New Studies Show Social Media Food Advertising of Unhealthy Foods and Fast Food Portion Size Increase Health Risks

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Two recent articles show how food company practices contribute to unhealthy eating and  high rates of obesity and diet-related diseases.  The firs article  in Pediatrics conducted an experiment to examine the impact of social media influencer marketing of healthy and unhealthy foods on children’s food intake.  

The study found that children after viewing social media influencers consuming unhealthy snacks , children significantly increased overall intake of calories and of unhealthy snacks specifically compared with children who viewed influencers with nonfood products. Viewing influencers with healthy snacks did not significantly affect intake.

The authors conclude that popular social media influencer promotion of food affects children’s food intake. Influencer marketing of unhealthy foods increased children’s immediate food intake, whereas the equivalent marketing of healthy foods had no effect. Increasing the promotion of healthy foods on social media may not be an effective strategy to encourage healthy dietary behaviors in children.

A forthcoming article in the Journal of the Academy of Nutrition and Dietetics compared changes over time across menu categories such as entrées, sides, and desserts in fast-food menu items over 30 years.  US national survey data shows fast food accounted for 11% of daily caloric intake in 2007-2010. Fast-food entrées, sides, and dessert menu item data for 1986, 1991, and 2016 were compiled from primary and secondary sources for 10 popular fast-food restaurants.

The authors found that from 1986 to 2016, the number of entrées, sides, and desserts for all restaurants combined increased by 226%. Portion sizes of entrées and desserts, but not sides, increased significantly, and the energy and sodium of items in all three menu categories increased significantly. Desserts showed the largest increase in energy, and entrées had the largest increase in sodium. Calcium increased significantly in entrées and to a greater extent in desserts, but not sides, and iron increased significantly only in desserts.

The authors concluded that these results demonstrate broadly detrimental changes in fast-food restaurant offerings over a 30-year span including increasing variety, portion size, energy, and sodium content. Research is needed to identify effective strategies that may help consumers reduce energy intake from fast-food restaurants as part of measures to improve dietary-related health issues in the United States.

Citations:  Coates AE, Hardman CA, Halford JCG, Christiansen P, Boyland EJ.  Social Media Influencer Marketing and Children’s Food Intake: A Randomized TrialPediatrics. 2019 Mar 4. pii: e20182554.

McCrory MA, Harbaugh AG, Appeadu S, Roberts SB. Fast-Food Offerings in the United States in 1986, 1991, and 2016 Show Large Increases in Food Variety, Portion Size, Dietary Energy, and Selected Micronutrients. Journal of the Academy of Nutrition and DieteticsDOI:

Towards quantifiable metrics warranting industry-wide corporate death penalties

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Cholla power plant near Joseph City, Arizona, photographed on Jan. 16, 2010.PDTillman/Wikipedia

In the singular search for profits, some corporations inadvertently kill humans. If this routinely occurs throughout an industry,  this company  may no longer serve a net positive social purpose for society and should be eliminated. This article provides a path to an objective quantifiable metric for determining when an entire industry warrants the corporate death penalty. First, a theoretical foundation is developed with minimum assumptions necessary to provide evidence for corporate public purposes. This is formed into an objective quantifiable metric with publicly-available data and applied to two case studies in the U.S.: the tobacco and coal mining industries. The results show the American tobacco industry kills 4 times more people per year than it employs, and the American coal-mining industry kills more than one American every year for every coal miner employed. The results clearly warrant industry-wide corporate death penalties for both industries in America. Future work is discussed to ensure industries only exist to benefit humanity in all the societies in which they operate.

“If we know that life trumps employment because you have to be alive to work,” author Joshua Pearce of Michigan Techological University told  Michigan Tech News, “then for a company or industry to exist it must employ more people than it kills in a year. What this paper has done is set the minimum bar for industry existence.”

Full citation: Pearce, J. M. Towards quantifiable metrics warranting industry-wide corporate death penalties. Social Sciences,2019: 8(2), 62

Increasing disparities in unhealthy food advertising targeted to Hispanic and Black youth

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Unhealthy food marketing aimed at youth under age 18 is a significant contributor to poor diets and diet-related diseases. Therefore, greater exposure to this marketing by Hispanic and Black children and teens, both in the media and in their communities, likely contributes to diet-related health disparities affecting communities of color, including obesity, diabetes, and heart disease. A new report on targeted food marketing by the Rudd Center for Food Policy & Obesity University of Connecticut,  the Council on Black Health , and Salud America! assessed whether the 10 companies with the most targeted advertising spending documented in the Rudd Center’s 2015 report have made changes in their targeted advertising.

By collecting  data on advertising expenditures on Spanish-language and Black-targeted TV programming by company, brand and product category, the study identified  television advertising targeted to Hispanic and Black consumers.

From 2013 to 2017, the total amount that companies spent to advertise restaurants, food, and beverages on all types of TV programming declined by just 4% (from $11.4 billion to $10.9 billion). However, greatly reduced TV viewing by children and teens resulted in large reductions in exposure to food-related TV ads: -28% for children and -43% for teens overall.

Despite this decline, on average children and teens continued to view approximately 10 food-related TV ads per day in 2017. Total food-related advertising spending on Spanish-language TV also declined by 4% over the past five years (from $817 million in 2013 to $787 million in 2017), and reductions in TV viewing and food-related ads viewed by Hispanic youth mirrored declines for all youth. In contrast, total food-related advertising spending on Black-targeted TV increased by more than 50% from 2013 to 2017 ($217 million to $333 million). Disparities between Black and White youth in exposure to all food-related TV ads also increased. In 2013, Black children and teens viewed 70% more food ads than their White peers viewed.

In 2017, these disparities grew to 86% more ads viewed by Black children compared to White children and 119% more ads viewed by Black teens than by White teens. On average in 2017, Black children and teens saw 16.4 and 17.1 food-related TV ads-per-day, respectively. This increased disparity in ads viewed resulted from increased food-related spending on Black-targeted TV advertising as well as greater declines in TV watching among white than Black children.

The authors of the report call on food manufacturers to market healthy products to Black and Hispanic consumers and for fast-food, candy, sugary drink, and unhealthy snack food brands to stop disproportionately targeting their advertising in Spanish-language and Black-targeted media. Public health advocacy campaigns should also focus on improving marketing practices of companies that disproportionately target Hispanic and Black youth and explore opportunities to engage youth of color in campaigns to address targeted food marketing as a social justice issue.

Read the full report.

The Commercial Determinants of Non-Communicable Diseases(NCDs): Developing Strategies for Prevention



Aadeliah Maker Diedericks, David Sanders, Fran Baum, Carlos Monteiro, Nicholas Freudenberg and Téa Collins at the Prince Mahidol Awards Conference (PMAC).

At the 2019 Prince Mahidol Conference on Global Health held in Bangkok, Thailand on the theme of the political economy of Non Communicable Diseases (NCDs) from January 29 to February 3, 2019, a special session on commercial influences on NCDs analyzed the role of the food, alcohol, tobacco, banking and other sectors in shaping the global prevalence and distribution of non-communicable diseases such as cardiovascular conditions, diabetes, hypertension and some forms of cancer.  Panelists sought to answer these questions:

  • What are the commercial drivers influencing the risk factors of NCDs in different contexts?
  • What is the role of industries such as food and beverage, tobacco, alcohol,  and extractive industries in influencing the commercial determinants?
  • What are the common strategies of marketing to children and adolescents (e.g. particularly digital marketing) and mechanisms to reduce exposure to NCD risk factors, notably alcohol, tobacco and unhealthy foods and beverages?
  • How have governments engaged with industry to mitigate the risk to health and enhance public health benefits? What has worked and what has not?
  • What is the role played by different institutions in facilitating or regulating the commercial determinants, including Governments, and other stakeholders such as WTO, multilateral organizations and civil society?

The panel included these presentations:

The Commercial Determinants of NCDs: Public Health Strategies to Reduce Harmful Influences, Nicholas Freudenberg, Distinguished Professor of Public Health, City University of New York, New York, USA. View presentation

The Role of the Transnational Ultra-Processed Food Industry in the Pandemic of Obesity and its Associated Diseases: Problems and Solutions. Carlos Monteiro, Professor, Center for Epidemiological Studies in Health and Nutrition, University of Sao Paulo, Brazil. View presentation

What’s the Role for Advocacy and Campaigning Body? Aadeliah Maker Diedericks, Coordinator Southern Africa Alcohol Policy Alliance , Cape Town South Africa.  View presentation

A WHO Perspective on Commercial Influences on NCDs. Téa Collins, Adviser, Division of Noncommunicable Diseases and Health Promotion,  World Health Organization, Geneva, Switzerland, View a recent paper on commercial influences by Collins and colleagues.  Link to:

Reducing the impact of Trans-National Corporations on Non-communicable Disease: the Nutcracker Effect, Fran Baum, Matthew Flinders Distinguished Professor. Southgate Institute, College Medicine and Public Health, Flinders University, Adelaide, Australia. View Presentation

The moderator for the session was David Sanders, Emeritus Professor, School of Public Health, University of the Western Cape and co-founder People’s Health Movement.


Revealed: the free-market groups helping the tobacco industry

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Atlas Network

More than 100 free-market thinktanks from North America to Europe and south Asia took positions helpful to the tobacco industry or donations,  an investigation by The Guardian shows. These thinktanks  have provided a powerful voice of support to cigarette manufacturers in battles against tougher regulations. At least 106 thinktanks in two dozen countries have accepted donations from tobacco companies, argued against tobacco control policies called for by the World Health Organization (WHO), or both, according to The Guardian analysis.

These groups have opposed plain cigarette packaging, written to regulators in support of new tobacco products, or promoted industry-funded research. In one extreme case, an Africa-based thinktank questioned whether the link between cancer and smoking “was yet to be empirically established”, before backing away from the claim.

Patricio Marquez, lead specialist on health global practice at the World Bank, said such activity could impact public health efforts. The thinktanks “have created an arsenal of evidence in order to influence policy-making and decision-making,” he said.

The Guardian examined one of the largest networks of independent free-market thinktanks in the world, organized by Atlas Network, a not-for-profit based near Washington DC in Arlington, Virginia, which it says “connects a global network of more than 475 independent, civil society organizations in over 90 countries to the ideas needed to advance freedom.” The Guardian coverage for this report  was supported by Vital Strategies.

Read The Guardian’s Free-market groups and the tobacco industry database

The Oil Industry’s Covert Campaign to Rewrite American Car Emissions Rules

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When the Trump administration laid out a plan this year that would eventually allow cars to emit more pollution, reports The New York Times, automakers, the obvious winners from the proposal, balked. The changes, they said, went too far even for them.

But it turns out that there was a hidden beneficiary of the plan that was pushing for the changes all along: the nation’s oil industry.

In Congress, on Facebook and in statehouses nationwide, Marathon Petroleum, the country’s largest refiner, worked with powerful oil-industry groups and a conservative policy network financed by the billionaire industrialist Charles G. Koch to run a stealth campaign to roll back car emissions standards, a New York Times investigation has found.

report released at the  First WHO Global Conference on Air Pollution and Health earlier this year found that air pollution – both ambient and household – is estimated to cause 7 million deaths per year, 5.6 million deaths are from noncommunicable diseases and 1.5 million from pneumonia. The wider economic impacts of premature deaths due to ambient air pollution amount to US$ 5.7 trillion in welfare losses, or 4.4% of the global Gross Domestic Product (GDP) in 2016.  Motor vehicles are a primary cause of ambient pollution. The Trump-Marathon plan to allow more automobile pollution will increase this health and economic burden, as well as contribute to global warming.

The Corporatization of Marijuana: Marlboro maker in takeover talks with cannabis firm Cronos

Altria, the maker of Marlboro cigarettes, is in talks about a potential takeover of the Canadian cannabis producer Cronos as it seeks to diversify its business beyond traditional smokers, reports The GuardianCanada legalized recreational use of marijuana this year, and the country is seen as a testing ground for marijuana companies hoping to expand globally as other countries follow suit.  A deal would mark one of the largest combinations between mainstream tobacco and the booming but volatile marijuana sector, which has attracted interest from a variety of large consumer companies that are monitoring the industry for disruptive threats and faster-growing product possibilities.

Last year, the University of California -San Francisco Tobacco Control Policy Making: United States released a report by Rachel Barry and Stanton  Glantz titled  Lessons from Tobacco for Developing Marijuana Legalization Policy


New report expected to boost push to make company climate-risk disclosures mandatory

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The latest alarm bell to be rung on climate change — last Friday’s government report warning that the damage caused by the warming planet could shrink the U.S. economy by 10% by the end of the century — is expected to support the push for mandatory climate-risk disclosures among corporations, according to experts, writes MarketWatch, a business newsletter.

But much remains to be done to get companies to consistently make disclosures on how climate-change-related events, such as the recent deadly wildfires in California, are impacting business. ‘[W]e are looking at an economic crisis that, not unlike the subprime meltdown, will impact every sector of the economy and company within it”, says Mindy Lubber, chief executive of the sustainability-oriented nonprofit Ceres.  According to Lubber, the report differed from other climate studies in one respect: most climate research is science-based and tends to seek to generate a sense of urgency around time frames, public health and the future of the planet. “This one zeroed in on the economic impact, and that’s very important because we are looking at an economic crisis that, not unlike the subprime meltdown, will impact every sector of the economy and company within it,” she said.

In 2017, The Guardian reported that since 1988,  just 100 companies, mostly in the energy sector, were responsible for 71% of the world’s carbon emissions, suggesting that action by a limited number of corporations could yield significant reductions.

What rules for e-cig?

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Earlier this month, the U.S. Food and Drug Administration proposed new rulesthat would restrict  flavored e-cigarettes and tobacco products that have lured young people into vaping and smoking.Fast Company, a media outlet that “chronicles how changing companies create and compete”, recently published a profileof  Juul, a company founded in 2017 to make and sell  e-cigarettes.   Juul is now valued at more than $16 billion and controls 72% of the U.S. e-cigarette market.   It’s also hooking teens on nicotine and drawing scrutiny from the FDA. Can the company innovate its way out of a crisis it helped create, asks Fast Company?

Another story last week, this one in The New York Times, describes how Matt Murphy, a high school senior then 17 years old in Reading , Massachusetts, become addicted to Juul.  “It was love at first puff,” said Matt, now 19.  As the United States debates what rules will govern the marketing of e-cigarettes, public health researchers and advocates will have to digest and synthesize a growing body of literature — and misleading claims.   Two recent reviews, cited  below, can help readers to begin to sort through this evidence.

Breitbarth AK, Morgan J, Jones AL. E-cigarettes-An unintended illicit drug delivery system. Drug and alcohol dependence. 2019(88): 144-149.

Unger M, Unger DW. E-cigarettes/electronic nicotine delivery systems: a word of caution on health and new product development. Journal of thoracic disease. 2018;10(Suppl 22):S2588.

The Capital NCD-Nexus: The Commercial Determinants of Health and Global Capital Flows

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Cross-border Merger and Acquisitions  purchases in food, beverages, and tobacco. Source: World Investment Report 2018, Table 10 (Annex); calculations and illustrations by CPC Analytics. Note: The average M&A value in the sectors food, beverages, and tobacco between 2000 – 2009 is calculated by excluding the two crisis years. Credit

In the past, the role of global capital flows for health has not been considered in the debate about key risk factors of Noncommunicable Diseases (NCDs). This is a blind spot in public health. A significant share of the global food and beverage industry is owned by institutional investors. Cross-border mergers and acquisition volumes in the food, beverage, and tobacco industries have substantially increased. Progress on preventing and controlling NCDs requires the public health community to engage in a forward-looking discussion to address investors’ responsibility in relation to global health in general and the tsunami of NCDs in particular.

Citation: Franz C, Kickbusch I. The Capital NCD-Nexus: The Commercial Determinants of Health and Global Capital Flows  Eurohealth 2018;24(3): 21-25.