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The Rudd Center Health Digest

March 2013

Rudd Report Highlights Children’s Exposure to Food and Beverage Ads on TV

Preschoolers see an average of more than 11 food ads per day, despite food companies’ promises not to advertise to very young children, and one out of ten of those ads appear on just one show – SpongeBob SquarePants, according to a recently released Rudd Report. 

The report demonstrates that there is no clear differentiation between programming viewed by preschoolers, children, and early adolescents, which makes it difficult to protect children from junk food advertising.

Rudd Center researchers suggested that the Children’s Food and Beverage Advertising Initiative (CFBAI) expand its pledges to promote only healthier dietary choices in programming widely viewed by all children, including 12- to 14-year-olds. They also recommended that the CFBAI expand the definition of children’s programming to include programs viewed by large numbers of children, not just programs with a high proportion of children in the audience.

Media companies, such as Viacom, should establish more protective nutrition standards for ads that appear during their children’s programming, as Disney and ION have already done. Read more.

Rudd Report

New York City’s Sugary Drink Size Limit Halted by Judge

Mayor Michael Bloomberg’s initiative to limit the portion size of sugary drinks sold in restaurants and other venues was halted by a state judge, just one day before the law was to take effect. State Supreme Court Justice Milton Tingling called the regulation “arbitrary and capricious,” and declared it invalid. The Bloomberg administration said it would appeal the decision.

“The judge is wrong, plain and simple,” said Kelly Brownell, PhD, Rudd Center Director. “This ruling is neither capricious nor arbitrary, so the judge's ruling is a victory for the soda companies, but not for the public good. It is just a matter of time before New York City or another city successfully passes this regulation and a judge will see its wisdom.”

The regulation was supposed to take effect on March 12, 2013 and prohibit restaurants, food carts, delis, theaters, and arenas from selling sugary drinks in cups or containers larger than 16 ounces. The aim of the measure is to combat obesity through reducing consumption of sugary drinks.

While many health experts lauded the passage as a major step forward in making New York City residents healthier, the American Beverage Association and other business groups sued the city in October 2012 claiming the ban was unfair and undemocratic. 

Evaluation of Bright Horizons’ Wellness Polices Presented at Partnership for a Healthier America Summit

During the Partnership for a Healthier America’s 2013 "Building a Healthy Future Summit" in Washington, DC, Rudd Center researchers presented results from an evaluation of the wellness policies of Bright Horizons Family Solutions, the nation's second largest child-care provider.

The evaluation aimed to help Bright Horizons advance its nutritional, physical activity, and screen-time policies. The company goal is for all of its child-care centers to meet wellness standards and serve as an example for other child-care centers nationwide.

The evaluation reviewed all relevant corporate policies and gathered data on policy implementation and practices from all of its centers nationwide. Focus areas included eliminating sugar-sweetened beverages from all centers, serving a fruit and/or vegetable with every meal, providing a minimum of one hour of physical activity per day, supporting breastfeeding, limiting juice, and limiting screen time.

Results from the evaluation show that Bright Horizons has achieved a high level of compliance with the commitments across centers in all regions of the country. Read more.

Upcoming Seminars

Tuesday, April 9, 12:30 pm
Dan Harris
Anchor and Correspondent, ABC News
A Skeptic's Guide to Using Meditation to Fight Overeating -- and Making Yourself 10% Happier, Generally
Location: Yale Peabody Museum, 170 Whitney Avenue, 3rd Floor Auditorium
Co-sponsored by the Yale Poynter Fellowship in Journalism

Harris

Dan Harris joined ABC News in March 2000 and has covered some of the biggest stories in recent years including the mass shootings in Newtown, Connecticut; Aurora, Colorado; and Tucson, Arizona. He has covered natural disasters from Haiti to Myanmar to New Orleans, and reported on combat in Afghanistan, Israel, Gaza, and the West Bank, making six visits to Iraq.

Harris has made it a priority to report on the world's most vulnerable populations, producing stories about child slaves in Haiti, youth accused of witchcraft in the Congo, and predatory pedophiles who travel from the United States to Cambodia. He has also covered endangered animals from such diverse datelines as Namibia, Madagascar, Papua New Guinea, and Nepal.

In addition, Harris has an interest in food policy and has covered some of the Rudd Center’s initiatives including Cereal FACTS and Fast Food FACTS. He recently became interested in how practicing meditation can impact self-awareness, compassion, and stress. He hypothesizes that meditation may also have implications for the way we eat.

Harris has been honored several times for his journalistic contributions. He received an Edward R. Murrow Award for his reporting on a young Iraqi man who received the help he needed in order to move to America, and in 2009 won an Emmy Award for his Nightline report, "How to Buy a Child in Ten Hours."

 

Canceled – may be rescheduled for a later date
Tuesday, April 16, 12:30 pm
Elizabeth S. Moore, PhD
Associate Professor of Marketing, University of Notre Dame
Options for Combating Childhood Obesity: An Assessment of the Aggregate Food Marketing System

Unless otherwise noted, seminars are held at the Rudd Center and are free and open to the public. Seating is limited. The full schedule for the Spring Seminar Series is available online and for download.

Just Published

Cereal Companies Leverage Digital Marketing to Target Children with Sugary Products

Cereal companies, the third biggest food marketer to children, are using sophisticated online marketing techniques to target children with unhealthy products and get them to engage with brands in ways not possible through television advertising, according to a study by the Berkeley Media Studies Group and the Rudd Center published in the Journal of Health Communication: International Perspectives.

Researchers identified 17 branded cereal websites (containing a total of 452 unique web pages) between October 2008 and March 2009 that targeted children. Most of these sites marketed cereals high in sugar and low in nutrients. The less nutritious the cereal, the more likely it was to be marketed to children.

There is minimal regulation of such online marketing targeted to children. Unlike with television commercials, which the Federal Communications Commission restricts to 12 minutes per hour, there is no limit to online ad exposure. Instead of seeing 30 seconds of advertising at a time, children often interact with brands for hours online.

Cereal companies use a variety of multimedia features including games and advergames (found on 82 percent of sites), online video (found on 10 percent of pages across the sites), and “immersive environments” to keep children on their websites. They also use viral marketing techniques to turn children into marketers by encouraging them to invite their friends to join them online. Read more.

Industry Self-Regulation Permits Junk Food Ads in Programming Popular with Children

Loopholes in industry self-regulation allow food companies to continue to reach large numbers of children with advertising for unhealthy products, such as fast food, candy, and cookies, during “tween” programs and popular children’s holiday specials, according to a new Rudd Center study published in the American Journal of Preventive Medicine.

To address concerns about food marketing to children, the Better Business Bureau created the Children’s Food and Beverage Advertising Initiative (CFBAI), through which participating companies pledge to advertise only healthier dietary choices during “child-directed television programs.”

The study found problems, however, stemming from the definition of “child-directed programming.” Most CFBAI companies define this as programs with an audience of 35 percent or more children under 12. Under CFBAI guidelines, food advertising that airs only during these programs must meet criteria for healthier dietary choices. The study found that more than half of the food and beverage advertisements viewed by children are not subject to CFBAI guidelines because the programs on which they appear do not qualify as “child-directed” under the guidelines.

The authors calculated that if the definition of “child-directed” was expanded to include advertising during programs with an audience of 20 percent or more children under 12 and/or 500,000 or more child viewers, 70-71 percent of food advertising seen by children would be covered by industry self-regulation, compared to just one-third of ads seen by adults. Read more.

Researchers Provide Evidence to Support Regulation of Energy Drinks to Protect Youth

Citing evidence that energy drink consumption among youth is a significant public health concern, researchers from the Rudd Center recommended government intervention to revise labeling requirements, address problematic ingredients, and enact retail restriction of energy drinks. The article is published online in the Journal of Public Health Policy.

The authors noted that energy drink consumption among youth is a concern due to high levels of caffeine and novel ingredients that are not normally found in the food supply. The authors asserted that inconsistent labeling standards make it difficult for consumers to determine which ingredients are in energy drinks and in what amount.

According to the American Academy of Pediatrics, “energy drinks have no place in the diet of children and adolescents.” The authors reported on a 2011 Rudd Center survey that demonstrated parents’ concerns about energy drinks. Given the fact that energy drinks contain harmful ingredients, have inconsistent labeling, and are heavily marketed to adolescents, coupled with parent concern and support, the authors concluded that increased regulation is warranted to protect adolescents. Read more.

Food Banks Address Obesity with Nutrition-Related Policies

Food banks are altering their nutrition-related policies and practices to address concerns about the rise in obesity and diet-related diseases among individuals struggling to afford food, according to a study by the Rudd Center. The study, published in the Journal of the Academy of Nutrition and Dietetics, examined these strategies and identified the challenges and opportunities related to their implementation.

“For those who struggle to put food on the table it is not just about too few calories, it is also about not having access to healthy foods and adequate nutrition,” said Marlene Schwartz, PhD, senior author and Deputy Director of the Rudd Center. “In response, leading food banks across the country have adapted to strategically promote healthier foods and beverages.”

Researchers interviewed administrators from 20 food banks throughout the country about their current nutrition policies and practices, and the barriers to change they have faced. All of the food banks that participated in the analysis were part of the Feeding America Network, a non-profit network of more than 200 food banks nation-wide.

The majority of food bank personnel reported that their organization’s staff, board members, and community partners saw obesity and chronic disease as an issue that needed to be addressed by food banks. As a result, many food banks described efforts to provide more fresh produce to their communities. Read more.

Obesity Stigma Prevalent in Videos Accompanying Online News Coverage

Obese adults and youth shown in online video coverage are frequently portrayed in a negative and stigmatizing way, according to a study from the Rudd Center. The study, published in the Journal of Health Communication, is the first to examine portrayals of obese individuals in videos about obesity-related topics covered online.

The researchers found that 65 percent of obese adults and 77 percent of obese youth were portrayed in a negative and stigmatizing way. Compared to thin individuals who were depicted in a flattering manner, obese individuals were more likely to be portrayed in unflattering ways - as headless, with an emphasis on isolated body parts such as a rear view of their excess weight, eating unhealthy foods, engaging in sedentary behavior, and dressed in inappropriately fitting clothing.

A previous Rudd Center content analysis of online images in news stories found that 72 percent of photographs paired with online news stories about obesity are stigmatizing of obese individuals.

The Rudd Center offers a free media gallery and media guidelines to aid journalists, editors, bloggers, advertisers, and other influencers in the creation and delivery of fair, unbiased coverage of obesity and weight-related topics on television, in print, and online. Read more.

Stronger Support Needed for Healthy Beverage Practices in Child Care

Support is needed in child-care centers to help meet existing water policies and new water requirements included in the 2010 Child Nutrition Reauthorization Act (CNRA), according to a study published by the Rudd Center in the Journal of Nutrition Education and Behavior. The study is the first to document availability and accessibility of water in compliance with state and federal policy and accreditation standards in child-care centers.

Researchers reviewed national, state, and child-care center water regulations, and observed water availability and teacher behaviors during lunch and physical activity in 40 centers in Connecticut. They found that many centers were in violation of water-promoting policies. While water was available in most classrooms (84 percent), it had to be requested from an adult in over half of those classrooms. The researchers also found that water was available during only one-third of physical activity periods observed and there were few verbal prompts from staff for children to drink water.

“The lack of water availability during a meal diminishes its importance as a viable beverage choice for young children and highlights a missed opportunity for centers to normalize consumption of a non-caloric beverage,” said co-author Kathryn Henderson, PhD, Director of School and Community Initiatives at the Rudd Center.

The researchers asserted that policy change is one approach for improving healthy beverage practices in child care and that support is needed to help centers implement existing water policies and meet new water requirements included in the CNRA. Read more.

Overweight Physicians are also Vulnerable to Weight Bias

Overweight patients are not the only ones who suffer weight stigmatization in the doctor’s office, according to a study published by the Rudd Center. Physicians who are overweight or obese are vulnerable to biased attitudes from patients, which could interfere with quality of care. The findings, published in the International Journal of Obesity, showed that a provider’s excess weight negatively affected patients’ perceptions of his or her credibility, level of trust, and inclination to follow medical advice. This is the first study to examine whether physicians themselves are vulnerable to the same weight bias from patients.

Participants reported more mistrust of physicians who are overweight or obese, stated they would be less inclined to follow their medical advice, and would more likely change providers if their physician appeared overweight or obese — whereas normal-weight physicians elicited more favorable opinions from respondents. These biases toward doctors remained consistent regardless of participants’ own body weight, and were more pronounced among individuals who demonstrated stronger weight bias toward obese persons in general.

A provider’s body weight may lead to biased perceptions by patients that could impair the quality of patient-provider interactions and impact patient compliance with their provider’s health advice, asserted the authors. The Rudd Center offers free resources on weight bias to improve provider-patient communication. Read more.

Rudd Center Blogs

Educating Parents about Junk Food Marketing
Food companies manipulate kids and their parents in their quest to create lifelong loyal customers. Read more.

Companies Putting Profit before Children’s Health
Many food companies and media companies are seizing every opportunity to make money in exchange for our children’s health. Read more.

How Obese Persons are Portrayed in the Media 
Weight bias is very present in news media, which has considerable power to influence public perceptions about key social and health issues, including obesity. Read more.

Recommendations for Healthier Beverages

Healthy Eating Research, a national program of the Robert Wood Johnson Foundation, has developed a comprehensive set of age-based recommendations for healthier beverages. Implementation of the recommendations across a variety of environments including child care, schools, workplaces, parks, recreational facilities, and hospitals, would help improve the health of Americans.

Marlene Schwartz, PhD, Rudd Center Deputy Director, was part of the expert advisory panel that developed the recommendations.

Beverage choices contribute significantly to caloric intake in the United States. Choosing healthier beverages instead of high-calorie, sugar-sweetened beverages, has great potential to help Americans reduce caloric intake, improve diet quality, and reduce their risk for obesity.

Rudd Center Spotlight: Glenn E. Schneider, MPH, and Nikki Highsmith Vernick, MPA

SchneiderHighsmith Vernick

The Horizon Foundation’s Glenn E. Schneider, MPH, Chief Program Officer, and Nikki Highsmith Vernick, MPA, President & Chief Executive Officer, presented Unsweetened: Can a Focused, Outcomes-Based, Sugary Drink Campaign Reduce Childhood Obesity? on March 26 as part of the Rudd Center’s Spring Seminar Series.

The Horizon Foundation is one of the largest health philanthropies on the East Coast and seeks to improve the health and wellness of people who live and work in Howard County, Maryland. In December 2012, The Horizon Foundation launched Howard County Unsweetened, a multi-faceted, community-wide campaign to reduce childhood obesity by helping children and parents choose healthy beverages. Howard County Unsweetened will be the most-evaluated sugary drink campaign in the country and the Rudd Center is assisting in this evaluation.

Ms. Highsmith Vernick cares passionately for improving health and health care for vulnerable Americans and has almost 20 years of health policy and philanthropic experience. She has led quality and equity work in state capitols across the country and has brought together disparate stakeholders, including Medicaid agencies, private payers, providers, community organizations, state departments of health, and social service agencies to improve health outcomes and achieve common health care reform objectives.

Mr. Schneider works on the development and implementation of The Horizon Foundation’s major initiatives. His work as a national consultant, community organizer, grassroots strategist, and policy director has resulted in the passage of over 25 state and local laws across the nation that increased access to health care, raised tobacco prices, created smoke-free public places, and cut youth access to tobacco.

The Latest Rudd Center Podcasts

Robert S. Lawrence, MD
Director and Professor, Center for a Livable Future; Professor of Environmental Health Sciences, Health Policy, and International Health, Johns Hopkins Bloomberg School of Public Health
Sustainability: Antibiotic Use in Farmed Animals
Sustainability: Genetically Modified Foods
Sustainability: CAFOs (Concentrated Animal Feeding Operations)

Dianne Neumark-Sztainer, PhD, MPH, RD
Professor, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
Positive Approaches to Body Image
Controversies Between the Eating Disorders and Obesity Fields

Mike Daube
Professor of Health Policy and Director of the Public Health Advocacy Institute, Curtin University, Perth, Western Australia; President, Australian Council on Smoking and Health
Lessons Learned from Tobacco Control
Tobacco Plain Packaging

The Rudd Center’s extensive library of podcasts is available for download on iTunes.

Front Burner News

Menu Labeling Law Delayed

Writing the new menu labeling law is complicated and will take a little longer to finalize, according to Food and Drug Administration’s Commissioner Margaret Hamburg. Read more.

Index on Access to Nutrition

The Global Alliance for Improved Nutrition, a non-profit organization with funding from the Bill & Melinda Gates Foundation, has created the Access to Nutrition Index, a new global initiative that evaluates food and beverage manufacturers on their policies, practices, and performance related to obesity and under-nutrition. Read more.

Calorie Counts Sway How Much People Eat

Displaying how many calories are in restaurant food items may influence how much people eat, especially among the least health-conscious diners, according to a study published in the International Journal of Behavioral Nutrition and Physical Activity. Read more.

German Officials Respond to Horse Meat Detection

German officials have vowed to place tighter controls on meat products after an incident of improper use of horsemeat and mislabeling of meat products. Read more.

Whole Foods Market to Label GMO Products

GMO

Whole Foods Market, the largest natural-foods grocer in the U.S., will label products that contain genetically modified organisms. Read more.

Let's Move! Expanded

First Lady Michelle Obama announced a five-year expansion of her Let's Move! initiative which will keep her involved in anti-obesity issues even after she leaves the White House. Read more.

Calories from Fast Food

U.S. adults get roughly 11 percent of their daily calories from fast food, according to a study by the Centers for Disease Control and Prevention. Read more.

South Carolina Asks for SNAP Restrictions

South Carolina officials have asked the federal government to restrict certain foods from the Supplemental Nutrition Assistance Program in an effort to curb obesity. Read more.

Ontario Government Calls for Menu Labeling and Ban on Junk Food Marketing to Kids

The government of Ontario, Canada is recommending that all restaurants list the calories of each item on their menu and ban the marketing of junk food to kids under age 12. Read more.

Candy makers’ Pledge to Fight Obesity

Debra Sandler, the President of Mars Chocolate in North America, is calling for candy makers to come up with ways to help solve the obesity crisis before the government steps in and forces them to. Read more.

Americans Favor Limiting Junk Food Sales in Schools

If given the opportunity, two-thirds of Americans would vote for a law that limits unhealthy food sold in public schools, according to a Gallup poll. Read more.

Fresh Food Sales Mark Progress in Obesity Fight

Anti-obesity efforts by large companies, including Wal-Mart and Walgreens, have led to more fresh foods in poor neighborhoods, reduced soda consumption, and a jump in vegetable sales, according to a report by the Partnership for a Healthier America. Read more.

Children Eating Fewer Calories

American children consumed fewer calories in 2010 than they did a decade before, according to a report by the Centers for Disease Control and Prevention. Read more.

Parents Unaware of Child’s Weight

Many American parents fail to see that their children are overweight or obese, according to a poll conducted by the Robert Wood Johnson Foundation, the Harvard School of Public Health, and NPR. Read more.

Preschool Teachers Behind on Nutrition

Preschool teachers in the Head Start program scored low on a nutrition knowledge quiz and engage in unhealthy eating habits themselves, according to a study published in the Journal of the Academy of Nutrition and Dietetics. Read more.

Celebrity Endorsements Influence Children’s Eating

Celebrities who endorse specific foods in TV commercials have a powerful influence on children’s food consumption, according to a study published in the Journal of Pediatrics. Read more.

Grants to Promote Nutrition

The Nutrition Education and Obesity Prevention Grant Program will authorize grants to states that follow specific dietary guidelines seen as promoting “healthy food choices.” Read more.

VOICES

The Science behind Addictive Junk Food

Food industry executives are more concerned about selling food than the food itself and will engineer foods to contain sugar, fat, and salt to “hook” consumers, according to a book by Michael Moss. Read more.

The Food Industry’s Ethics

The food industry will always try to camouflage itself as just one of many causes in the obesity crisis, according to Michael Mudd. Just as the National Rifle Association points to mental illness and violent video games as a way to deflect attention from the inherent dangers of guns, food companies point to lack of physical activity. Read more.

Sugar’s Public Health Threat

Sugar may not be the only problem with the standard American diet, but research shows that it is a major one, according to Mark Bittman. The Food and Drug Administration must respond to this information by re-evaluating the toxicity of sugar, arriving at a recommended daily value, and ideally removing fructose from the “generally recognized as safe” list. Read more.

Selling Out for Soda

African-American and Latino communities have high rates of obesity and diabetes, according to Derrick Z. Jackson. Advocacy groups should work together to fight the efforts by soda companies to defeat legislation to tax or place limits on their products. Instead, too many of them are partnering with the soda industry. Read more.

Soda Companies Soften Criticism through Charitable Giving

Soda companies garner consumer support through philanthropic activities and financial donations. However, Big Soda gives so they can soften, or even silence, potential criticism and public health policies, according to a report by The Center for Science in the Public Interest. Read more.

Cost of Big Soda

Big Soda's freedom to push increasingly larger portion sizes comes at the cost of parents' ability to raise healthy children, according to the Berkeley Media Studies Group. Read more.

FOOD MARKETING

SquarePants Markets Unhealthy Food

The Center for Science in the Public Interest placed an ad in The Hollywood Reporter that highlights Nickelodeon’s SpongeBob SquarePants marketing of unhealthy food to children. The group said that Nickelodeon lags in nutritional advertising guidelines. Read more.

Limited Progress in Food Marketing to Children

There has been some progress to improve the foods offered and marketed to youth at home, in schools, and in restaurants, but children and adolescents are still surrounded by advertising for unhealthy foods and beverages, according to a report by the Berkeley Media Studies Group. Read more.

UK Doctors Urge Sugary Drink Tax and Junk Food Ban

The Academy of Medical Royal Colleges, which represents the majority of doctors in the United Kingdom, is calling for a tax on sugary drinks and a ban on junk food television advertisements that appear before 9:00 pm. Read more.

Happy Meal Website Criticized

The Advertising Standards Board in Australia said the McDonald's Happy Meal website has violated several parts of the industry’s self-regulatory code and is still marketing junk food to children. Read more.

Food Labels Trick Consumers

Green calorie labels increase perceived healthfulness of foods, according to a study published in the journal Health Communication. Food companies use many marketing tricks to increase sales. For example, Twix Cookie Bars uses a green front-of-package calorie label. Read more.

SUGAR-SWEETENED BEVERAGES/TAXES

Vermont Sugary Drink Tax Narrowly Defeated

Soda

The Vermont House Ways & Means Committee voted 6-5 against a penny per-ounce tax on sugar-sweetened beverages. The tax was estimated to have raised $28 million. Read more.

Obesity and Sugary Drink Correlation

New York City officials released statistics that underscore the correlation between obesity and sugary drinks consumption. Read more.

Energy Drink Marketing Restricted in Suffolk County, New York

Lawmakers in Suffolk County, New York have passed legislation that prohibits companies from aggressively marketing sugary drinks to minors. Read more.

Obesity-Related Deaths Linked to Sugary Drinks

Americans account for about 25,000 of the obesity-related deaths linked worldwide to over-consumption of sugar-sweetened beverages, according to a study by the Harvard School of Public Health. Read more.

UC Berkeley Professor Supports Sugary Drink Taxes

University of California Berkeley professor Lori Dorfman provides reasons for taxing sugary drinks, in a commentary published in the American Journal of Preventive Medicine. Read more.

Regulating Energy Drinks

Health experts debate whether energy drinks should be regulated like cigarettes and alcohol. Read more.