and weaker animals – national, regional and local farming, distribution, manufacturing, retailing and catering businesses, that in many countries in the global South are collectively responsible for long-established traditional food systems.
The transnationals are united in their determination to displace this competition. They are doing so, all the time, now. This ruthless practice sometimes drives smaller firms out of business. Transnationals also take over national and regional firms, and may keep the original brand name under the general corporate name, while degrading and cheapening the products in order to generate more profits.
What then is to be done
Two related themes constantly brought up at our Rio2012 conference, were conflicts of interest, and 'public-private partnerships'. Yes, scholarship is needed – knowledge. Yes, general agreements are needed – policy. But what came over most clearly at the conference, in the matter of a third and very concrete theme, is that with the scandal and outrage of the advertising and marketing of ultra-processed products to children, what's needed above all is resolute and even militant action. What is driving global obesity, especially in children and young people, with all that follows? This is obvious. We have a task here, as professionals and also as citizens. The last thought comes from Philip James, from his 'As I see it' contribution this month, in Box 4.
Philip James says: Now, I am now moving to the view that the real challenge now, is to identify non-conflicted industry with whom we can work. Actually, I am inclined to go further, and think we need to find ways of engaging honourably with conflicted industries, so that they do not... frustrate our purposes and impede public health nutrition. This won't be easy,
Participants at Rio2012 will remember the constant discussion on how to address conflicted industry. I trust this will also be addressed in the conference's final report. It is becoming a burning issue. The challenge is how to deal with industry in ways that re-capture the high ground of policy-making, so that we can indeed, in real partnerships, make progress in population nutritional health and well-being.
Acknowledgement and request
Readers may make use of the material in this editorial if acknowledgement is given to the Association, and WN is cited. Please cite as: Anon. Processing. The big issue. Q: What drives global obesity? A: This is obvious. [Editorial] World Nutrition, June 2012,3, 6: 250-256. Obtainable at www.wphna.org
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