Is always helpful to remember
what we are doing at nutrition
conferences, and what is their
purpose. So if you have not
already, I ask you to read the
September and October editorials
in World Nutrition:
‘Conferences: What for?’(1) and
‘Conferences: What for.’(2). And
I will continue some themes from
my column last month (3).
Experience is stronger than
words. Our attitudes are more
effective than our speeches.
What we say is more authentic
when we have experienced what we
are talking about. This does not
mean we have to develop cancer
to become an expert on cancer,
nor that we have to move to a
poor community to become an
expert on poverty. Knowledge
derived from scientific
paradigms, and traditional and
popular wisdom, are
complementary.
What was the attitude of
participants at the Porto
congress, to the presence of
Coca-Cola Iberia (picture
above), with its absurd slogan
‘we take care of your
hydration’? My guess that some
of us were bothered, confused,
or outraged, and that some of us
were indifferent or found it –
and its products – pleasant or
convenient. What would be the
proportion of participants in
any of these categories? What
would you guess?
If in congresses we act in ways
that are inconsistent with what
we write and say, how can we
expect to be any kind of a force
for good health in the world? If
congress organisers think they
are so short of funds that they
have to take money from
conflicted industries, whose
products are bad for public
health, how can they expect to
make a difference for the
better? If our nutrition
students and young nutritionists
are being trained to repeat
claims such as ‘industry is part
of the solution’ and ‘bad foods
do not exist, every food has its
place in a balanced diet’ what
next in future conferences? Free
cigarettes? Offers of whisky?
The arms trade?
At their stands in conferences,
conflicted food and drink
industry buy off participants –
old as well as young – with toys
and cheap colourful gifts. But
the stories we buy are much more
costly. We hear that we cannot
tackle public health nutrition
problems without industry’s
help. Really? Has public health
really benefited from the
support of food and drink
manufacturers of conferences?
Why do you think industry
sponsors public health and
nutrition conferences?
Obviously, to claim that they
are ‘part of the solution’.
Conflicted industries tout
themselves as part of the
solution to the problems they
themselves have created, such as
the replacement of traditional
diets with processed products.
It’s evident to me now that most
(not all) change for the better
in public health nutrition comes
from outside the profession. See
the picture above. It shows a
young nutritionist drinking
Coca-ColaTM in the Infante room
at the Porto congress venue. Is
she really interested on helping
public health nutrition to
progress? The problem here is
not just drinking a Coca-ColaTM.
The problem is a health
professional having a Coca-ColaTM
during a world congress on
public health nutrition. By this
act she is complicit in the
financing of the marketing of
sugary drinks for children, she
is supporting the environment
that has created the obesity
pandemic. She has become an
advertisement for Coca-ColaTM in
a potent context.
References
- Anon. Conferences: What
for? [Editorial] World
Nutrition, September 2010,
1, 4: 178-184.
Obtainable at
www.wphna.org
- Anon. Conferences: What
for. [Editorial] World
Nutrition, October 2010,
1, 5: 204-210.
Obtainable at
www.wphna.org
- Gomes F. Six hours of
words from our sponsor, and
other items. [Column]
Website of the World Public
Health Nutrition
Association, October 2010.
Obtainable at www.wphna.org
Agrobiodiversity
Yes we have blackberries
In October, with the themometers
down to 20oC and lower in the
orchard I frequent in Maricá,
Rio de Janeiro, it is time to
harvest blackberries. Yes, we
have blackberries in Brazil. The
one in the picture above didn’t
need any pesticide or
fertiliser. It is a gift from
nature. It is almost impossible
to arrive back home with a full
pot after harvesting them from
the orchard. For each one I
collect, I eat three!
The verse this month quoted
below supports my colleagues
Geoffrey Cannon in his
celebration of the sexy
dimension of nutrition (1). The
almost indescribable experience
of blackberries was transformed
into song by the Brazilian
composers and musicians Alzira
Espíndola, Paulo Salles and
Itamar Assumpção:
Finally
(Finalmente)
My whole life I've waited for
now
(A vida toda eu esperei por
agora)
To feel your body’s scent so
close.
(Sentir o teu perfume assim
tão de pertinho)
That smell of yours that’s
found in nature,
(Esse teu cheiro que existe
só na flora)
In those flowers that also
contain thorns.
(Naquelas flores que também
contém espinhos)
My whole life I've waited for
this glory
(A vida toda eu esperei essa
glória)
To kiss you, to bite your lips,
your red mouth,
(Beijar mordendo esses teus
lábios de fruta)
The colour of blackberry, the
colour of the dawn.
(Boca vermelha cor de amora
cor da aurora)
References
- Cannon G. Burger, shake,
fries and statin, please,
and other items. [Column]
Website of the World Public
Health Nutrition
Association, September 2010.
Obtainable at
www.wphna.org
Food and drink processing
What for, and for whom?
During my discussions with
Association founder member
Walter Willett, on the occasion
of the Porto debate between
Carlos Monteiro and John Lupien
on food processing (since Carlos
won 35-0),Walter said to me that
healthy diets can include a
fairly high proportion of
ultra-processed foods and
drinks,
I mentioned this last month.
Afterwards he and I continued
the discussion. He points out
that countries with colder
weather need more food to be
processed, while he also agrees
that ultra-processing has
devastating effects on health
and the planet. Some processing
is necessary, but it should
always where possible be minimal
and benign.
In his WN commentary this month,
my colleague and good friend
Carlos Monteiro develops his
thinking about ultra-processing.
The issue, as he stresses, is
not processing as such. Some
processing is essential and some
is beneficial or benign. The
issue is that an increasing
proportion of food supplies all
over the world are made up from
ultra-processed products.
A share of the food and drink in
temperate countries has always
needed to be processed, in some
form. But where is the value –
profit aside – of pushing more
and more ultra-processed foods
and drinks into tropical
countries? I am reminded of a
remark by my colleague and
friend the food sociologist
Claude Fischler, He once told me
he will never understand why
Brazil and other hot countries
have imported the hooded and
cloaked and booted obese figure
of Santa Claus to our sunny
Christmas. Well, one of the
reasons is that Santa Claus as
we know this Christmas symbol
nowadays, was redesigned and
rebranded by the Coca-Cola
Company to sell more of its
product worldwide, in hot and
also cold seasons and countries.
More on this is coming up in
Geoffrey Cannon’s December
column.
References
-
Gomes F. Six hours of words
from our sponsor, and other
items. [Column] Website of
the World Public Health
Nutrition Association,
October 2010. Obtainable at
www.wphna.org
World nutrition
Parabéns Carlos!
Here is our Association
Council member Carlos Monteiro,
being congratulated by Pan
American Health Organization
director Dr Mirta Roses-Periago.
From Porto Carlos flew to
Washington DC. There he received
the Abraham Horwitz Award for
Excellence in Leadership in
Inter-American Health. The
award, created in 1975,
established to honour creative
public health leaders in the
Americas, is named after a
distinguished former PAHO
director(1).
I bring you this news to
congratulate Carlos and also to
highlight some features from his
speech. Carlos called on the
national minsters of health
present at his award ceremony,
as well as PAHO. to act firmly
and radically to protect public
health nutrition in the
Americas, and to face two major
interrelated problems: chronic
undernutrition in childhood, and
obesity in childhood and at all
ages. You can access his speech
here.
During his speech, Carlos gave
examples of good policies and
programmes, including the sharp
reduction of chronic
undernutrition in children in
Brazil. He showed that the
reasons include increased
purchasing power in impoverished
populations, the improvement of
the education of women, improved
access to safe and clean public
water supplies, and universal
access to basic primary health
care services, including before
and after the birth of children.
He showed brilliantly that
public policies and actions can
reduce chronic undernutrition in
a quite short period of time, as
in Brazil.
Moving to obesity, he started by
saying he wouldn’t mention the
absolute figures, as he made for
child undernutrition, because he
didn’t want ‘to give this speech
a gloomy tone.’ He then stressed
that ‘in various countries of
the Americas excess weight is
already the norm’. He
highlighted two major reasons
for the global failure to
control obesity. ‘The first one
is to believe that the problem
can be faced by a diagnosis and
treatment strategy. Obesity
treatment, besides being
expensive, is inefficacious’.
The only way is prevention. The
second reason for failure is to
assume, wrongly, that the reason
for the increase in obesity are
individual decisions.
Citing the WHO Global Strategy
on Diet, Physical Activity and
Health (2) he reminded his
audience that this agreement
made by all WHO member states
stresses that information and
education campaigns focused on
behaviour changes can only be
effective when they are
feasible. ‘It is necessary that
the environment... be more
propitious to the consumption of
fresh foods than to the
consumption of highly processed
and energy dense foods’ he said.
But these days it’s the other
way round.
He proposed to PAHO and to
national health authorities two
of the most powerful strategies
to confront obesity effectively.
These both confront the
transnational food and drink
companies. The first one – and
now Carlos raised his voice –
‘is the regulation of the
aggressive publicity for of
sugary drinks and
ultra-processed foods,
particularly focused on children
and adolescents.’ (I’ll come
back to this below). The second
way is the taxation of unhealthy
food products, from which
revenues could be used to
finance campaigns and to
subsidise production of fresh
foods including fruits and
vegetables Bravo! Well done my
friend!
References
-
http://www.paho.org/english/PAHEF/horwitz.htm
- World Health Assembly
57.17. Global strategy on
diet, physical activity and
health. Geneva: World Health
Organization; 2004.
Obtainable at
http://www.who.int/gb/ebwha/pdf_files/WHA57/A57_R17-en.pdf
Legislation
Food regulation. Who loses, who
wins?
When in his PAHO speech of
acceptance, Carlos Monteiro
suggested food marketing
regulation as one of the most
effective measures to tackle
obesity, he gave as an example,
the Brazilian food regulation
proposals. I have already been
telling this story (1-3).
In 2006, the Brazilian National
Health Surveillance Agency (ANVISA)
convened a national debate on
the regulation of food
advertising through a
transparent and democratic
process. This involved from the
beginning all the actors
involved. A public consultation
was open to all, including
consumers, policy makers,
industry and regulated sector
representatives as a whole. From
this debate was born the first
systematised and organised
national initiative in Brazil to
protect public health nutrition
against the massive hugely
funded push by transnational and
big national food processors for
the population to consume
unhealthy ultra-processed
products.
The regulation was published on
29 June this year. Industry was
given 180 days to comply.
Meaning, that in Brazil, from
next month, 26 December,
advertisements of food and
drinks high in sugar (15 grams
or more per 100 grams, or 7.5
grams per 100 millilitres), high
in saturated fat (5 g or
more/100g, or 2.5g/100 ml), high
in trans fat (0.6g or more/100g
or 100ml; high in sodium (400 mg
or more/100g or 100ml) were to
be regulated.
As shown on television, radio,
newspapers, magazines, outdoors,
websites, and the internet
generally, such advertisements
were to be followed by explicit
written or verbal warnings about
their risk to health. The
regulation also requires the
regulated sector to attach the
warnings to toys, gifts, free
samples, discount coupons, and
charity campaigns associated
with those foods.(4) So will
this be the last Brazilian
Christmas with junky food
marketing free of the true
information and protection
consumers and children deserve?
We have hoped so. I say ‘were to
be’ because there are still
plenty of obstacles in the way.
Industry fights back
From the very beginning, before
the proposed regulation was
officially published, the the
food and drink manufacturing
industry, the marketing
industry, and the gifts/toys
industry made it very clear that
they were not interested in
providing information to
consumers through the specified
warnings. They are against any
sort of statutory regulation.
This was evident in their last
statements at the public hearing
during the consultation process,
which in effect were: ‘See you
in court.’(2).
The conflicted industries gave
up arguing technical aspects.
They focus on two major points:
public opinion, and the legal
competence of ANVISA as the
regulatory agency. They support
the media with their
advertising, and so the media
editorial pages have been full
of propaganda against the
regulations. Plus they have
published and advertised a
formal letter designer to
convince viewers, listeners and
readers that their right to
commercial free speech was being
denied. They say: ‘We are
confident therefore that the
usurpation of power now in
progress will not prosper.’(5)
‘We’ here are:
Brazilian Association of
Advertisers
Brazilian Association of
Advertising Agencies
Brazilian Association of Radio
and Television
Brazilian Association of Food
Industries
Brazilian Association of
Manufacturers of Soft Drinks and
Non Alcoholic Beverages
Brazilian Association of Pay TV
National Association of Magazine
Publishers
National Newspaper Association
Outdoor Centre
National Federation of
Enterprises of Cinematographic
Exhibiters
National Federation of
Advertising Agencies
Interactive Advertising Bureau
Open Word Institute
Who is usurping what? Looking at
the signers of that letter you
can try to figure out where
public health nutrition could
possible get space to show
Brazilian citizens and consumers
the good news of having a food
marketing regulation. Open TV?
No. Pay TV? No. Radio? No.
Magazines? No. Newspapers? No.
Outdoor? No. Cinema trailers?
No. Internet? Yes! Flyers in the
streets? Maybe, but
environmentally unhealthy.
Can industry be part of the
public health solution? Maybe in
the USA and in Europe. That’s
for others to judge. But I can
tell you that industry is not
interested in becoming part of
the solution in Brazil and other
‘emerging economies’. They are
the problem. In the USA and
Europe, multinational food
companies pledge not to
advertise to children. Although
they are still not honouring all
their pledges, they are at least
publicly declaring they intend
to do it. In Brazil, you don’t
see anything like this.
Additionally, as indicated in
the letter above, specific food
and drink companies never expose
themselves and their brands.
They hide behind associations
such as the Brazilian
Association of Food Industries,
and the Brazilian Association of
Manufacturers of Soft Drinks and
Non Alcoholic Beverages. This is
highly significant. At the
International Congress on
Obesity held in Stockholm last
xxxxxx, I asked Derek Yach of
PepsiCo what are the Pepsi plans
to restrict the marketing of
sugary drinks in lower-income
countries such as in Latin
America, as pledged for the US
and the EU (6,7). He said that
Pepsi policies are global. No,
he did not say that PepsiCo has
no intention of restricting its
marketing in Latin America, or
Asia or Africa. No, you do not
see PepsiCo signing the industry
letter above and declaring they
are against the Brazilian
statutory regulation.
But wait; take a closer look at
the letter’s signatories. There
they are: the Brazilian
Association of Food Industries,
and the Brazilian Association of
Manufacturers of Soft Drinks and
Non Alcoholic. Who is behind
them? Of course, PepsiCo,
Coca-Cola, Nestlé, Kraft Foods,
and others, hiding their names
and brands behind association
names. Clever stuff. They are
evading the scandal breaking
news: ‘Giant food companies
pledged not to advertise to
children in the US and EU, are
impeding food marketing
regulation in Brazil’.
Can public health
protection be illegal?
After publication by ANVISA of
the regulation, the pressure
from the conflicted industries
was intensified. As they said
they would, they have heavily
invested in lawyers. They have
hired the most influential
jurist on constitutional law,
Luís Roberto Barroso, to claim
that the regulation was
unconstitutional. Dr. Barroso’s
interpretations of the Brazilian
constitution are commonly used
by judges to support their
decisions. So it has been easy
for him to suggest to the judge
in this case, an interpretation
of the Brazilian constitution
leading to a verdict that would
benefit his client, the
Brazilian Association of Food
Industries. Thus, Dr. Barroso
requested the judge, Gilda
Sigmaringa Seixas, to suspend
the regulation. His argument has
been that article 220, paragraph
4 of the current Brazilian
constitution says that ‘The
commercial advertisement of
tobacco, alcoholic beverages,
pesticides, medicines and
therapies will be subject to
legal restrictions, in terms of
section II of the preceding
paragraph and shall contain,
whenever necessary, a warning
about the harms resulting from
their use’(8). His ingenious
argument has been that since
unhealthy foods and drinks are
not mentioned, they cannot be
regulated!
Judge Seixas has granted the
suspension. This is not a
definitive decision so the
regulation can still get into
effect.(9) But after the
verdict, you can readily imagine
what side got virtually all the
supportive publicity in the
Brazilian media.
In order to preserve the
regulation, ANVISA now needs to
convince the judge that the
rational interpretation is that
because the paragraph 4 of
article 220 does not include
unhealthy foods, the regulation
is the opportunity for the
Brazilian government to amplify
the protection of population
health.
This is also ANVISA’s
opportunity to remind Judge
Seixas, and the nation, that
regulation of heavily marketed
ultra-processed foods and drinks
will help save millions of
Brazilians from obesity, and
from diabetes, cardiovascular
diseases, various common
cancers, and other chronic
diseases. These are in large
part caused by excessive
production of unhealthy food and
drink products, and consumption
that is in large part driven by
excessive and aggressive
advertising and promotion. Plus,
what does the new Brazilian
president think of all this? We
will see.
References
- Gomes FS. Marketing
of unhealthy food to
young children:
Brazilian David
and multinational
Goliath. [Letter].
Public Health Nutrition
2009; 12:1024.
- Gomes FS. Marketing
of unhealthy food to
young children:
Brazilian Goliath
skulking. [Letter]
Public Health Nutr ition
2009; 12:2250-1.
- Gomes F. What’s the
matter?, and other
items. [Column] Website
of the World Public
Health Nutrition
Association, April 2010.
Obtainable at
www.wphna.org
- Agência Nacional de
Vigilância Sanitária.
Resolução-RDC nº 24,
from June 15th, 2010.
Obtainable at
http://portal.anvisa.gov.br
- Associação
Brasileira de
Anunciantes e outros. Em
defesa do Estado de
Direito. (accessed in
Oct 6th, 2010)
Obtainable at
http://www.abia.org.br/anexos/AF-COMUNICADOANVISA.pdf
- EU-Pledge. Food and
drink companies pledge
to change advertising to
children. Obtainable at
http://www.eu-pledge.eu
- Better Business
Bureau. Children’s food
and beverage advertising
initiative. Obtainable
at
http://www.bbb.org/us/children-food-beverage-advertising-initiative
- Brasil. Constituição
da República Federativa
do Brasil, 1988.
Obtainable at
http://www.senado.gov.br
-
http://portalexame.abril.com.br
Joke of the month
Sugary water
In my last afternoon at the
Porto congress, I went to a
confeitaria (bakery store)
and found another industry
prank, as you can see in the
picture below.
Pleno TisanasTM
is advertised on its
package as similar to water. It
recommends you to drink as much
as feel like. ‘Pleno Tisanas /
To drink whenever you feel like.
Like water.’ (‘Pleno Tisanas
/ Para beber sempre que lhe
apetece. Tal como água.’) So
I went to their website to see
the details of the product and
they describe it as a ‘very soft
and natural infusion, low
calorie, that transforms the
need for liquid intake into
moments of refreshing pleasure.’
(1).
Guess what though! I didn’t know
that in Portugal water contains
sugar. The perpetrator of this
fable is LACTOGAL, Produtos
Alimentares SA, a Portuguese
food industry, manufacturer of
the
Pleno TisanasTM
. It also manufactures
the sugary
FreskyTM
Laranja (orange)
drink served in the lunch boxes
given to participants at the
Porto congress on the last day,
together with a processed meat
sandwich (see below).So it goes
– until public health nutrition
congresses stop being penetrated
by the manufacturers of
processed food and drink
products.
Reference
-
http://www.lactogal.pt/presentationlayer/marcas_06.aspx?marcaid=51&detalhe=1
Request and acknowledgement
You are invited please to
respond, comment, disagree, as
you wish. Please use the
response facility below. You are
free to make use of the material
in this column, provided you
acknowledge the Association, and
me please, and cite the
Association’s website.
Please cite as: Gomes F. Six
hours of words from our sponsor,
and other items. [Column]
Website of the World Public
Health Nutrition Association,
Novenber 2010. Obtainable at www.wphna.org
The opinions expressed in all
contributions to the website of
the World Public Health
Nutrition Association (the
Association) including its
journal
World Nutrition, are
those of their authors. They
should not be taken to be the
view or policy of the
Association, or of any of its
affiliated or associated bodies,
unless this is explicitly
stated.
This column is reviewed by
Geoffrey Cannon. My thanks to
Juan Rivera, Walter Willett and
Geoffrey Cannon, for the
energising meetings we had in
Porto and for the great
opportunity to share ideas I
also thank Walter Willett for
the follow up on our discussion
on ultra-processed foods. My
congratulations again and my
many thanks to Carlos for the
great dinners and talks we
shared, and for pushing and
inspiring us all to push the
public health nutrition agenda
forward. Regarding the Brazilian
food marketing regulation story
I owe a thousand thanks to the
brave Brazilians that have been
deeply dedicated to its approval
and implementation. I thank
Catarina Prima and Sueli Couto
for inspiring the November's
'Joke of the month'.
fabiodasilvagomes@gmail.com |