Alexandra Lewin

Background

The vending machine in Savage Hall, Cornell University’s home to the Division of Nutritional Sciences, has traditionally stocked common vending foods – highly processed candy bars, chips, chocolate, gum and other products of poor nutritional quality.

Next to the snack food vending machine is a beverage machine selling the typical array of soda and juice. It is from these two – the food machine and the beverage machine – that one can buy a quick snack. Students, staff and faculty can bring food and leave it in the refrigerator in the adjacent room but if one wants to purchase something on the spot, they are left with a set of unhealthy food choices. This easily accessible, cheap, unhealthy food created an unhealthy food environment in the Division of Nutritional Sciences.

Actions and Outcomes Prior to Changes in the Vending Machine

Graduate students in the Division of Nutritional Sciences decided to take on improving the healthfulness of this food vending machine. It was, more than anything, embarrassing to host visitors, only for them to see this machine as the center piece of our dining area. We began this endeavor, working with Cornell Dining and the vending company, to improve the offerings in this machine.

A vending team consisting of two graduate students and a Senior Extension Associate was formed to spearhead this effort. Once the team was formed, a few crucial events and information gathering sessions occurred. Selected events and outcomes below.

– The vending team conducted research to learn about the vending contract between the Division, Cornell Dining and the vending company. The Division of Nutritional Sciences has a contract with Cornell Dining and Cornell Dining has a contract with a specific vending company.
– The vending team approached Cornell Dining to see whether or not it would be possible to include healthier offerings in the vending machine. Cornell Dining and the vending company agreed that Savage Hall could serve as a pilot program for healthier offerings in vending machines throughout campus.
– Cornell Dining asked the vending team for a set of food standards that could guide the healthier options. The vending team used standards already in place in multiple school districts (and similar to those in the not yet published by the Institute of Medicine’s Nutrition Standards for Food in Schools Report).
– The vending team met to assess products brought forth by the vending company, as possibilities for the updated machine. Cornell Dining and the vending company decided that the entire machine would be healthier options, removing all traditional vending options (with the exception of gum and mints). In addition to healthier options, nutrition facts for each product were posted on the outside of the vending machine.
– The vending team emailed the Division of Nutritional Sciences (faculty, staff and graduate students) soliciting feedback about preferred foods and to increase awareness of project.
– The vending team met with Cornell Dining and the vending company to go over email responses, list of foods presented to the vending team and to determine a timeline for the implementation of healthier foods.
– The vending team provided Cornell Dining and the vending company with a prioritized list of foods (from the initial list they provided to the vending team). Cornell Dining asked the vending team to provide a “wish list” of healthy foods and their respective brands.
– Phase 1 of the project, the healthier food line-up, began at the beginning of the fall semester and lasted until mid-October.

Results: The Product Line-Up for Phase 1 and 2

Phase 1 (August 2007-January 2008)

Foods included: Sun Chips, Smart Food popcorn, baked chips, crackers, pretzels, rice snacks, Oreo Thin Crisps, trail mix, Nutter Butter Bites, peanuts, tuna, fruity snacks, Snackwell’s sandwich cookies, Fig Newtons, granola bars, Nutrigrain bars, sunflower seeds, oatmeal, sugar-free wafers, graham crackers and animal crackers.

These food options remained in place until mid-January, at which time Cornell Dining and the vending company reevaluated the offerings.

Phase 2 (January 2008-March 2008)

Selected products were changed based on availability. The vending company adds “Balanced Choice” labeling.

“Balanced Choice” label affixed to specific foods based on vending company’s supplier. A “green leaf” sticker on a slot in the vending machine indicates a “Balanced Choice” and meets the following nutritional criteria:

• 7 net grams of fat, or less
• 260 calories, or less
• 250 mg of sodium, or less

Phase 2 sales results: For the periods 1/22/07 – 2/15/07 vs. 1/21/08 – 2/15/08, sales transactions were down by 17%, and dollar value of sales were down by 9%. According to Cornell Dining, the machine could not sustain itself with phase 2 sales and product line-up.

Phase 2 sales were compared to vending sales throughout the rest of Cornell and it was determined that the drop in sales might not be due solely to healthier options. Sales also declined for traditional vending machines.

Results: The Survey

The vending team conducted a survey during Phase 2. Thirty individuals completed the survey; 100% of respondents were from within the Division of Nutritional Sciences, 58.6% were graduate students, 6.9% were faculty and 37.9% were staff. The information below represents selected survey responses.

69% of respondents noticed changes in the vending machine. In response to an open- ended question, some changes noticed included:

– Healthier and more hunger-satisfying options – I can now count on finding something I want to eat, at least when it is stocked (which it often isn’t).
– Changes disguised as healthier options but still same old companies with same old corn syrup and allergens.
– Healthier better foods!!
– The tuna fish caught my eye–love it.
– The selection has narrowed somewhat — mostly chips and crisps, mostly high sugar low fat. The high-end entrees are nice though (oatmeal, tuna).
– Nutritional info on the vending machine, 100-cal packs.

29/30 respondents noted additional food or beverage items he/she you would like to see offered in the vending machine. In response to an open-ended question, some desired foods included:

– A trail mix with something sinful in it, ideally bits of chocolate. whole grain crackers (maybe there are some and I just haven’t caught them stocked?). chocolate covered coffee beans (beans are vegetables, right?). reduced fat/salt chex mix. snyder’s honey wheat prezels.
– Organic chocolate.
– More types of nuts and dried fruit varieties.
– CHOCOLATE! Not a lot, nothing crazy — peanut m&m’s or hershey bars…plain good old chocolate.
– Fruit leather.
– Stacys brand pita chips. annies brand cheddar bunnies. fruit leather. small packs of chocolate covered raisins or some other kind of lower fat candy options. any kind of kashi tlc cereal bar or snack chip.
– More chocolate the choices are very bad. Here’s what I think I’m an adult and don’t need someone tell me what I should and shouldn’t eat, I can make the decision myself. I like having healthy choices but bring back the candy. If I’m going to eat bad make it dark chocolate not poptarts.

There were many suggestions for fresh fruit, yogurt, bagels, and other refrigerated items we were unable to stock. There were also suggestions for beverage changes. Our intervention did not alter the beverage selection in any way.

Respondents where then asked the importance of 1) brand, 2) personal preference, 3) health, and 4) price in making purchasing decisions on a scale of 1 to 5, with 1 being least important and 5 being most important.

34.5% of respondents ranked brand as the least important in making a purchasing decision. Personal preference was ranked highest by 51.7% of respondents. Somewhere in between these two variables were health and price.

Respondents answered an open-ended question that asked about their top three most frequently purchased items. Selected answers are listed below.

 

Most Frequently Purchased Items	Why Purchased Most Frequently
Nut/fruit mix, crackers, granola bars.	Satisfy hunger and, in the case of granola bars, also a sweet tooth. not too awful health wise.
Water, baked chips, nuts.	Those are the only things I would eat from the vending machine. I don’t like chocolate bars or regular chips.
M&Ms.	Need chocolate at work.
Nutrigrain bars, low fat microwave popcorn (when it was available).	I don’t really eat potato chips or packages of cookies, so low fat versions of those items aren’t appealing to me. If fruit/veggies/yogurt, etc were available, I’d be buying that instead.
I would buy candy if it was there. Chips.	No other choices. Extra comment. I am an adult I don’t need Cornell Dining telling me I can’t have something by not providing it. Currenty I have to walk to another building to get what I want. Takes away from my job and is inconvenient. Please make the vending machines for EVERYONE not just what you THINK I should eat. I can do that myself. Also parents send their kids to us because they are smart and ready to make their own choices. I don’t think we should police what they eat, after all we aren’t their parents. Choices yes but no choices no.
Dairy sandwich (or closest alternative).	Because I need energy (and food) to be able to study at school, with least time spent in going to and coming back from home.
Pretzels (any kind); granola bar (crunchy); popcorn.	Low in fat, sustaining, nice snacks.
Nuts, popcorn, trail mix.	They are the least processed and the ones that will not compromise me in terms of allergies.
Trail mix.	Only recognizable ‘whole’ food available.
Natural nut mix, baked Lays.	They make me feel better rather than worse after I eat them. They do not have trans fats or too much sugar.
Fruit chips fruit and nut trail mix.	They are cheap and healthy.
Water, diet soda.	No cal.
Strawberry yogurt bars.	I love the taste. Cheap.
Mixed nuts, popcorn, pretzels.	I like them.
Popcorn (much prefer the low fat version when it is in the machine), Coke, Baked Lays Potato Chips.	Popcorn can be shared. Coke tastes yummy.
Peanuts, wheat thins, tuna and crackers.	They taste good and are reasonably healthy.
Tuna, chips (baked lays), granola bars (crunchy quaker– not gooey kind).	Dessert for lunch late afternoon snack; chocolate needs no explanation.
Popcorn; pretzels; granola bars.	Volume of food; fat content; satiety.

Results: Product Line-Up for Phase 3

Phase 3, March-May 2008

The vending company reinstated some of the traditional snack items, and included more chocolate and fruit (dried or as chips). More chocolate and fruit were a reflection of the survey results.

More specifically, Phase 3 eliminated the 10 or so worst-selling items from the Phase 2 healthier food line-up. 10 or so high-selling traditional snack items were reintroduced into the machine. 2/3 of the items, then, were healthier items and approximately 1/3 were traditional snack products.

Phase 4, May 2008-Present

Cornell Dining and the vending company are meeting to review the current food line-up in Savage Hall and to implement selected high-selling healthier options in other vending machines around Cornell’s campus.

Challenges, Concerns and Lessons Learned

Defining “Healthy”

Establishing a definition for “healthy” is complex and can take many forms, making it difficult to determine a set of food standards. The vending team confronted tradeoffs and unknowns beyond nutritional quality such as feasibility, taste, and likability. Some of the questions asked included:

– What may be realistic guidelines?
– What guidelines would align with consumer preferences?
– Is it necessary to cater to consumer preferences, or should improved health and well-being be maintained as the ultimate goal?

The vending company decided that the new machine was to include only healthier foods that met a minimum standard. Previous experience with pilot projects have showed that altering only selected foods is not an accurate indication of the potential for healthier food sales. If the entire machine is overhauled, consumers may be more apt to buy these healthier items.

Contractual Obligations

Contractual obligations between the Division of Nutritional Sciences, Cornell Dining and the vending company constrained the vending team’s ability to source from other healthy vending (see http://www.yonaturals.com, for example) companies.

Consumer Demand

Because the vending machine is located in a nutrition building it may not be indicative of potential healthier food sales throughout the rest of campus.

Baseline demographic data of those that bought and did not buy food from the vending machine was unknown. This made it difficult to know whether or not the same individuals used the vending machine before and after the implementation of healthier options.

The vending team also confronted internal challenges. After sending an initial email to the entire Division of Nutritional Sciences soliciting feedback about preferred healthy options, staff, faculty and graduate students responded.

Below are selected responses, highlighting the spectrum of consumer demands:

– Thanks for doing this. How about (1) bagels, (2) milk (including skim), (3) yogurt, and (4) fruit (if the quality is good).
– What a wonderful initiative. However, some of us still want need our occasional Snickers/Twix, etc.! Don’t obliterate junk food completely – please.
– Best wishes with the negotiation with vendors.

These responses, ranging from a desire to keep the status quo to encouragement and demand for healthier options, raise a number of questions.

– Should nutritionists, or those working in a nutrition department, eat (or be expected to eat) differently than people in other departments?
– Should selected nutritionists impose these changes on other nutrition and non-nutrition staff working in the building?
– Is it our job to be a role model for other departments? Given the great amount of support for these healthier changes, we may wonder whether there is a stigma attached to eating junk food in the nutrition department.
– Perhaps individuals want the current food offerings but fear being shunned by fellow nutritionists?
– Do nutritionists eat differently elsewhere, in the privacy of their office or home?

Transparency and Availability

The entire list of in-stock and special order foods was never made available to the vending team. Instead, Cornell Dining and the vending company reviewed the vending team’s food standard and product suggestions and approached the vending team with a range of choices, pre-selected from an unidentified master list. The process of selecting foods from this master list of in-stock foods remains unknown.

Although it was clear that Cornell Dining and the vending company were invested in this project, the updated vending machine was severely constrained by the healthier options available. From the food lists the vending team was privy to it was clear that the healthier foods were healthier than traditional vending foods but would still be considered junk food by many health professionals.

This raised additional questions:

– Were there items that were healthier that they had in stock but hadn’t been reviewed by the vending company?
– Does the vending company have a contract with certain brands that limits our ability to get a greater array of healthier foods in the machine?
– If we did have to special order foods, how would it impact the price of products in the vending machine

In order to have even healthier foods, such as whole fruit or milk, the vending company would have to special order them, the machine would require refrigeration and/or the Division would have to work with a different company.

Truck drivers stocking the machine may also influence the availability of healthier options in the machine. Because the vending machine in Savage Hall is different from the rest of Cornell’s campus, the truckers have an added step to ensure what they stock in Savage Hall is indeed what the vending company, Cornell Dining and the vending team has agreed on. This required the truck drivers to set apart Savage Hall foods from the rest of the vending foods. The vending company told us that the drivers may try to “cheat” – that if there was a food that didn’t belong in the machine to notify Cornell Dining. It is easier for the truckers to stock the machine with the same traditional snack foods they use to stock the other machines on campus.

As noted previously, Phase 3 plans do allow these drivers increased flexibility.

A Financial Bottom Line

The vending company is open to stocking healthier items but this is largely because sales may decrease with increased consumer demand for healthier options. Additionally, school wellness policies require healthier options in grade school, forcing companies to make significant changes to their product line-up. The distinct school wellness policies between districts results in a series of fragmented policies and a food industry that can no longer use one standard to determine the specific products available in vending machines. They don’t know what sells, they don’t know which foods may be considered healthier, and importantly, they don’t know how to market themselves. The healthier vending machine in Savage Hall provided an opportunity for this vending company to pilot healthier foods and to ultimately improve their current and future bottom line. The implementation of these school wellness policies, although unfunded, has had a positive impact on vending company buy-in.

Final Thoughts

We all know we are supposed to eat healthfully and exercise regularly. But translating theory into practice involves a deeper and more nuanced understanding of the values at play, the politics of the situation, consumer demand and perhaps most of all, the distinct group of stakeholders involved in the decision-making process.

Mainstream thinking is that nutritionists tend to frame policy decisions around science. We view experts as credible, our science as facts and improving public health as the ultimate goal. If we base our decisions around what science tells us are good and bad foods, we’d likely remove the vending machine altogether. There’s nothing in the machine that even resembles a “health food.” Science tells us, generally, that minimally processed foods are better than processed foods, and that low-salt, low-sugar foods are better than high-salt, high-sugar foods. But beyond this general notion of what’s good and what’s bad, there is much ambiguity and controversy over labeling specific foods as healthy or unhealthy. If we want a healthy machine, should it be filled only with milk? Should it be stocked only with fruit? Or is a mixed fruit and nut granola bar healthy?

One might also expect nutritionists to rebel against traditional snack foods but for years this vending machine has been profitable for the vending company. Although it’s the norm for vending machines to contain high fat, high sodium and highly processed products, we debate whether or not this is acceptable for nutritionists. One questions whether or not, as nutritionists, we should behave differently, desire different foods, and serve as role models for the standards we teach.

We again ask ourselves what it means to be part of the Division of Nutritional Sciences. Do we have a responsibility to be healthy? How do we, and should we, be responsible for changing the set of choices available to individuals? If we create a healthier vending machine, will the consumer base change? Will those who want junk food walk over the next building to buy the traditional unhealthy food offerings? There are no simple answers and no one opinion, even within the Division of Nutritional Sciences. Perhaps most of all, we ask ourselves, is “better-for-you” good enough?

At the end of the day it comes down to who determines our set of choices. The vending team is not trying to taking away choice, but is instead implementing a new set of choices. We are trained to believe choice is set by food companies. If the vending team’s bottom line is public health, and the vending company’s bottom line is dollar signs, who should have the final say? Someone has to set the choices – it’s just a matter of who, and how.

This research was conducted as part of Alexandra Lewin’s doctoral research. The author would like to thank Jennifer Wilkins (Senior Extension Associate, Cornell University), Marion Nestle (Professor, New York University) and Sue Wernimont (graduate student in the Division of Nutritional Sciences) for their contributions and help with this project.

*This research was exempt from human subjects.

 

Photo Credits:
1. trp0
2. programwitch

If you are feeling a pinch from increased dairy prices, imagine the impact of a program serving 30 million school meals a day—with each meal including 8 oz of milk on the tray.
— Jennifer Weber, Manager of National Nutrition Policy, Journal of the American Dietetic Association, April 2008

Gas prices are exorbitant and the price of wheat and milk is through the roof. Consumers may make lifestyle adjustments—drive a bit less, opt out of a cappuccino or attend fewer movies, but there are also large institutional changes occurring. And it’s shaping our kids, literally. In the face of rising obesity rates, especially in low-income communities where obesity rates are disproportionately high, schools are having an even tougher time battling the bulge. In the long run, these changes could reduce access to healthy food for children in low-income communities, further exacerbating inequities in health between these and better off children.

Both the National School Lunch Program (NSLP) and competitive foods, those foods sold a la carte outside the NSLP, are affected by rising food and gas prices. As documented by the Economic Research Service, in 2007 milk prices increased by 17%, cheese by 15%, bread by 12% and rice and pasta by 13%.

Kids in poorer communities will suffer most – these already cash-strapped schools are looking for ways to cut costs, undermining many efforts districts have made to implement the mandated, but unfunded, school wellness policies.

School wellness policies, mandated through the Child Nutrition and WIC Reauthorization Act of 2004, required that all school districts participating in the NSLP established wellness policies by July, 2006 and adopted these policies by the start of the 2006 school year. This law requires, among other actions, that schools define their goals for nutrition education, physical activity and nutrition guidelines selected by the local educational agency for all foods available on each school campus.¹

But this was more easily said than done and under-resourced school districts are facing major challenges. Schools with good intentions are finding they can’t keep up with the nutritional guidelines set through the program. Many times the healthier items that meet the standards aren’t available, and more recently, to increase revenues , some schools are looking for ways to bring back hot ticket items—highly processed junk sold outside the NSLP by private food and beverage companies.

For the past two decades, school districts have traditionally relied heavily on sales from both vending machine pouring rights contracts and a la carte items to increase school funding. Restricting these foods is clearly beneficial for kids’ health in both the short and long term, and may prove to be financially beneficial in the long run. At least for now, however, schools are feeling the pinch from this lost revenue. And disparities among districts cause certain areas to feel the brunt of this more than others – for example, compared to mostly white school districts, districts with proportionally more Latinos have earned more revenue from pouring rights contracts.^{2, 3} At the same time, these are frequently the communities in dire need of obesity prevention programs. Low-income, urban, African-American and Latino communities have rates of overweight or obesity that can exceed 40% of elementary school kids.⁴

But that’s only part one of the double whammy. The NSLP, which serves more than 30 million children, over half of whom receive either free or reduced price lunch, is also suffering from rising food costs. Increasingly expensive meals are causing schools to grapple with how to keep healthier, quality items on the menu. Districts throughout the country are cutting back on fruits and vegetables as costs continue to soar.

Below is a breakdown, as compiled by the School Nutrition Association (SNA), detailing school food prices, reimbursement and total revenue, excluding labor and other costs:

Cost of School Lunch

	Average Meal Prices for Students	Reimbursement Rates	Total Revenue per Lunch
Full Paid Lunches	Elementary: $1.66 Middle School: $1.85 High School: $1.90	$0.23	Elementary: $1.89 Middle School: $2.08 High School: $2.13
Reduced Price Lunch*	$0.38-$0.40	$2	$2.38-$2.40
Free Lunch**	$0	$2.40	$2.40
*Students with household incomes between 130%-185% of the poverty level receive meals at a reduced price rates **Students with household incomes below 130% of the poverty level receive meals for free.

Compiled by the School Nutrition Association (SNA)
Sources: School Nutrition Operations Report: The State of School Nutrition 2007 and United States Department of Agriculture (USDA)
SNA researchers found that based on an estimated average cost to prepare a school lunch (including labor, food and other inputs) of about $2.70 to $3.10, and revenue of anywhere from $2.00 to $2.60 to offset that cost (from federal reimbursements, commodity entitlement and the average price paid for a school lunch) school nutrition programs are experiencing a potential loss of $5 to $8 million per school day based on 30 million school lunches provided.⁵

Their research also indicates that more than 60% of school nutrition directors had meal costs that exceeded the NSLP reimbursement⁶ and more than 78% of school nutrition programs have increased costs, largely from the cost of healthier items as a result of implementing district’s nutrition standards,⁷ coupled with rising food costs. At the same time, about half the school nutrition directors ranked both funding and cost of food/food preparation as the biggest obstacle within their programs.⁸

Some school administrators are lobbying schools to use general funds for school foods – clearly easier in high-resource areas with a larger revenue stream. For many low-income districts, schools either lack these funds altogether or end up cutting other valuable programs instead, risking widening gaps in educational achievement as well as health.

Food prices show no sign of decreasing and with the lack of necessary funding for school food programs, districts are forced to pass along this increased cost to kids’ parents. According to the School Nutrition Association, about one-third of school districts raised the cost of full-price lunch by about 9% during the 2006-2007 school year. Errors in verifying eligibility can magnify the adverse impact of price rises. A 2004 USDA study found that under current verification procedures, children in more than one of every three families selected for verification in metropolitan areas lost their free or reduced-price meal benefits despite being eligible for such meals.^{9, 10}

Recently some food analysts have argued that rapidly rising prices for unhealthy foods (e.g., wheat and corn) will encourage people to eat more fruits and vegetables, whose prices are increasing more slowly. But schools in these resource-poor districts have never been able to afford lots of fruits and vegetables. Now they are merely adding to the growing list of increasingly expensive and out of reach foods.

If there is one glimmer of something positive to come from this, perhaps it’s that schools are learning to conserve, cook from scratch, be creative. A recent article in the Birmingham News said the following about one school district in Alabama:

In Hoover schools, nutrition program personnel are controlling costs by monitoring food purchases and keeping an eye on inventory to prevent waste, Wood [coordinator of the school system’s child nutrition program] said. They’ve also substituted food items as prices fluctuate. They’ve eliminated maraschino cherries as a garnish, for example, and opted for apples and bananas instead of pricier grapes. They are using more mandarin oranges and less fruit cocktail, and they’ve started making their own steak and gravy instead of buying pre-made product.

But these are modest changes and bigger, threats to affordable and healthy school food loom ahead. As food prices increase and federal support remains flat or declines, schools will find it ever more difficult to say no to an easy source of revenue: soda, cookies, and other junk food. Here we go again.

Alexandra Lewin is a staff person at Corporations and Health Watch and is finishing her PhD in nutrition at Cornell University.

 

References1. School Nutrition Association and School Nutrition Foundation. From Cupcakes to Carrots: Local Wellness Policies One Year Later. September 2007.
2. Johnston LD, Delva J, O’Malley PM. Sports participation and physical education in American secondary schools: current levels and racial/ethnic and socioeconomic disparities. Am J Prev Med 2007;33(4S):S195-S208.
3. Johnston LD, Delva J, O’Malley PM. Soft drink availability, contracts, and revenues in American schools. Am J Prev Med 2007;33(4S):S209-S225.
4. Slusser WM, Neumann CG, Cumberland WG, Browdy BL. Overweight in urban, low-income, African-American and Hispanic children attending Los Angeles elementary schools: research stimulating action. Public Health Nutr 2005;8:141- 8.
5. School Nutrition Association. SNA Statement on USDA Meal Cost Study. 11 April 2008.
6. School Nutrition Association. SNA 2007 Trends Report. Alexandria, VA: School Nutrition Association; 2007.
7. School Nutrition Association. From Cupcakes to Carrots: Local School Wellness Policies One Year Later; September 2007.
8. School Nutrition Association. School Nutrition Operations Report: The State of School Nutrition 2007; August 2007.
9. Neuberger, Z. Reducing Paperwork and Connective with Low-Income Children with School Meals: Opportunities under the New Child Nutrition Reauthorization Law. Center on Budget and Policy Priorities. 22 November 2004.
10. Neuberger article references: Case Study of National School Lunch Program Verification Outcomes in Large Metropolitan School Districts, prepared by Mathematica Policy Research, Inc. under a research contract with the Food and Nutrition Service, USDA, Report CN-04-AV3, April 2004, available at http://www.fns.usda.gov/oane/MENU/Published/CNP/CNP.HTM and What Have We Learned from FNS New Research Findings about Overcertification in the School Meals Programs?.
11. Osburn, L. Rising food prices forcing schools to get creative at lunchtime. The Birmingham News. 21 April 2008.

 

Image Credit:

1. freefoto.com

As public concern about obesity and nutrition has increased, the food and beverage industry has worked tirelessly to avoid any additional regulation of its practices. Most recently, legislation to restore the Federal Trade Commission’s power to restrict junk food marketing, update school food standards, and mandate nutrition information on chain restaurant menus have all been introduced but none have been successful. Among others, the American Beverage Association, National Restaurant Association, Grocery Manufacturers Association, the Snack Food Association and the National Automatic Merchandising Association work to hold on to their ability to have their members rather than the government monitor their business practices. The industry and its trade associations use their political muscle to shift the decision-making process away from Congress and the President and into their own hands.

To help achieve this outcome, during the 2006 Congressional election cycle, the food and beverage industry contributed more than $3.5m to Democrats and nearly $7.5m to Republican federal candidates (from both PACs and individuals). In 2008, according to the Center for Responsive Politics, the food and beverage industry has already contributed more than $2m to Democrats and more than $3m to Republicans.

The top twenty food and beverage industry political donors 2008
The National Restaurant Association ($426,500) Osi Restaurant Partners ($340,500) McDonald’s Corp ($134,420) Coca-Cola Co ($97,750) Ilitch Holdings ($96,100) Starbucks Coffee ($84,979) Wendy’s ($82,850) Mjkl Enterprises ($65,100) Brinker International ($63,650) Coca-Cola Enterprises ($60,250)	Yum! Brands ($55,950) Triarc Companies ($51,150) Coca-Cola ($47,575) Aramark Corp ($45,160) Darden Restaurants ($42,050) American Beverage Assn ($41,350) Pizza Hut Franchisees Assn ($39,750) Waffle House ($36,800) Trident Seafoods ($34,700) Davco Restaurants ($34,200)

 

Presidential Candidates and the Food Industry

In the 2008 primary campaign, Senator Clinton has been the top recipient of money from the food and beverage industry ($689,378); Senator Obama ranks fourth ($216,273), and Senator McCain, sixth ($114,600), as of February 11, 2008.

As obesity rates continue to climb and as we near the presidential election, it’s critical to examine how the three remaining Presidential candidates have responded to the food industry’s political agenda to avoid government oversight.

The “Cheeseburger Bill,” known officially as the Personal Responsibility in Food Consumption Acti in the House and the Common Sense Consumption Act in the Senate, would protect food companies from being sued by individuals for weight gain. It passed in the House in 2004 and 2005, failed to pass in the Senate but has garnered more co-sponsorship support than perhaps any other federal food-related bill. Republicans have been the main backers of the Cheeseburger Bill. Neither Senator Clinton, Senator McCain nor Senator Obama has supported any version of this bill.

The majority of the bills to further regulate the food and beverage industry go through the Senate’s Agriculture, Nutrition and Forestry Committee. None of the three candidates sit on this committee. Other health-related bills fall under the jurisdiction of the Health, Education, Labor and Pensions (HeLP) committee. Both Senators Clinton and Obama are members of this committee. An examination of their committee work and the bills they have co-sponsored can provide a window into these candidates’ perspectives on multiple health-related issues.

Perhaps the bill with the most momentum this year (although it ultimately died) was Senator Harkin’s bill (S.771) to revise the definition of “foods of minimal nutritional value” which would further regulate competitive foods sold in schools, at any time of day. Senator Clinton supported this bill along with 27 of her Senate colleagues. Senator McCain and Senator Obama did not cosponsor this bill.

Below is a table showing how the three main candidates chose to sponsor or cosponsor additional selected obesity-related bills in 110th Congress. Some of these bills would work to further regulate the food and beverage industry. For example, one element of Senator Harkin’s Healthy Lifestyles and Prevention America Act (S.1342) requires some restaurants and vending machines to provide nutritional information about each food available for purchase.

2008 Presidential Candidates sponsorship and cosponsorship of obesity-related bills in the 110th Congress

 

Bill #	Bill Title	Clinton	McCain	Obama
School Foods
S.2066**	A bill to establish nutrition and physical education standards for schools(aswell as other food issues)	N	N	Y (sponsor)
S.1432	A bill to amend the Food Stamp Act of 1977 and the Richard B. Russell National School Lunch Act to improve access to healthy foods, and for other purposes.	Y	N	N
Physical Activity
S.2173	A bill to amend the Elementary and Secondary Education Act of 1965 to improve standards for physical education.	N	N	N
S.651	A bill to help promote the national recommendation of physical activity to kids, families, and communities across the United States.	Y	N
S.2066**	See above	N	N	Y (sponsor)
Funding and Research
S.1068	A bill to promote healthy communities.	Y	N	Y (sponsor)
S.866	A bill to provide for increased planning and funding for health promotion programs of the Department of Health and Human Services.	Y	N	N
S.1067	A bill to require Federal agencies to support health impact assessments and take other actions to improve health and the environmental quality of communities, and for other purposes.	Y	N	Y (sponsor)
S.1172	A bill to reduce hunger in the United States.	Y	N	Y
Employee Wellness
S.1753	A bill to amend the Internal Revenue Code of 1986 to provide a tax credit to employers for the costs of implementing wellness programs, and for other purposes.	N	N	N
Broad-Based
S.1342	A bill to improve the health of Americans and reduce health care costs by reorienting the Nation’s health care system toward prevention, wellness, and self care.	N	N	N

Source: THOMAS, Library of Congress.

**Although Senator Obama did not support Senator Harkin’s bill to update school food standards, he did sponsor S.2066. This bill would also update standards for competitive foods sold in schools. Standards would be consistent with recommendations made by the Institute of Medicine’s Report Nutrition Standards for Food in Schools. It is stalled in the Ag, Nutrition and Forestry Committee and has no cosponsors.

In a previous Congressional session, Senator Clinton spoke about her concern for media’s effect on children. On March 8, 2006, she explained her support for Children and Media Research Advancement Act (S.1902):

The bill I introduced with Senators Lieberman, Brownback, Santorum, Bayh, and Durbin included pilot projects to look at the effect of media on young children, and to look at food marketing and obesity. Although those projects were not included in this manager’s package, I continue to be very pleased with the bill. It’s a step forward for children. And I look forward to working with my colleagues in other venues to ensure that the pilot projects get done.

None of the candidates have cosponsored Senator Harkin’s Menu Education and Labeling (MEAL) Act, requiring, among other practices, nutrition information on chain restaurant menus.

Junk Food Marketing

Commonsense Media posed the following questions on junk food marketing to the presidential candidates.

Childhood obesity has reached epidemic proportions in this country. The latest research suggests that junk food ads are a major contributing factor. Would you support legislation to regulate the type of foods that could be advertised during children’s programming (similar to laws considered in Australia and the United Kingdom)?

Senator Clinton’s response:

According to a Kaiser Family Foundation report released this year, “Food for Thought: Television Food Advertising to Children in the United States,” a committee convened by Institute of Medicine found that “television advertising influences the food preferences, purchase requests, and diets, of children under age 12 years and is associated with increased rates of obesity among children and youth.” That’s why, according to the report, policymakers in Great Britain have banned ads for foods high in fat, salt, or sugar in programming aimed at children under 16 years of age and have prohibited the use of premiums or children’s characters in food ads to young people.

In the United States, we are going in the right direction: In December 2006, 10 of the top food companies in the country announced a new Children’s Food and Beverage Advertising Initiative that includes a commitment to devote at least 50 percent of all advertising to healthier foods or to messages that encourage fitness or nutrition. I believe there is more work to be done. I would like to see the entire food industry come together to develop voluntary guidelines that take their responsibility to children seriously. I think that there are a lot of steps that the private sector and the public sector, working together, can take to curb marketing and availability of unhealthy products to our children. In the Senate, I co-sponsored the Improved Nutrition and Physical Activity Act — which passed in the Senate — to address obesity and eating disorders in children, and I introduced the School Food Fresh Program that links schools with local farmers to bring healthy locally grown snacks to schoolchildren. When I am president, I will continue to explore these options and support measures to put our children on a path to healthy living.

As I mentioned earlier, I championed the Children and Media Research Advancement Act to study the impact of electronic media on child development. This bill provides targeted funding to research the links between advertising and childhood obesity. Since 1980, the proportion of overweight children has doubled, and the rate for adolescents has tripled. We have to understand the relationship between advertising and obesity if we are to build the public will to take action.

And Senator Obama responded:

We’re never going to be able to shield our children from all the potentially bad influences out there. And it would be counterproductive to just build walls that shield them entirely. Our best hope is to educate our children and give them the information and the tools they need to make wise choices. Our children are bombarded by all sorts of messages all the time. If it’s not from television commercials, it’s from somewhere else. We need to teach them how to sort out these messages. I question whether legislating to control certain types of advertising is going to help our children in the long run. I think there are other, helpful steps we can take to reduce childhood obesity. A generation ago, nearly half of all school-aged children walked or biked to school. Today, nearly 9 out of 10 children are driven to school. And once there, children are not very physically active — only 8 percent of elementary schools require daily physical education. Childhood obesity is nearly epidemic, particularly among minority populations, and school systems can play an important role in tackling this issue. For example, only about a quarter of schools adhere to nutritional standards for fat content in school lunches. I will work with schools to create more healthful environments for children, including assistance with contract policy development for local vendors, grant support for school-based health screening programs and clinical services, increased financial support for physical education, and educational programs for students.

Senator McCain has yet to issue a response to these questions. On his campaign website he explains his belief in personal responsibility:

• We must do more to take care of ourselves to prevent chronic diseases when possible, and do more to adhere to treatment after we are diagnosed with an illness.
• Childhood obesity, diabetes and high blood pressure are all on the rise. We must again teach our children about health, nutrition and exercise – vital life information.
• Public health initiatives must be undertaken with all our citizens to stem the growing epidemic of obesity and diabetes, and to deter smoking.

In their focus on education, Senators Obama and McCain reinforce a more conservative framework that emphasizes teaching children as the key to healthier lifestyles, rather than restricting, regulating or more closely monitoring the food industry. Senator Clinton’s language does address junk food advertising directly, but she advocates voluntary self-regulation and increased funding to study the links between advertising and childhood obesity.

The Candidates on Family Farms

Both Senator Clinton and Senator Obama preach support for family farms. In a questionnaire from the Congressional Hunger Center and Drake University Law School, the presidential candidates were asked:

In both rural and urban areas, many Americans lack convenient access to food. As President, how would you increase individuals’ and communities’ access to food?

Senator Clinton’s response:

I will work to increase access to locally grown and distributed food. As Senator, I was proud to start the Farm-to-Fork initiative, to provide consumers with better access to fresh, high quality, locally grown products through farmers’ markets, retailers, restaurants and schools. Given Farm-to-Fork’s success, I would consider working to replicate it around the country.

And Senator Obama’s response:

I support improved access to food through local and regional food systems. As president, I will emphasize the need for Americans to Buy Fresh and Buy Local, implement USDA policies and promote local and regional food systems, support funding for farm-to-school projects, and allow schools to give priority to local sources when ordering food (and grow vibrant and rural economies).

Senator McCain did not respond by the deadline.

Both Clinton and Obama voted for an amendment which would limit farm subsidies in the 2007 Farm Bill. McCain did not cast a vote but was a cosponsor of this amendment, initially introduced by Senator Dorgan (D-ND). This amendment has since been rejected.

All three candidates failed to vote either for or against the 2007 Farm Bill. This Bill, passed in the Senate this past December, is largely viewed as more of the same – subsidies to the largest agribusinesses — and would have been an opportunity for these candidates to take a stand against Big Food. The Senate and the House have passed distinct versions of the bill which now must be negotiated in Congress.

Can food be a political issue in the 2008 election?

At the end of the day, none of the candidates have been outspoken critics of the powers that rest in the hands of the food and beverage industry, nor have any called on the federal government to take a more direct approach in restricting this industry’s influence on society. As the Presidential campaign plays out in the coming months, nutrition,food advocates and journalists have the opportunity to ask the candidates – and voters – to consider what role the next President should play in addressing our nation’s food problems and confronting the growing epidemics of obesity and diabetes.

Alexandra Lewin is a doctoral studuent in nutrition at Cornell University and is completing her dissertation on federal obesity policy.

 

View CHW’s coverage on Corporations, Health and the 2008 Presidential Race:

Part 1: Following the Money
Part 2: Clinton, Obama and McCain on the Role of Corporations